The Changing Healthcare Landscape in California Shannon McConville Northern California Grantmakers...

The Changing Healthcare Landscape in California

Shannon McConville

Northern California Grantmakers Annual Conference—From Ideas to ActionMay 2015

2

ACA Medi-Cal enrollment levels have exceeded expectations

Total enrollment

Enrollment targets

Eligible population

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

Covered California, subsidized

Medi-Cal

SOURCE: Covered California enrollment totals, May 2014; UC Berkeley/UCLA CalSIM model version 1.8.

3

Federal gov’t provides bulk of new Medi-Cal funding, but future state costs uncertain

2013-2014 Budget 2014-2015 Budget 2015-2015 Budget$0

$20,000

$40,000

$60,000

$80,000

$100,000Other

State General Fund

Federal funds

To

tal e

xpe

nd

iture

s (i

n m

illio

ns)

SOURCE: Department of Health Care Services, Medi-Cal Local Assistance Estimates, May 2014 and November 2014

Despite coverage gains, 1 million may remain uninsured in Northern and Central regions

4

0

100,000

200,000

300,000

400,000Not eligible due to immigration status

Eligible for Covered California without subsidies

Eligible for Covered California with subsidies

Eligible for Medi-Cal

Re

ma

inin

g u

nin

sure

d, 2

01

9

SOURCE: Lucia et al., 2015, “Which Californians Will Lack Health Insurance Under the Affordable Care Act.”

5

State and county policy strategies to manage costs and improve access and outcomes

State-level– Coordinated care initiative, Health homes for chronic

conditions, payment reforms New Medicaid waivers, state innovation model

– Coverage options for undocumented immigrants SB4, PRUCOL

County-level– Medical homes for uninsured, Electronic Health

Records My Health LA, HealthPAC

– Dedicated revenue for county safety net systems Alameda County Measure A/AA

6

But improving the health of Californians requires more than access to medical care

SOURCE: Robert Wood Johnson Foundation, Commission to Build a Healthier America

The Changing Healthcare Landscape in California

Shannon McConville

Northern California Grantmakers Annual Conference – From Ideas to ActionMay 2015

8

Notes on the use of these slides

These slides were created to accompany a presentation. They do not include full documentation of sources, data samples, methods, and interpretations. To avoid misinterpretations, please contact:

Shannon McConville (mcconville@ppic.org; 415-291-4481)

Thank you for your interest in this work.