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California Health Reform Proposal

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Presentation on theme: "California Health Reform Proposal"— Presentation transcript:

1 California Health Reform Proposal
Proposed by Governor Schwarzenegger January 8, 2007

2 Health Insurance Coverage of the Nonelderly in California, Massachusetts, and the U.S., 2004-2005
Total Population: 35.8 million 6.3 million 256.3 million Uninsured: 6.7 million 677,000 45.4 million SOURCE: KCMU/Urban Institute Analysis of the March 2005 and 2006 Current Population Survey. Two-year pooled estimates also used for the United States.

3 Covering All Californians
Individual Mandate Public Coverage Expansions All children to 300% FPL Legal parents and childless adults up to 100% FPL County-based coverage for undocumented adult immigrants up to 250% FPL Subsidies for Adults % FPL For purchasing pool or share of employer-sponsored insurance premium Insurance Market Reforms New purchasing pool Guaranteed issue for plans 85% of plan revenues on patient care Financing Medicaid/SCHIP federal match 4% of payroll fee for non-offering employers with 10+ employees “Coverage dividend” fee of 4% for hospitals, 2% for physicians Reprogramming of current state, county, and local funding

4 Proposed Coverage by Poverty Level
Above 300% FPL SOURCE: Governor’s Health Care Proposal, January 8, 2007

5 How the Uninsured are Covered
People in Thousands Total: 4.6 million Uninsured SOURCE: Governor’s Health Care Proposal, January 8, Coverage estimations are approximations.

6 Financing for California’s Reform Plan
Dollars in Billions $12.1 billion $12.1 billion Prevention/Wellness State Savings* 125 Plan State Tax Loss Local Funds County Coverage for Adult Undocumented Immigrants County Funds** Employer Fee Subsidies for Low-Income Adults Provider Fee Medi-Cal/SCHIP Expansion Medi-Cal Payment Increases Federal Funds *The state expects to save $203 million through the elimination of several state programs after the reform (Access for Infants and Mothers, Managed Risk Medical Insurance Program, and MediCal Share-of-Cost) ** County funds will be available from the relief of other county obligations

7 Key Challenges in California
Large number of uninsured Political challenges Individual mandate Employer fee Provider fee Coverage of immigrants Affordability of coverage Adequacy of benefits and subsidies in purchasing pool Ability of individual market to meet increased demand Long-term funding challenges


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