Implementing Health Care Reform For A State With High Needs And Limited Funds

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California rose to the challenge of implementing health care reform in a state with high needs and limited funds by expanding its Medicaid program (Medi-Cal) and establishing its own marketplace (Covered California). As a result, by June 2014 California 's uninsured rate had dropped from 22% to 11%. However, thoughtful examination of the rollout process reveals avoidable bumps in the road that, if corrected, could , have provided a better enrollment experience and thus better access to coverage for our most vulnerable populations. In order to assess California 's success in widening the doorway to Medicaid coverage this report reviews policy decisions that shaped efforts in reaching out to, enrolling, and retaining eligible low-income…show more content…
Those successes and barriers identified by at least three of the six participating organizations were selected as key successes and barriers.
Outreach: Key informants identified the outreach and education work of community-based organizations as an area of success in California’s efforts to usher eligible consumers to the Medi-Cal doorway. The outreach barriers identified included investments in funding outreach work, DHCS and Covered California communication with consumers, and the limited availability of enrollment data throughout during the first year of the expansion.
Enrollment: Medi-Cal enrollment figures far surpassed the 1.2 million predictions. By October 30, 2014 2.7 million new residents were enrolled in Medi-Cal. Key informants unanimously identified this as a success and identified several enrollment policies and the in-person assistance doorway as important contributors to that outcome. Barriers included the availability of data, DHCS and Covered California communication with consumers, technology challenges, policy and protocol adherence, and staff training across service channels.
Retention: Key informants agreed that delaying the annual
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