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 forward naic may 30 2008

Health Reform in California: Moving ForwardNAICMay 30, 2008


Overview

Overview

  • ABx1: Policy Advances

  • Tuesday Morning Quarterbacking

  • Moving forward


Abx1 policy advances

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 advances1

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

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

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

Tuesday Morning Quarterbacking

  • Budget context

  • Adequacy of financing

  • Market-based versus government-based

  • Cost containment


Basis for moving forward

Basis for Moving Forward

  • Status quo/inaction not an option

  • Gubernatorial leadership and resolve

  • Framework for reform

  • Broad coalition for reform


Phase 1 affordability

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

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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