How We Plan to Achieve This Goal

CHCF's Health Reform and Public Programs Initiative supports the implementation of health reform and advances the effectiveness of California's public coverage programs through the pursuit of these two objectives:

1. Advance state efforts on health coverage expansion. In the wake of passage of the federal Affordable Care Act (ACA), CHCF seeks to provide state officials, policymakers, and other stakeholders with information and assistance to maximize the number of Californians who are able to obtain affordable, appropriate health insurance. Projects that support this objective provide analytic and technical assistance to California's health reform implementation team on health insurance exchange design and governance. Projects will also focus on advancing the implementation of the Medi-Cal waiver; developing options and recommendations for implementing select provisions of health reform legislation, including the temporary high-risk pool and state oversight of the insurance market; and promoting federal and state efforts to streamline enrollment systems and processes. Read details about this objective's initiatives.
2. Support the Evolution of Medi-Cal and Other Publicly Financed Coverage Programs. Health reform will increase by two to three million the number of Californians enrolled in Medi-Cal. This objective helps the Medi-Cal program improve access to primary and specialty care; improve quality; and slow the growth of health care costs. Projects that support this objective develop options for redesigning the way Medi-Cal works to promote greater quality and efficiency; partner with key stakeholders to test new approaches to manage the care and costs of high-need Medi-Cal populations; assist in the effective implementation of the Medi-Cal Electronic Health Record (EHR) incentive program; and monitor and report on progress transforming the state's public programs. Read details about this objective's initiatives.

Why We Focus on This Goal

As a result of the ACA, new responsibilities and new funding opportunities will require action from California's leaders. For example, the state must create a health insurance exchange for consumers to shop for and access coverage, and it will oversee new insurance rules. Effective implementation of federal health reform depends on the ability of Medi-Cal, already facing deep budget cuts, to enroll and provide access to care for the flood of new enrollees.

"These new demands come at a challenging time. A transition in California's administration, severe and chronic budget deficits, and many competing demands on legislative and administration staff could slow implementation of these new laws," says Marian Mulkey, M.P.H., M.P.P., director of CHCF's Health Reform and Public Programs Initiative, formed in June 2010 to respond to the shifting policy landscape. "But this environment also creates a once-in-a-generation opportunity to leverage federal resources to expand the number of Californians with health insurance."

What We Are Working Toward

California's implementation of the ACA will go beyond enrolling more people in the coverage options that exist today to improve the way public programs are administered and private insurance is structured. Not only will more consumers have access to health insurance, they will find it easier to understand and compare their options and enroll in the program that's right for them. Benefits, provider arrangements, and enrollment systems will evolve to meet the needs of the new population. Public programs will pursue new payment and care delivery system approaches to improve the quality and reduce the cost of care. To achieve these goals, policymakers, industry leaders, payers, providers, and consumers will have the information and support they need to make sound decisions, allocate resources wisely, and monitor progress.

Our Approach

• Convene key stakeholders and offer a supportive setting in which to explore opportunities, address challenges, and pursue solutions in the areas of health insurance exchange implementation, eligibility and enrollment simplification for public programs, and implementation of the Medicaid Waiver, among other issues.
• Provide reliable, useful, and timely information and analysis to state health care decision-makers and other stakeholders.
• Conduct independent analysis of policy options.
• Support state health care policy and program leaders to develop and test sustainable approaches to address issues brought about by national health reform.
• Monitor the progress of state efforts to fulfill the requirements of the ACA and report on that progress to the public.

For More Information

See highlights of this program's reports and initiatives and the list of staff.