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

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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  1. Health Reform in California: Moving ForwardNAICMay 30, 2008

  2. Overview • ABx1: Policy Advances • Tuesday Morning Quarterbacking • Moving forward

  3. 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

  4. 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

  5. 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

  6. 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

  7. Tuesday Morning Quarterbacking • Budget context • Adequacy of financing • Market-based versus government-based • Cost containment

  8. Basis for Moving Forward • Status quo/inaction not an option • Gubernatorial leadership and resolve • Framework for reform • Broad coalition for reform

  9. Phase 1 - Affordability • Medical loss ratio • Transparency • Health information technology – electronic personal health records; e-prescribing • Regulatory barriers – retail clinics • No new mandates

  10. 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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