Map of Progress

Map of Progress

Two Year Overview

The key health question bedeviling California is how to address the very large numbers of uninsured. The policy solutions at the federal level and in other states have been to seek to increase coverage of the low wage working uninsured though the public and private sectors. California has not yet made the same commitment as leader states such as Massachusetts, Minnesota, Wisconsin, Tennessee, Washington, Oregon and New York. The challenge is significantly more difficult for California due to its large immigrant communities and state and federal restrictions on funding care to recent immigrants. California has made no progress on private sector initiatives.

ITUP's Map of California's Progress
(1996-2001)

Done:

Public:	Private:
Healthy Families for children up to 250% of FPL	Purchasing pools for small employers
Healthy Families for parents	Increase in very small employer offering
MediCal for two parent families with incomes up to 100% of FPL	HIPAA reforms for health plan renewal and portability of coverage
Coverage for new legal immigrants	Subsidized coverage for home care workers in San Francisco and state funding of county health coverage for IHSS workers
Continuity of coverage (12 months)	Subsidized coverage for child care workers in San Francisco
Elimination of quarterly status reporting, improvements in application and retention process	Development of low cost transitional coverage by several carriers (Kaiser and Blue Cross)
Los Angeles waiver for federal matching of ambulatory care to the uninsured	California Kids
Coverage initiatives by local health plans in Santa Clara, Alameda and San Francisco	Development of some voluntary systems of care for the uninsured
Funding increase for primary care clinics	Union organizing of some low wage workforces (e.g. Justice for Janitors, LAANE)
MediCal coverage of working disabled up to 250% of FPL	Experiment with low cost niche or wrap around coverage (MediFam)
Clarification of "public charge"	Subsidized premium pilots for "uninsuring" employers (Sharp Health Plan)
Coverage for breast cancer treatment for low income women	Products for uninsured employers (Community Health Group)
Family PACT	Coverage for flex workers (Working Partnerships, Western Growers Assn.)
Increase in funding for physicians' uncompensated care to the uninsured
Universal coverage for children initiatives in Santa Clara

Not done:

Public:	Private:
Subsidized premiums for coverage of low wage working adults without children	Subsidies for coverage of the low wage small business workforce
1115 waiver for MediCal coverage of medically indigent adults (MIAs)	New structures for coverage of flex workforce
Seamless coverage	Subsidies for coverage of low wage flex workforce
Program simplification and consolidation (e.g. six programs to cover low income children)	Connections between public and private sector coverage
Development of organized systems of care for the uninsured by safety net providers and others	Repair of perverse incentives of DSH funding
Elimination of MediCal Asset test for parents	Coverage for immigrant workforces
Development of an appropriate funding source for public subsidies of coverage of the medically uninsurable	Individual market reform
Repair of the repercussions of Prop 187 and welfare reform on participation in public programs by legal immigrants	Medium sized employer market reform
Effective outreach to the working eligible-but-unenrolled	Subsidies for transitional coverage

More information on the programs and organizations listed below is available in our
Reports page.

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