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Viewpoints: Expanded Medi-Cal will bring federal money in reform

Op-ed, Sacramento Bee

Earlier this year, a San Bernardino doctor told a middle-aged patient named Lupe that she was facing a life-or-death situation. Her blood glucose level was alarmingly high, and she was diagnosed with diabetes.

Over the years, Lupe has held multiple part-time jobs requiring strenuous manual labor and long hours, but no job ever offered her health insurance. Being uninsured and diagnosed with a complex and potentially life-threatening condition was frightening to her.

Today, Lupe has health care coverage through a county-based program that gives her access to a primary care physician who can manage her chronic disease. This coverage helps Lupe to continue working, avoid costly hospital stays and lead a healthier life.

The program operates as part of a partnership among the counties and state and federal governments as a “bridge to reform” that is serving more than 500,000 low-income Californians through the end of 2013. The state’s agreement with the federal government calls for these individuals to be transferred to Medi-Cal on Jan. 1, 2014.

California is now sprinting to implement the federal health reform law to provide coverage to millions of people like Lupe in 2014. At this critical juncture, some claim the costs are too high and the federal budget situation remains too unpredictable to implement the law fully. On the contrary, full implementation of the Affordable Care Act will bring federal dollars that are critical to our state’s recovering economy.

A joint study released this week by the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research found that the state would receive as much as $3.5 billion in new federal funds in 2014 by expanding Medi-Cal to meet the goals of health reform. In addition, over time as people who are currently uninsured get more appropriate preventive and primary care when they gain coverage, there will be additional savings to taxpayers as costly hospitalizations are prevented.

The health care coverage offered by Medi-Cal, California’s Medicaid program, is much more than simply a budget obligation. The health programs offered by Medi-Cal are tailored to meet the unique needs of our diverse population.

Recent experiences in Oregon give us a good indication of the human benefits of expanding health insurance. In 2008, 10,000 slots opened in the state’s Medicaid program. In the first year alone, researchers found that people who received coverage had more primary care and preventive visits to their doctor, lower out-of-pocket medical costs, and better physical and mental health.

The Affordable Care Act presents an historic opportunity to improve our state’s health care system. Gov. Jerry Brown’s “Let’s Get Healthy California” task force recognized this opportunity in its final report last month, stating that health reform implementation will enable more people to connect to a regular source of primary and preventive care, and reduce health disparities. It will also enhance California’s ability to implement payment reforms that reward value and health outcomes, rather than volume.

Expanding Medi-Cal coverage to more low-income Californians will improve the health care system for everyone. It achieves such broad benefits by reducing the burden on hospitals and doctors of the cost of caring for the uninsured and by encouraging incentives for rewarding health plans and providers for keeping people healthy.

California has been the “pace car” for implementation of the Affordable Care Act. Now that the race has begun and the green flag dropped, it is the time to accelerate the work that has been started to benefit all Californians. The good news is that the state has tremendous support to make this happen.

As leaders of two of the largest health care foundations in the state, we share a commitment to improving the lives of Californians. Since the law was passed in 2010, we have worked closely with the state, counties and the safety net health care system to make sure the Affordable Care Act will achieve its full promise. This year, our foundations will make major investments to support outreach and enrollment for both Medi-Cal and Covered California, our health benefit exchange. We are also supporting promising efforts to expand access to health care for the newly insured and make health care more affordable for everyone.

When Lupe’s doctor told her she could die, she could have given up. Instead, Lupe decided she wanted to live to see her grandchildren grow up. Now she watches what she eats, exercises, measures her blood sugar and checks in with her doctor regularly. She is committed to her health.

As we begin the new year, let us all resolve to make the same level of commitment to improving the health of all Californians by implementing health reform.