State Officials Seek To Expand Low-Income Workers' Coverage

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California policymakers are grappling with how to determine the best way to help low-income workers obtain health coverage, the Ventura County Star reports.

Many low-income workers are uninsured but earn too much to qualify for Medi-Cal, California's Medicaid program.

Meanwhile, the state is preparing to add as many as three million new Medi-Cal beneficiaries under the federal health reform law and open the Health Benefit Exchange, which will be tasked with helping as many as two million Californians purchase private health insurance.

Basic Health Program Option

Senate Health Committee Chair Ed Hernandez (D-West Covina) has introduced a bill (SB 703) that would create a state-run Basic Health Program as an alternative to the state's health insurance exchange.

The plan would be open only to Californians who have incomes between 133% and 200% of the federal poverty level -- or between $14,484 and $21,780 annually for individuals.

Hernandez said he thinks the basic plan would improve the insurance risk pool.

John Ramey -- executive director of Local Health Plans of California, an association of safety-net health plans that supports SB 703 -- said the plan could make coverage more affordable for consumers while offering health care provider payments rates that are higher than Medi-Cal rates.

The plan would become effective in 2014, at the same time the health insurance exchange is slated to become operational.

Opposing the Plan

Health Benefit Exchange officials have expressed concern that creating the basic plan could reduce the pool of consumers who would purchase plans through the insurance exchange.

They added that the basic plan could make it more difficult to negotiate low prices for the exchange.

They also have said a lack of federal guidelines on the basic plan raises questions as to the program's risks and benefits.

Next Up

The Basic Health Program bill is before the Assembly Committee on Appropriations.

Hernandez said he will push to get the bill passed this year (Herdt, Ventura County Star, 8/14).

Michael Lyon
It looks to me like Hernandez wants to create a special grouping for previously-uninsured low-income people who would get coverage by PPACA's expansion of Medicaid. Instead of going into California's Exchange, the regular way of purchasing insurance, and where there are some regulations on the insurance companies, these newly-covered low-income patients would go into a Basic plan, without the federal guidelines. (More tiered healthcare, in the name of free market choice.) Those doing the planning to set up the California exchange are upset because with a smaller number of patients, the Exchange would have less leverage to negotiate for lower rates. It's ironic that Hernandez didn't want to vote for single-payer (SB 810) because it would undermine the Obama plan, but now he's undermining Obama's exchange that California is so proud to be setting up in advance of other states. We need EQUAL, comprehensive, affordable, accessible healthcare for every single person: Single payer.

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