The Affordable Care Act (ACA) has created a new system of health insurance exchanges. States can design and implement the exchanges to offer new opportunities for access to affordable, accountable health insurance. California’s law is the first in the nation..
Under the federal ACA, exchanges will open in 2014 to offer standardized insurance plans to individuals and small businesses, with subsidies available to people earning up to 400% of the federal poverty level. The California law creates a 5- member governing body with two important features. First, it must “take into consideration the cultural, ethnic, and geographical diversity of the state so that the board’s composition reflects the communities of California.” Secondly, its strong conflict of interest provisions exclude participation by active agents of the insurance and health care industries.
In a key provision for affordability, the state will have the right to engage in “selective contracting” with insurance plans, meaning it will be able to negotiate on premium rates. In addition, it has the right to “require carriers to offer additional products within each of” the five levels of coverage specified by the ACA. These could conceivably refer to supplementary dental plans.
The exchanges for individuals and small employers are initially separate. They could be united in the future, pending a study due by 2018.
The exchange must be self-supporting, after repaying an initial loan for administrative start-up, although there is a prospect for General Fund support. Critics have noted that this funding limitation could hamper the exchange’s viability.
The law includes other important features. It requires coordination with existing health programs. The exchange must provide “oral interpretation services in any language for individuals seeking coverage through the Exchange and makes available a toll-free telephone number for the hearing and speech impaired.” And, “The board shall ensure that written information made available by the Exchange is presented in a plainly worded, easily understandable format and made available in prevalent languages.” Further, the Board must “consult with stakeholders relevant to carrying out” its activities, including “health care consumers who are enrolled in health plans, individuals and entities with experience in facilitating enrollment in health plans, representatives of small businesses and self-employed individuals, the State Medi-Cal Director, and advocates for enrolling hard-to-reach populations.”
Read the bills here:
California Exchange Bill AB 1602
CA Exchange Bill – Senate Bill 900 (Governance)
Showing posts with label immigrants. Show all posts
Showing posts with label immigrants. Show all posts
Monday, October 11, 2010
Wednesday, March 24, 2010
Historic
Yay! We passed the bill! No question about it, seeing the House pass the health reform bills, and watching the President sign one of them, felt like moments of triumph. Despite our many many reservations, so many of us have worked so hard over the last year to achieve this victory! From my own work with the remarkable network that has sprung up around EQUAL, and my colleagues at KPFA; to the hard work of women's groups, progressive organizations, and public health; to the members of Congress who took on enormous obstacles: we all have a claim to this step forward. Speaker Nancy Pelosi clearly deserved major credit for working the bill through the Democratic caucus.
But there are bitter disappointments. The public option failed though it was and is popular. Reproductive rights and immigrants' rights are under assault. Corporations are gaining legal as well as de facto rights. The rabid right, while possibly diminishing and cornered, is nevertheless frightening. The opposition leadership is fanning the flames of hate, divisiveness and willful ignorance, as they experience defeat for the first time in a decade. Members of Congress are heckling each other, the President and the public. One staff member described the atmosphere as “vicious.”
It’s not all over yet, even on the most pragmatic level. The Senate will debate all week, and Republicans will attempt every possible maneuver to derail the proceedings.
Both the President and Rep. Dennis Kucinich framed the victory as one that could begin to reverse 30 years of regressive Reagan-era policies. While the details of the bill are largely technical, and far from revolutionary, one has only to think back to the tsunami of corporate opposition that buried similar proposals in the Clinton era to appreciate the potential significance of this accomplishment.
The legislation itself offers significant improvements for health coverage for many, while ducking the most far-reaching controls on costs. The immediate benefits this year include a tax credit for small businesses that offer insurance, a ban on pre-existing condition exclusions for children, the elimination of copayments for preventive care, and a $250 rebate to Medicare beneficiaries who fall into the prescription drug plan’s doughnut hole. In 2014, 16 million people will begin coverage through Medicaid (called MediCal in California), and millions more will be able to buy insurance through pools created by new state-based exchanges. The plan will limit insurance plans’ ability to gouge sick enrollees in the small group market.
The public option would be a crucial factor in controlling costs and holding insurance companies accountable. Like Medicare and other public programs, the public option was envisioned as an entity with the clout to demand lower prices from health care providers, and also a real alternative for people seeking an escape from the predatory insurance industry. Its absence leaves a gaping hole in the program’s viability.
