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End-of-Life Choices

Trends in end-of-life care show that not only does the care given vary widely from region to region and hospital to hospital, but also patients often don't get the care they prefer. What can be done?

Care Management Puzzle

Chronic diseases and the cost of care are rising. Are disease management programs improving outcomes for patients with complex, chronic conditions?

No Middleman

Under the "direct primary care" model, patients pay a monthly fee for basic medical services. Learn about the history and current landscape of physician practices offering this arrangement.

Health Care Reform

Wednesday, June 20, 2012

Calif. Could Lose $15B Annually if Court Strikes Down Health Law

California could lose as much as $15 billion annually in federal funding if the U.S. Supreme Court strikes down the federal health reform law, the Los Angeles Times reports (Terhune et al., Los Angeles Times, 6/20).

Background on Supreme Court Case

The Supreme Court case centers on whether the federal government can require residents to purchase insurance and whether federal lawmakers have the power to pressure states to expand insurance coverage through Medicaid.

The court is expected to make a decision by the end of June (California Healthline, 6/18).

Potential Gains From Reform Law

California stands to be one of the biggest recipients of federal funding because of its large number of uninsured residents. According to the Times, the state has 7 million uninsured residents, making up nearly 20% of its population.

Under the reform law, California could receive as much as $9 billion annually to expand Medi-Cal, the state's Medicaid program. According to calculations from the Urban Institute, the state could receive an additional $6 billion annually for low- and middle-income residents who buy subsidized insurance through the state health insurance exchange.

In addition, California physicians could receive an additional $700 million annually in increased reimbursements under the law for treating patients who obtain coverage under the Medi-Cal expansion.

Comments on Implications of Supreme Court Decision

John Holahan, director of health policy at the Urban Institute, said, "California would be a net loser if the court overturns the law because it stands to receive such a big flow of money for the uninsured."

Gerald Kominiski -- director of the UCLA Center for Health Policy Research -- said, "It's really a bleak forecast for the future" if the Supreme Court overturns the law because "[t]he state returns to a system that's unsustainable."

Sen. Ed Hernandez (D-West Covina) -- chair of the Senate health committee -- said, "Federal subsidies are key" to making health reform efforts work in California. He said the state on its own does not "have the resources to put together a robust health package" (Los Angeles Times, 6/20).



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