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The CHCF Blog

The California Health Care Foundation draws on experts from within and outside CHCF to share their health policy insights on this blog. We encourage readers to join the conversation by using the comments feature at the bottom of each article.

  1. Shalala: What I Learned About How Hard It Is to Reform Health Care

    J. Duncan Moore Jr.
    J. Duncan Moore Jr.
    J. Duncan Moore Jr.

    Independent journalist J. Duncan Moore, Jr., has been writing about health policy for more than 20 years. Recently he attended a health policy conference at the University of Miami where former Health and Human Services Secretary Donna Shalala reflected on lessons learned from her career in health policy and politics. Here is his report.

    President Trump and Republican members of Congress continue to struggle with their many different plans to repeal and replace the Affordable Care Act (ACA). This is a high-risk venture on two levels. If they get their way, it could reduce the number of Americans with health insurance by more than 24 million, do away with essential health benefit rules, allow insurance companies to exclude customers with pre-existing conditions, and more.

  2. Californians in Individual Market Spent $2,500 Less on Care in 2015 Than Before the ACA

    Amy Adams, Senior Program Officer, Improving Access
    Amy Adams
    Amy Adams

    Two years into the Affordable Care Act (ACA), Californians who bought health insurance on the individual market spent $2,500 less on health care compared to 2013, the year before the ACA was fully implemented, according to data from the US Census Bureau's Current Population Survey (CPS) available on ACA 411. This decline was likely driven primarily by the premium tax credits and cost-sharing reductions provided through the ACA's health insurance marketplaces. This progress toward making health care more affordable is at risk as federal lawmakers debate repealing or radically changing the ACA.

  3. First Do No Harm: Changing Tactics in the Opioid Epidemic

    Kelly Pfeifer, Director, High-Value Care
    Kelly Pfeifer
    Kelly Pfeifer

    The California Department of Public Health (CDPH) recently presented CHCF's Kelly Pfeifer, MD, with the Beverlee A. Myers Award, its highest honor for an individual exhibiting outstanding leadership and accomplishments in public health in California. Pfeifer was recognized for her work leading efforts to address the opioid epidemic, which claims the lives of more than 2,000 Californians each year. This article is adapted from Pfeifer's remarks at the April 4 award ceremony.

  4. California Cost & Quality Atlas Helps Map Path to Higher-Value Care

    Jeffrey Rideout, President and CEO, Integrated Healthcare Association
    Jeffrey Rideout
    Jeffrey Rideout

    California is often celebrated for its rich diversity. Geographic, population, and cultural differences are embraced as key ingredients that make our state successful. But when it comes to health care services, differences are neither expected nor valued.

    Study after study indicates that where you live has a direct impact on your health and well-being. In fact, as Dr. Tony Iton of The California Endowment has said about determinants of health status, your zip code is probably more important than your genetic code. One look at the results from an Integrated Healthcare Association online tool, the California Regional Health Care Cost & Quality Atlas, confirms wide geographic variation in health care measures across the state — and the tremendous opportunities that exist to improve quality and contain costs.

  5. Can California Find Better Ways to Pay for Medi-Cal?

    Christopher Perrone, Director, Improving Access
    Chris Perrone
    Christopher Perrone

    With the demise of the American Health Care Act, massive cuts in federal financing of Medicaid are off the table for now. Yet there is little doubt that efforts to curb federal spending on Medicaid will continue or that California has a lot at stake.

    Even before the November election, state policymakers and stakeholders were seeking options to address the shaky financing of California's Medicaid program, Medi-Cal. Rising health care costs, economic downturns, and threats to federal funding are nothing new, but Medi-Cal's scale is unprecedented — 14 million people (one in three Californians) are enrolled at an annual cost of $100 billion (the federal government currently covers about 66% of those costs). What can California lawmakers do to ensure the health of this program?

  6. Medi-Cal: A Lifeline for Former Foster Youth in California

    Ted Lempert, President, Children Now
    Ted Lempert
    Ted Lempert

    Avanti Alias, a 23-year-old former foster youth, works part-time while also attending business school full-time to pursue an MBA. Avanti struggles with depression, and coverage under Medi-Cal (California's Medicaid) allows her to see a therapist when she is feeling low. She says that Medi-Cal is critical for former foster youth. "It puts us in a better health position today and in the long term," she says. "Health affects everything from work, to school, to every aspect of your life. Many people have health coverage, but we [former foster youth] don't always have supports like this. No one is there to help us with this stuff. This law gives us that protection, which is something we've never had before."

  7. Celebrate the Survival of the ACA's Principles, But Remain on Guard

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez
    Sandra R. Hernández

    I am one of millions of Californians celebrating the decision of leaders in Washington not to bring the misguided American Health Care Act (AHCA) to a vote in the House of Representatives. Because of this surprising and historic turn of events last week, the tremendous gains our state achieved under the landmark Affordable Care Act remain intact. That is good policy for vulnerable people, for the health care system, for democracy, and for California's cherished values of inclusivity and social justice.

  8. ACA Repeal Bill Is Cruel Medicine

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez
    Sandra R. Hernández

    Last week, the House bill to repeal and replace the Affordable Care Act (ACA) emerged from the shadows into the glare of public scrutiny, and it wasn't a pretty sight. The American Health Care Act (AHCA) is a deeply disturbing plan that would shift hundreds of billions of dollars to the rich and the healthy at the expense of the poor, the sick, and the elderly.

    Four years after the ACA enabled millions of Californians to gain health coverage from California's Medicaid program (Medi-Cal) and the Covered California marketplace, House Speaker Paul Ryan, with support from President Donald Trump, wants to revoke coverage and care for our most vulnerable people. In the process, he wants to dismantle the carefully constructed broad base of revenues that finance that care. The Congressional Budget Office (CBO) estimates that the Ryan bill would reduce the number of Americans with health insurance by 14 million next year, rising to 24 million in 2026.

  9. How California Can Meet the Challenge of Accurately Diagnosing Autism

    Peter Currie, Senior Vice President, Program Strategy and Innovation
    Peter Currie
    Peter Currie

    A few months ago, I went back to the community where I lived for more than 30 years to attend a big party. The venue looked like a garden-variety medical office, but every one of us at the party knew it was so much more than that. We were there to celebrate the realization of a shared dream — raising the standard of care for a population of vulnerable children. Overcoming professional and institutional barriers, we were able to establish a first-of-its-kind center to ensure that low-income children with autism and related disorders would benefit from more accurate evaluation — at a point in their lives when the interventions would do the most good. The creation of the center ensures that parents and providers get a comprehensive diagnostic assessment and detailed treatment recommendations, and that their health plans can confidently authorize the treatment resources needed to make sure these children get the help they need.

  10. 'The ACA Allowed Me to Pursue My American Dream'

    Anne Sunderland, Senior Communications Officer, Improving Access
    Anne Sunderland
    Anne Sunderland

    Three Californians. Three Stories of How the Affordable Care Act Affected Their Lives.

    On Monday night, legislation to repeal and replace parts of the Affordable Care Act (ACA) was introduced in Congress.

    More than 5 million Californians are now covered under provisions of the ACA. Here are just three. While their stories are different, each shares one thing in common — before the ACA, they all would have likely fallen into the ranks of the uninsured.

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