There’s no similar dispassionate analysis of the harm inflicted on women and immigrants. At best, the bills strengthen existing prohibitions on spending federal funds on abortion and for the first time intrude on the right and ability to buy abortion coverage with private dollars; and exclude tax-paying immigrants from health benefits others enjoy. These assaults are driven purely by vitriol.
The job for progressives is to rejoice in the prospects that may be opening up, and to stay angry about what we have lost, while taking a cold, hard look at the power dynamics that landed us here. A map of the House vote suggests a huge geographically-based divide in the U.S., with representatives from the more isolated middle of the country accounting for most of the Republicans, and the 34 Democrats who voted no. Can progressives win primaries against ConservaDems in those districts? A number of organizations are chomping at the bit to find out.
We have to come up with strategies to deepen and consolidate the public’s approval of Medicare as a model for a stronger public role in the health care system, and link state based and national campaigns to pursue it.
Challenging sexism, racism and homophobia will be problematic in an era of economic recession. But our communities are organized and articulate. Winning the power to defend and advance our interests is not an option; our opponents have their knives drawn, in some cases literally.
Quoting Rep. Dennis Kucinich:
“We're at a pivotal moment in American history, and in contrast to a crippled presidency, I have to believe that this effort, however imperfect, will now have a broad positive effect on American society, and make possible many things that might not have otherwise been possible. Once this bill is signed into law, more Americans are going to be aware of this as they ask, What's in it for me? And as they become more familiar with the new law, more people will be accepting this bill. The president will have a stronger hand in domestic and international affairs, and that will be good for the country.”
Is this President up for it, and up to it? Are we? The coming months will tell.
But there are bitter disappointments. The public option failed though it was and is popular. Reproductive rights and immigrants' rights are under assault. Corporations are gaining legal as well as de facto rights. The rabid right, while possibly diminishing and cornered, is nevertheless frightening. The opposition leadership is fanning the flames of hate, divisiveness and willful ignorance, as they experience defeat for the first time in a decade. Members of Congress are heckling each other, the President and the public. One staff member described the atmosphere as “vicious.”
It’s not all over yet, even on the most pragmatic level. The Senate will debate all week, and Republicans will attempt every possible maneuver to derail the proceedings.
Both the President and Rep. Dennis Kucinich framed the victory as one that could begin to reverse 30 years of regressive Reagan-era policies. While the details of the bill are largely technical, and far from revolutionary, one has only to think back to the tsunami of corporate opposition that buried similar proposals in the Clinton era to appreciate the potential significance of this accomplishment.
The legislation itself offers significant improvements for health coverage for many, while ducking the most far-reaching controls on costs. The immediate benefits this year include a tax credit for small businesses that offer insurance, a ban on pre-existing condition exclusions for children, the elimination of copayments for preventive care, and a $250 rebate to Medicare beneficiaries who fall into the prescription drug plan’s doughnut hole. In 2014, 16 million people will begin coverage through Medicaid (called MediCal in California), and millions more will be able to buy insurance through pools created by new state-based exchanges. The plan will limit insurance plans’ ability to gouge sick enrollees in the small group market.
The public option would be a crucial factor in controlling costs and holding insurance companies accountable. Like Medicare and other public programs, the public option was envisioned as an entity with the clout to demand lower prices from health care providers, and also a real alternative for people seeking an escape from the predatory insurance industry. Its absence leaves a gaping hole in the program’s viability.
There’s no similar dispassionate analysis of the harm inflicted on women and immigrants. At best, the bills strengthen existing prohibitions on spending federal funds on abortion and for the first time intrude on the right and ability to buy abortion coverage with private dollars; and exclude tax-paying immigrants from health benefits others enjoy. These assaults are driven purely by vitriol.
The job for progressives is to rejoice in the prospects that may be opening up, and to stay angry about what we have lost, while taking a cold, hard look at the power dynamics that landed us here. A map of the House vote suggests a huge geographically-based divide in the U.S., with representatives from the more isolated middle of the country accounting for most of the Republicans, and the 34 Democrats who voted no. Can progressives win primaries against ConservaDems in those districts? A number of organizations are chomping at the bit to find out.
