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New Healthcare Initiatives for 2019

New Healthcare Initiatives for 2019

New Healthcare Initiatives for 2019, Repeal / Replace / Repair, Ken Ruotolo, Chief Operating Officer

On his first day in office, Governor Newsom:

  • Said that his first budget will include funds to help make it more affordable for “middle income” individuals and families to purchase health care coverage:
    • Current subsidies phase out at 400% of the Federal Poverty Level.
    • Newsom’s plan would extend subsidies to those making up to 600% of the FPL.
    • Newsom intends to finance the subsidy increase by reinstating the individual mandate monetary penalty which was zeroed out by Congress in the Tax Cuts and Jobs Act passed in December 2017.
  • Said that his first budget would include funds to provide Medi-Cal coverage to undocumented young adults up to age 26 who meet certain requirements.
    • Currently, undocumented children up to age 19 are eligible to receive Medi-Cal benefits if they meet certain requirements.
  • Issued an executive order to strengthen the state’s position when negotiating and purchasing prescription medication:
    • By 2021, the Department of Health Care Services will negotiate and purchase on behalf of all 13 million Medi-Cal members, a dramatic increase from the 2 million members for whom they currently provide this service.
    • By July 2019, the Department of Health Care Services will review and recommend ways to pool the negotiating and purchase processes for all state purchases of prescription medication, effectively creating one purchaser of medications on behalf of the State of California.
    • By May of 2019, the Department of General Services will develop a framework to allow private companies to join with the state in purchasing in bulk.

Separately, Newsom sent a letter to President Trump and congressional leaders asking for the right to use federal funds to pursue a single-payer initiative in California. In order to implement single-payer fully, the state would need to use funds currently administered by the federal government for programs such as Medicare, TriCare (military healthcare coverage), Medicaid and others. It is highly unlikely that such a request will be approved by the Trump administration or the U.S. Senate, however, it shows that Governor Newsom is intent on taking the first steps towards exploring a single-payer system in California.

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.


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