Californians to Be Covered | Not yet estimated. Emphasis on access to affordable care though expansion of community clinics and regulatory reform—not coverage expansion. |
Requirements Imposed on
Consumers/Individuals | None. |
Treatment of Self-Employed | Tax conformity on Health Savings Accounts. |
Requirements Imposed on
Employers | - No requirements.
- Incentives to establish Section 125 plans and to make HSA contributions.
- Incentives to offer health insurance with flex-time work schedules for employees.
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Treatment of Small Employers | No differentiation based on employer size. |
Requirements Imposed on
Providers | None stated. Repeals prohibition against hospitals directly hiring physicians. |
Changes in Provider Payments or Reallocation of Funds for Providers | - Medi-Cal rate increase for physicians.
- New tax credits (10%) for primary care providers. New tax credits (25%) for primary care providers practicing in rural areas of CA.
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| Changes in Health Care Workforce/Care Delivery | Expands professional scope of practice for nurse practitioners. |
Public Program Expansions and
Support for Low-Income Individuals | Reallocates First Five funds, subject to voter approval, for children’s health care. |
Role of Counties | - Counties’ obligation to serve the medically indigent unchanged.
- Reallocates First Five funds, subject to voter approval, that flow to county First Five Commissions.
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Role of Federal Government | - Plan envisions federal government would reimburse the state for approximately $1 billion in costs associated with federally mandated health care services to undocumented immigrants.
- Redirects First Five funds, subject to voter approval, and allows those funds to be used to potentially pull down additional federal SCHIP matching funds.
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Changes in State Tax Code and State Tax Revenue | - State tax conformity on Health Savings Accounts.
- Encourage employers to establish Section 125 plans.
- Provides tax credits to employers who contribute to employees’ HSAs.
- Provides hospitals and physicians with a tax credit to purchase health IT.
- Establishes a provider tax credit of 50% for cost of "Charity Care" for the uninsured.
- Establishes a tax credit for primary care providers.
- Establishes a tax credit for primary care providers practicing in rural areas of California.
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Insurance Market
Requirements/Reforms: Guaranteed Issue, Rating Reforms, and Other Requirements
Imposed on Health Plans | - Encourage greater availability of benefit designs that conform to federal requirements for HSAs and high deductible health plans.
- Allows plans sold in other states to be available in CA without approval from DMHC or DOI.
- Require Cal-PERS to offer 401K-style health plans to state employees.
- Permit greater flexibility for coverage rates in the Small Group Market.
- Allows hospitals to offer "preventive services only" coverage.
- Continues operation of existing high risk pool.
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Insurance Market
Requirements/Reforms: Connector/Purchasing Pool | Not applicable. |
Insurance Market
Requirements/Reforms: Participant Contribution to Obtain
Coverage Through Purchasing Pool | Not applicable. |
Financing Sources and Cost Estimates | - Envisions reallocation of funds provided to disproportionate share hospitals (DSH) to create and expand primary care clinics.
- Realign Medi-Cal benefits to private benefits for cost savings.
- Reallocate $500 million from First Five, subject to voter approval, to children’s health care .
- Requests that the federal government pay for $1 billion in un-reimbursed cost of providing healthcare services to undocumented immigrants.
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Cost Containment: Prevention and Wellness | Expansion of clinics to be used to provide primary care services and in lieu of emergency rooms for non-emergency visits. |
Cost Containment: Additional Provisions | - Make pricing and quality information more visible to consumers.
- Encourage greater availability of benefit designs that, at a minimum, conform to federal requirements for HSAs and high deductible health plans.
- Require DMHC and DOI to allow plans to put more products on the market.
- Require CalPERS to offer 401K-style health plans to state employees.
- Permit greater flexibility for coverage rates in the small group market.
- Establishes low-interest loans for health institutions to acquire health information technology.
- Repeals prohibition against hospitals directly hiring physicians.
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Enforcement | Not applicable. |
Implementation Timeline | Not applicable. |
