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