Health reform in california moving forward naic may 30 2008
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Health Reform in California: Moving Forward NAIC May 30, 2008 PowerPoint PPT Presentation


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Health Reform in California: Moving Forward NAIC May 30, 2008. Overview. ABx1: Policy Advances Tuesday Morning Quarterbacking Moving forward. ABx1: Policy Advances. Coverage or expanded access for nearly all of California’s 5.1 million uninsured

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Health Reform in California: Moving Forward NAIC May 30, 2008

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Health Reform in California: Moving ForwardNAICMay 30, 2008


Overview

  • ABx1: Policy Advances

  • Tuesday Morning Quarterbacking

  • Moving forward


ABx1: Policy Advances

  • Coverage or expanded access for nearly all of

    California’s 5.1 million uninsured

  • Personal responsibility for coverage

  • Shared responsibility for financing – minimum

    employer contribution

  • Sweeping insurance market reforms


ABx1: Policy Advances

  • Medi-Cal provider rate increases

  • Full financing outside the General Fund

  • Mechanisms to protect the General Fund

  • Short term and long term affordability measures


Affordability – Short Term

  • Remove regulatory barriers

    • Reduce barriers to low-cost delivery models (e.g. retail medical clinics)

    • Prioritize hospital seismic retrofit based on “worst first”

  • Reduce regulatory red tape

    • Review mandates; - Eliminate unnecessary reporting requirements

    • Streamline health insurance product approval

  • Establish a “medical loss ratio”

    • Enhance insurer & hospital efficiency by requiring 85% of premiums & hospital dollars be spent on patient care

  • Provide tax breaks for individuals & businesses tied to purchase of health insurance

    • Section 125 plans; Health Savings Accounts


Affordability – Long Term

  • Support health promotion, prevention & wellness

  • Accelerate adoption of health information technology

  • Improve quality and price transparency

  • Promote quality and efficiency of care


Tuesday Morning Quarterbacking

  • Budget context

  • Adequacy of financing

  • Market-based versus government-based

  • Cost containment


Basis for Moving Forward

  • Status quo/inaction not an option

  • Gubernatorial leadership and resolve

  • Framework for reform

  • Broad coalition for reform


Phase 1 - Affordability

  • Medical loss ratio

  • Transparency

  • Health information technology – electronic personal health records; e-prescribing

  • Regulatory barriers – retail clinics

  • No new mandates


Closing Consideration

“Changes are Necessary, but what they Ought to be, what they will be, and how, and when to be produced are arduous questions.” John Jay (1787)


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