CPEHN Executive Director Sarah de Guia appeared on National Public Radio (via Bay Area affiliate KQED) to discuss the report and the impact the ACA has had in our state:
"This is really great news for California," said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, an advocacy group. She spoke of people being lifted from the fear of paying for care. "There's this sense of relief, that they're not one accident or incident away from bankruptcy. ... They can keep their costs contained."
Today we celebrate the 50th anniversary of President Lyndon Johnson’s signing of the Social Security Amendments of 1965, an act that created both the Medicare and Medicaid programs. With one stroke of his pen, President Johnson put in place an unprecedented commitment to health that has impacted the lives of hundreds of millions of Americans.
Earlier this month, the California Department of Health Care Services released a review of the rates paid out to dentists offering services through the Denti-Cal program. The report found that enrollment in the program has risen dramatically in the past five years, but low provider reimbursement rates have left the newly enrolled with limited options for oral health care.
Between 2009 and 2014, the number of children enrolled in Denti-Cal increased by 40%. (Note: Adult full-scope Denti-Cal services were cut in 2009.) Most of this increase occurred between 2011 and 2013 when the Healthy Families program transitioned into Medi-Cal. However, as enrollment skyrocketed, the number of Denti-Cal providers dropped by 14%.
The reason for the decreasing provider pool is clear: California’s reimbursement rates are some of the lowest in the country. California’s average reimbursement rates come in at less than one-third (28.3%) of the region’s commercial insurance rates. Compared to other states, California’s average rates are less than two-thirds of Texas’s (65.5%) and three-quarters of New York’s (75.4%).
A recent KPBS story discussed what California needs to do to increase provider participation:
Jenny Kattlove, programs director of The Children's Partnership, a nonprofit advocacy group, said dentists who treat kids with Denti-Cal coverage take a financial hit.
Today, California took an important step towards making affordable health care more accessible. The budget deal announced this afternoon includes a $40 million investment in Medi-Cal to enable all low-income children, regardless of immigration status, to access comprehensive health coverage. This budget shows that the Governor and legislature understand that immigrants are vital members of our state and that all children have a right to be healthy. The momentum is on our side, and today’s deal motivates us to continue supporting proposals, including SB 4 (Lara) the Health for All Act, to ensure that Californians of all ages, regardless of immigration status, have access to affordable health care through Medi-Cal and Covered California.
Additionally, we are looking forward to the special session on the Medi-Cal program, which now provides health coverage to nearly 12 million recipients, a majority of whom are from communities of color. Although more Californians are covered under Medi-Cal than ever before, many patients are struggling to find providers and specialists in their area. Having coverage means very little if there are no available providers and restoring reimbursement rates could help increase access to vital health care services for our communities throughout the state.
The special session on transportation and infrastructure is also a critically important opportunity for California to identify how to invest in more integrated strategies to promote clean, active transportation.
On Thursday, May 14th, Governor Jerry Brown released his revised budget proposal for the 2015-16 fiscal year. Despite a rosy economic picture with $6.7 billion in additional revenues, the revised budget does not restore any of the devastating cuts made during the recession to health and human services programs on which millions of Californians rely. The majority of the additional revenues ($5.5 billion) will go to K-12 education, but the remaining $1.2 billion will be split between the Rainy Day Fund and paying down debts.
Just as our state endures an historic drought, millions of Californians also face extreme needs and can’t afford to wait for that rainy day! Locking these funds away won’t help Medi-Cal recipients who are struggling to find a doctor because of low reimbursement rates or can’t access dental care due to limited dental benefits; or those on CalWORKS whose benefits were cut so severely that they remain in deep poverty. The budget proposal also fails to include funding for Health for All legislation to extend coverage to the over one million undocumented immigrants left out of the Affordable Care Act. Senator Holly Mitchell put it best when she said, “The budget is not simply a math problem…The Legislature has options to use a significant portion of the funds to meet human needs.”
Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation are examining ACA implementation in California at abriefing and panel discussion in Sacramento on May 28th. A state official, experts, and advocates will discuss issues and challenges related to the implementation of the law and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state marketplace or the Medi-Cal expansion.
The event will feature the release of the report Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation, based on the latest round of The Henry J. Kaiser Family Foundation’s Survey of Low-Income Americans and the ACA. The report, funded by the Blue Shield of California Foundation, provides a California snapshot of who gained coverage or remained uninsured in 2014. It also provides information on how the newly insured view their coverage and any problems they have encountered in using their coverage; how the remaining uninsured and newly insured fare with respect to access to medical care and financial burden; and why people in California continue to lack coverage.
On Wednesday March 11th, the Senate and Assembly Health Committees held a Joint Hearing on Health Disparities in California. Co-chaired by Senator Ed Hernandez (D-West Covina) and Assemblymember Rob Bonta (D-Oakland), the hearing featured panel presentations by advocates and researchers discussing the status of California’s communities of color and recommendations for addressing persistent health disparities. In addition, staff from the Department of Health Care Services (DHCS), Office of Health Equity, Covered California, Safety Net Institute, and Partnership Health Plan discussed initiatives to improve data collection and analysis to better align health care services to address health disparities.
Defining Disparities in California
CPEHN’s Executive Director Sarah de Guia framed the discussion by emphasizing the need to incorporate an equity lens into our post-ACA health care delivery system. She noted that the key to reducing health disparities is to ensure standardized data collection and analysis of demographic data for disparities reduction initiatives and incorporating primary prevention into our delivery system to address the root causes of disparities.
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