Medi-Cal Expansion under the Affordable Care Act: Significant Increase in Coverage with Minimal Cost to the State

Since 2011, California has been taking steps towards expanding Medicaid under the Afordable Care Act (ACA) by implementing Low Income Health Programs (LIHPs) in most California counties. Under the "Bridge to Reform" Medicaid §1115 waiver, just over 500,000 California adults are currently enrolled in coverage in advance of ACA implementation using federal and county funds. he vast majority of these LIHP enrollees can become eligible for Medi-Cal coverage under the ACA beginning January 1, 2014, and the remainder will be eligible for subsidies through Covered California (the California Health Benefit Exchange).In early 2013, California legislators will consider bills to implement a key provision of the ACA that would expand Medi-Cal to low-income adults under age 65, including those without children living at home. Lawfully-present childless adults with income up to 138 percent of the Federal Poverty Level and parents with income between 106 percent and 138 percent of the Federal Poverty Level will be newly eligible. Some unenrolled children and parents who are already income-eligible for the program under existing eligibility rules could also enroll due to the minimum coverage requirement to obtain insurance created by the ACA, improved eligibility, enrollment and redetermination processes, and enhanced awareness of coverage options.In this report, we estimate the growth in Medi-Cal enrollment among both the newly and already eligible using the UC Berkeley-UCLA California Simulation of Insurance Markets (CalSIM) model. We discuss the broader impact of the Medi-Cal Expansion in terms of health outcomes, providers and the economy. We estimate the federal and state spending on increased Medi-Cal enrollment, along with the state tax revenues generated by new federal Medi-Cal spending and potential savings in other areas of the budget

Proposed Regulations Could Limit Access to Affordable Health Coverage for Workers' Children and Family Members

Outlines implications of how the health reform law's premium subsidies apply if employer-sponsored self-only coverage is affordable but family coverage is not. Suggests basing family members' eligibility and affordability on additional cost to employee

12-Month Continuous Eligibility in Medicaid: Impact on Service Utilization

Summarizes findings on how allowing Medicaid enrollees to remain enrolled without reapplying for twelve months affected the number of Medi-Cal-enrolled children's emergency room visits and physician visits compared with those with discontinuous coverage

Number of Uninsured Jumped to More Than Eight Million from 2007 to 2009

Updates 2007 California Health Interview Survey data with estimates for 2009 population growth and changes in insurance status among the non-elderly. Examines trends by source of coverage and explores contributing factors

The transformation of community hospitals through the transition to value-based care: Lessons from Massachusetts

Enabling community hospitals to provide efficient and effective care and maintain competition on par with their academic medical center (AMC) counterparts remain challenges for most states. Advancing accountable care readiness adds to the complexity of these challenges. Community hospitals experience narrower operating margins and more limited access to large populations than their AMC counterparts, making the shift to value-based care difficult. Massachusetts has taken legislative action to ensure a statewide focus on reducing healthcare costs, which includes a nearly $120-million grant program supporting community hospital and system transformation toward a value-based environment. The Massachusetts Health Policy Commission’s Community Hospital Acceleration, Revitalization and Transformation (CHART) investment program is the state’s largest effort to date aimed at readying community hospitals for value-based care. In doing so, Massachusetts has created the largest state-driven, all-payer (payer-blind) readmission reduction initiative in the country. n this paper, we examine the design and evolution of CHART Phases 1 and 2 and offer insights for other states contemplating innovative approaches to bolstering community hospital participation in value-based care models

Health Coverage Expansion in California: What Can Consumers Afford to Spend?

Analyzes Californians' current spending on insurance premiums and out-of-pocket expenditures to assess whether proposals to make obtaining health insurance mandatory include sufficient measures to make it affordable for low- and middle-income families

What Does It Take for a Family to Afford to Pay for Health Care?

Addresses how much Californians can afford to pay for health care based on their current insurance premiums and out-of-pocket expenses as well as other basic necessities, such as housing, child care, transportation, food, and taxes

The State of Health Insurance in California: Findings From the 2009 California Health Interview Survey

Analyzes sources of coverage and uninsurance rates by county, effects of declines in income and employer-sponsored insurance, disparities, access to and affordability of care, role of public insurance, and projected impact of federal healthcare reform

An analysis of implementation issues relating to CHIP cost-sharing provisions for certain targeted low income children

This analysis, prepared for the Health Care Financing Administration and the Health Resources and Services Administration, examines issues that arise under laws designed to avert excessive cost-sharing in the case of low income families whose children participate in the State Children’s Health Insurance Program (CHIP). High cost-sharing has been shown to significantly affect children’s participation in insurance programs, as well as their utilization of health services. As a result, the Federal CHIP legislation, while permitting cost-sharing under certain circumstances, also places limitations on the total amount of cost-sharing to which families can be exposed for services covered by State CHIP plans