Following the U.S. Supreme Court's ruling to uphold the federal health reform law, California officials said the state will continue implementing the law's provisions, the Sacramento Bee's "Capitol Alert" reports (Siders, "Capitol Alert," Sacramento Bee, 6/28).
In a 5-4 ruling released Thursday, the Supreme Court upheld the federal health reform law's individual mandate, reaffirming the law's requirement that most U.S. residents must purchase health insurance.
The majority of the justices also affirmed the constitutionality of the Medicaid expansion provision in the law, which would require states to extend coverage to adults with incomes up to 133% of the federal poverty level beginning in 2014.
However, the justices struck down the provision that would have allowed the federal government to withhold existing Medicaid funding if the states failed to comply with the expansion.
Details of Reform Efforts in California
Since President Obama signed the reform law two years ago, California lawmakers have passed several state laws related to the overhaul, including measures that:
- Allow young adults to remain on their parents' health insurance plans until age 26;
- Block insurers from setting lifetime caps on health benefits;
- Establish a state health insurance exchange, called the California Health Benefit Exchange; and
- Prohibit insurers from denying health coverage to children with pre-existing conditions (California Healthline, 6/28).
State officials estimate that about two million residents, many of whom are uninsured, will obtain insurance through the exchange beginning in 2014 ("Capitol Alert," Sacramento Bee, 6/28).
In addition, 47 California counties are participating in the "Bridge to Reform" program, which aims to implement the reform law's Medicaid expansion ahead of schedule. The program provides low-income residents with health coverage that they can use for no-cost treatments at local hospitals and public clinics.
More than 360,000 Californians already are receiving coverage through the program (California Healthline, 6/25).
According to "Capitol Alert," the state is expected to receive $45 billion to $55 billion from the federal government from 2014 to 2019 to expand Medi-Cal, California's Medicaid program. Officials expect that an additional 1.2 million to 1.6 million state residents will gain health insurance coverage under the expansion.
State Officials Expect More Progress on Health Reform
Gov. Jerry Brown in a statement said that the ruling "removes the last roadblock to fulfilling President Obama's historic plan to bring health care to millions of uninsured citizens."
Diana Dooley -- California's Health and Human Services Secretary -- said, "California has been a leader in health care reform for a very long time. We've had many starts and stops, and we are now in the full go mode here" ("Capitol Alert," Sacramento Bee, 6/28).
She added, "This ruling makes it possible to complete the work that we've started and be ready in January 2014," when several reform law provisions kick in (Mieszkowski, The Bay Citizen, 6/28).
Assembly Committee on Health Chair Bill Monning (D-Carmel) said, "In other states, I'm sure, [the ruling] will get picked apart and analyzed. This has no bearing in California, since we fully intend to participate and take advantage of the federal subsidy and support" (Bazar, Santa Cruz Sentinel, 6/28).
Peter Lee, executive director of the California Health Benefit Exchange, said the state is "moving full-speed ahead" to establish the exchange and will launch a "major media and outreach campaign" in 2013 ("Capitol Alert," Sacramento Bee, 6/28).
Officials, Stakeholders Urge Caution
However, some state officials believe California should be cautious with health reform efforts.
Sen. Tom Harman (R-Huntington Beach) said that lawmakers should not enact any reforms that go beyond the federal overhaul because a recent budget plan signed by Brown reduces state spending by hundreds of millions of dollars (Santa Cruz Sentinel, 6/28).
In addition, James Hay, president of the California Medical Association, said that while physicians support reform efforts, more must be done to address shortcomings in Medicare and Medi-Cal. He said that the reform law "builds ... on the broken foundations of Medicare and Medicaid without addressing the underlying problems and inadequate funding."
Meanwhile, Patrick Johnston -- president and CEO of the California Association of Health Plans -- said the state must focus on addressing the "underlying cost drivers that are increasing the cost of care" (Herdt, Ventura County Star, 6/28).
On Thursday, KQED's "KQED News" reported on the implications of the Supreme Court's ruling for California (Johnson, "KQED News," KQED, 6/28).
The Santa Cruz Sentinel article was produced by the California HealthCare Foundation's Center for Health Reporting. The Center is supported by a grant from CHCF, which publishes California Healthline.