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Tuesday, November 9, 2010

More good news for California

Just last month, legislation was signed in California that created the state’s insurance exchange, making California the first state to establish an insurance exchange since the Affordable Care Act passed! If that wasn’t enough good news for you, we just heard more good news from the Golden State this week: On Tuesday, the federal government approved a five-year, $10 billion dollar “Bridge to Reform” plan to expand and improve California’s Medicaid program.

In a nutshell, California’s Bridge to Reform plan will:

  • Expand coverage to more uninsured adults;
  • Ensure funding to support access to care;
  • Improve care coordination for vulnerable populations; and
  • Improve quality of care.

So what exactly does this mean for Californians?

This means that non-elderly Californians aged 19 to 64, who will be newly eligible for Medicaid in 2014 as a result of the Medicaid expansion, do not have to wait until January 1, 2014 to get coverage. For adults struggling during these tough economic times, this is huge.

The state will phase in coverage that provides a set of core benefits now for these non-elderly adults with incomes below 133 percent of the federal poverty level (approximately $24,350 for a family of three in 2010). Benefits will include, among other services, inpatient and outpatient hospital services, prescription drugs, and mental health services.

California also plans to work with some counties to expand this coverage to adults with incomes up to twice the poverty level (approximately $36,620 for a family of three in 2010), who may not be able to afford health insurance now, but will be eligible for help buying coverage through the health insurance marketplaces in 2014.

According to an LA Times article, California’s Medicaid director, Toby Douglas, says that the state anticipates that as many as 500,000 low-income uninsured residents could enroll in coverage in California as a result of this plan.

In addition to expanding coverage, the Bridge to Reform plan looks to improve the efficiency and quality of care for low-income Californians and truly serve as a bridge to coverage.

To read more about the California’s Bridge to Reform Medicaid waiver, see this fact sheet.