By Governor Gavin Newsom
February 12, 2019
Next, if we’re serious about taming the cost crisis we need affordable healthcare for all Californians.
Our ability to invest in everything we care about is constrained by the pressure of rising health care costs. It impacts everything else we want to do.
The White House is laser-focused on destroying the Affordable Care Act. The vandalism they’ve already done to the individual mandate has had consequences. This year’s Covered California premiums increased almost twice as much as we expected. This is just what we feared, and it’s just what they wanted.
That’s why, when it comes to the individual mandate, California must act where Washington failed.
If we do, we will be able to deepen subsidies for those earning up to $48,000 and extend subsidies to families earning up to $150,000, something no other state in America has done. We all know California has among the lowest Medicaid reimbursement rates in America.
That’s why our budget devotes more than $1 billion to increase rates and address the provider shortage.
This investment will also allow us to increase access to preventative health measures like -immunizations, trauma screenings, and mental health services. And it provides $100 million for reproductive health and family planning.
As we pursue the long-term goal of single payer financing, let us make a down-payment now by expanding Medi-Cal coverage to all Californians up to age 26, regardless of their immigration status.
But access is only part of the solution. Cost is another.
We must address rising costs throughout the system, like the consolidation of hospitals and other health providers, which limits patient choice and makes care more expensive. And we must continue to bring down the cost of prescription drugs.
My first act as Governor was to lay the foundation for a single-purchasing system – the largest such system in the nation, which will save hundreds of millions of dollars a year for the people of California.
I want to thank President Trump for calling attention to prescription drug prices in his State of the Union. Yes, you heard that right. I hope he follows through. After all, this should be a bipartisan issue. But with or without the Federal government, California will lead.
By Don McCanne, M.D.
“As we pursue the long-term goal of single payer financing…” That is the take-home message of California Governor Gavin Newsom in his first State of the State Address.
In the meantime, there are several things that can be done to expand coverage and rein in costs. and Gov Newsom has proposed some of them.
Covered California (California’s ACA exchange) was made less effective by the Trump administration’s cancellation of the individual mandate penalty. As a transitional measure, Newsom would create a California individual mandate, until we have a single payer system.
He recommends expanding subsidies to middle-income families who still struggle with health care costs yet were not granted eligibility for the ACA subsidies. Although this does increase administrative complexity, it does provide some transitional relief until we have a single payer system.
California pays amongst the lowest rates for Medicaid, and he would increase those rates to help address the provider shortage – again helpful in providing some transitional relief until we have a single payer system.
He would expand Medicaid coverage to all Californians up to age 26, regardless of their immigration status, helping to fill in one of the more important voids in health care coverage, thereby providing some transitional relief until we have a single payer system.
He would increase access to preventative health measures like immunizations, trauma screenings, and mental health services, while authorizing $100 million for reproductive health and family planning, again providing some transitional relief until we have a single payer system.
One of the more important features of a single payer system is that it functions as a monopsony – a single purchaser that has more leverage in ensuring that prices are optimal. He would “lay the foundation for a single-purchasing system – the largest such system in the nation, which will save hundreds of millions of dollars a year for the people of California” – again providing some transitional relief until we have a universal single payer system.
Incrementalists, please note. These are not incremental steps moving toward some nebulous, aspirational goal of Medicare for All. These are merely interim measures to provide transitional relief while we move full speed ahead in demolishing the political barriers lying between us and health care nirvana: a single payer national health program – Single Payer Medicare for All. That includes everyone, folks. Everybody in, nobody out.
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