Leading up to the 5th anniversary of the Affordable Care Act on Monday, March 23rd, Health Access California released a new report describing implementation, impacts, and needed improvements going forward. The “power of coalition” to form a consensus for bold and far reaching reforms–is reflected in the report itself, which features substantive contributions from groups serving children and youth, ethnic minorities, immigrants, the uninsured and under-insured, workers, and county-based eligibility workers along with stories of California consumers who are directly benefting from the law. California provides a bright example of what a state can do to not only embrace the law but take it further to address priorities for the state.
Solid Results on Key ACA Benchmarks
As the report shows, the state went further than the law required on most ACA Exchange provisions and set up Covered California as an active purchaser with the power to negotiate lower rates for consumers. As a result…
- More than 60% of people previously uninsured in California now have coverage, and premium rates are growing at half the rate before the ACA went into effect.
- Over four million Californians are now covered in new options through Medi-Cal and Covered California, and millions more have new consumer protections and more financial security.
Improving on the ACA to Address State Priorities
Instead of repeal or replace or questionable Medicaid waivers, California has taken advantage of the considerable flexibility within the ACA itself to innovate and address specific priorities for the state and its diverse communities. Specific improvements made by California policymakers include:
- leveraging the exchange’s bargaining power to promote value for the consumer;
- standardizing plan choices for consumers;
- keeping insurers accountable by additional transparency on premium rates;
- simplifying eligibility and enrollment through “express lane” eligibility and hospital presumptive eligibility;
- expanding Medicaid early through Low-Income Health Programs;
- including certain immigrants in public programs through state-funded Medi-Cal; and (at least in certain counties) providing safety net care and coverage options for the undocumented and remaining uninsured.
- Dedicating significant resources to targeting and making headway in enrolling groups with high rates of uninsurance, including communities of color and LGBT Californians.
Lots More To Do!
The agenda for consumer advocates moving forward include care and coverage for the remaining uninsured, including the undocumented, further health system reforms to lower costs and improve quality, and a focus on health equity, not only by maximizing enrollment for communities of color but through prevention and population health initiatives and efforts to address the social determinants of health. In addition, Health Access California is sponsoring five bills this year in the California legislature to help consumers by preventing with surprise or unfair out-of-pocket costs.
The Bottom Line
The report highlights five years of solid results, but that work is not finished until everyone has quality, affordable coverage, and care that allow all Californians–no matter their income they make, language they speak or where they come from–to enjoy longer and healthier lives.