Alliance for Health Reform Congressional Briefing: State Implementation of Federal Health Care Reform Kim Belshe State of California December 6, 2010

California Context 8+ million uninsured 7.5 million Medicaid population Low Medicaid provider reimbursement Strained fiscal context ($25 billion deficit) Political leadership transition Executive branch brain drain Not starting from scratch

Preparing for PPACA 2010 Legislative Priorities Pre-existing condition insurance plan Insurance conformity Health Benefit Exchange Implementation Roadmap Medicaid Waiver Expanded coverage Care coordination for high-needs populations Public hospital system transformation

PPACA State Implementation Challenges State internal capacity Supporting a culture of coverage Simplifying and streamlining eligibility and enrollment systems Building provider capacity, esp. Medicaid Serving those outside the mandate Establishing an active purchaser Exchange