We have to come up with strategies to deepen and consolidate the public’s approval of Medicare as a model for a stronger public role in the health care system, and link state based and national campaigns to pursue it.
Challenging sexism, racism and homophobia will be problematic in an era of economic recession. But our communities are organized and articulate. Winning the power to defend and advance our interests is not an option; our opponents have their knives drawn, in some cases literally.
Quoting Rep. Dennis Kucinich:
“We're at a pivotal moment in American history, and in contrast to a crippled presidency, I have to believe that this effort, however imperfect, will now have a broad positive effect on American society, and make possible many things that might not have otherwise been possible. Once this bill is signed into law, more Americans are going to be aware of this as they ask, What's in it for me? And as they become more familiar with the new law, more people will be accepting this bill. The president will have a stronger hand in domestic and international affairs, and that will be good for the country.”
Is this President up for it, and up to it? Are we? The coming months will tell.
Saturday, March 20, 2010
Health Reform Debate Devolves (Further)
It's not just about the money. It's about fairness, and equality, and how profoundly our political culture is infused with the imperatives to keep us divided on the most fundamental bases. Our economic and legal systems have been engines of great progress, and also of divisions by class, race, gender, and all manner of measures of privilege and powerlessness.
It is not the same thing that anti-reform protestors on Saturday spat at Rep. Emmanuel Cleaver, and hurled a racial epithet at Rep. John Lewis, and an anti-gay slur at Barney Frank; that there is now consideration of an Executive Order strengthening even further the ban on federal funding for abortion - a life-crushing measure for millions of women - to win votes for health reform; and that the health reform package would extend no benefits to the undocumented workers who, parenthetically, pay taxes and have by and large been wrenched from their homelands by our own destruction of their domestic agricultural economies. Each of these injustices has its own history of oppression, and its heroes, heroines and triumphs.
But aren't we ready, really, to turn a tidal wave of shame and intolerance against the hate-mongers who are fanning these divisions? It's time to demand apologies, resignations, reparations, from right wing demagogues whose time-worn tactics threaten us with real harm, physical and otherwise, and attempt to keep us divided and to deflect attention from the bankruptcy of their own ideas.
Passage of the House health reform bill would be a landmark event in the march toward human justice and equality. We will no longer take it for granted that where we work should determine whether we get health care. Corporations will have to rely on their many other resources to discipline the workforce. More of us will enjoy longer and healthier lives, with greater security. The health care system itself will be constrained in its ability to penalize us for being women, for being older, for being sicker.
Let's turn our attention this Sunday not just to the vote on the House floor, but also to the march for immigrants' rights in Washington, D.C. And building on that, let's continue the momentum we began in November, 2008, to envision and implement an agenda that unites and lifts up all of us.
It is not the same thing that anti-reform protestors on Saturday spat at Rep. Emmanuel Cleaver, and hurled a racial epithet at Rep. John Lewis, and an anti-gay slur at Barney Frank; that there is now consideration of an Executive Order strengthening even further the ban on federal funding for abortion - a life-crushing measure for millions of women - to win votes for health reform; and that the health reform package would extend no benefits to the undocumented workers who, parenthetically, pay taxes and have by and large been wrenched from their homelands by our own destruction of their domestic agricultural economies. Each of these injustices has its own history of oppression, and its heroes, heroines and triumphs.
But aren't we ready, really, to turn a tidal wave of shame and intolerance against the hate-mongers who are fanning these divisions? It's time to demand apologies, resignations, reparations, from right wing demagogues whose time-worn tactics threaten us with real harm, physical and otherwise, and attempt to keep us divided and to deflect attention from the bankruptcy of their own ideas.
Passage of the House health reform bill would be a landmark event in the march toward human justice and equality. We will no longer take it for granted that where we work should determine whether we get health care. Corporations will have to rely on their many other resources to discipline the workforce. More of us will enjoy longer and healthier lives, with greater security. The health care system itself will be constrained in its ability to penalize us for being women, for being older, for being sicker.
Let's turn our attention this Sunday not just to the vote on the House floor, but also to the march for immigrants' rights in Washington, D.C. And building on that, let's continue the momentum we began in November, 2008, to envision and implement an agenda that unites and lifts up all of us.
Subscribe to:
Posts (Atom)