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March 2010 Policy Updates for City/Local, State, and Federal.

Policy Updates: City/Local

1) Citywide Healthy San Francisco Enrollment Tops 50,000 With Over 42% of Enrollees in SFCCC Clinic Medical Homes;

Total Citywide HSF enrollment is 50,768. Consortium clinics now care for 21,662 HSF participants, which represents 42.67% of the Citywide total.  Clinics have been focusing attention on re-enrolling clients to assure they have access to services when needed.

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Policy Updates: State

Per California Healthline:

California's uninsured population grew to 8.2 million in 2009, up from 6.4 million in 2007, according to a new study from the UCLA Center for Health Policy Research, the Los Angeles Timesreports. (The study excluded adults over age 65, who qualify for Medicare coverage.)
Researchers found that about 24.3% of California residents younger than age 65 were uninsured for part or all of 2009. Among respondents older than age 18, about one in three lacked insurance for all or part of the year.
In addition, the study found that the percentage of children without health insurance rose from 10.2% in 2007 to 13.4% in 2009. During that time, the total number of uninsured California children increased from 1.1 million to 1.5 million. The number of uninsured children might have been significantly higher if state and federal children's health insurance programs had not provided substantial support.  (Healthy Families is on the potential State budget cut list again this year.)
The study also noted that the rise in California's uninsured population occurred at the same time that the state's unemployment rate increased from 5.7% in 2007 to 12.3% by the end of 2009. During that period, some employers shifted more health care costs to workers.
Researchers predict that more people will join the ranks of the uninsured in the coming year, partly because California's jobless rate is not expected to drop significantly.
In addition, experts say many Californians without coverage are postponing medical care or seeking treatment at emergency departments, which could contribute to a rise in overall health care costs (Helfand, Los Angeles Times, 3/16).

2) March 24 Assembly Budget Health Subcommittee Hearing Will Focus on the Impacts of State Budget Health and Human Services Cuts on Californians; Written Comments on Impacts Sought  

The hearing will cover all of the major health and human services departments, issues, and reductions, but public comment will not be taken. The hearing will emphasize the magnitude and depth of effects on Californians of the Governor's proposed reductions for 2010-11 in the health and human services area, as well as a review of the major reductions adopted in the 2009-10 budget, which included some of the most drastic, historic cuts and policy changes in health and human services experienced in the past 30 years. 
The Subcommittee will ask representatives of various departments and the Legislative Analyst's Office to come forward and address the impacts resulting from the adopted changes in 2009-10 and to publicly speak to the anticipated effects of the Governor's proposals on communities and families.  Additionally, the administration will be asked to address the cumulative impact on families of the reductions and how multiple program changes affect disadvantaged and low-income families and individuals in our State.   

As noted, public comment will not be taken on the 24th but we encourage clinics to submit written stories for submission to the Subcommittee – particularly about the impact of the Medi-Cal adult dental reimbursement elimination on clinic patients.   Some State analysts are reporting the savings from eliminating adult dental are not as great as anticipated and, when patients delay care as a result, care that is finally sought is more expensive.  

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Policy Updates: Federal

1) Per NACHC – Health Reform’s Future and Your Role In It

By Craig A. Kennedy, MPH (NACHC)- 3/11/10
 We are definitely entering the stretch run for health care reform for this year (really we are this time!) and, perhaps, for many years to come.  As someone who sits in the middle of the arena, my read is that reform is either going to pass in the next month or two (probably shortly after the Easter break), or it will not pass this year.  With that in mind, there are a lot of groups working harder than ever to keep the momentum moving forward and to get reform passed (see the FamiliesUSA letters, among others). 

NACHC has signed onto a variety of letters supporting reform, and we have endorsed both the House and Senate bills because they meet our principles for reform.  However, new legislation is being written right now that may have a tremendous impact on the health center-specific provisions we have worked so hard to get included.  We are working with leaders in Congress and the Administration to preserve the health center priorities in the Senate-passed legislation, while also understanding that the big test will be navigating the process and winning votes in the House.

From the health center perspective, the House and Senate bills had different strengths for health centers.  The House bill contained higher guaranteed funding for health centers in its trust fund as well as higher Medicaid eligibility thresholds, and more generous subsidies for low income families looking to buy private insurance.  The Senate also had strengths in addition to its own Health Center Trust Fund, including the “Menendez” PPS amendment which would guarantee health centers their Medicaid PPS rate under the new private health insurance exchanges.

NACHC remains optimistic that leaders will find a way to pass the Senate bill, which we will continue to support because it is a good bill for health centers, and a “fix” bill that improves the legislation and doesn’t undermine key health center provisions.  In fact, the President himself indicated that he would use a “fix bill” to improve the Senate bill for health centers by expanding the Health Center Trust Fund even beyond the Senate’s proposal. 

Please call or email Dick Hodgson at 415 355-2230/ rhodgson@sfccc.org if you have questions or need additional information on any of these topics. 

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