CSAC Bulletin Article

Health and Human Services 03/08/2013

Covered California Approves “Narrow Bridge” Plan, Must Be Enacted by Legislature

The Board of Covered California, the state’s health insurance exchange, voted to pursue an option to provide continuous health care coverage to individuals transitioning from Medi-Cal eligibility to Exchange eligibility.
Called the “narrow bridge,” the plan would allow 670,000 to 840,000 individuals to keep their health plan and providers when their income or eligibility changes. Medi-Cal will cover those below 138 percent of the Federal Poverty Level (FPL), and those above 138 percent will be eligible to obtain private insurance through Covered California. The idea of a narrow bridge is to allow health plans that participate on either the Medi-Cal side or the Covered California side to retain individuals whose eligibility changes, or toggles, between eligibility levels. 

The Covered California board also considered a broader bridge program that would include individuals up to 200 percent FPL , but opted to move forward on the narrow bridge option while also gathering more information about the broader bridge idea. The narrow bridge would be operational in April of 2014. Either idea must be approved by the Legislature. 

Rural Managed Care Rollout Includes County-Supported Plans

The state Department of Health Care Services (DHCS) announced last week a selection of health plans that will provide Medi-Cal Managed Care services to the residents of 28 rural counties.

As reported last week, counties were pleased to see the decision by DHCS to allow eight northern counties (see list below) to use Partnership Health Plan of California, a County-Organized Health System (COHS) that currently already serves Solano, Sonoma, Napa and Yolo Counties. Eighteen other counties (see list below) will be covered by Anthem Blue Cross and the California Health and Wellness Plan, run by CSAC Premier Corporate Partner Centene Corporation. San Benito County will join the Central Alliance for Health – which is another COHS already serving Merced, Monterey, and Santa Cruz Counties – and the state is considering allowing Imperial County to follow the Local Initiative model, in which the county will develop partnerships with safety-net providers, traditional Medi-Cal providers, and local communities. The Imperial County decision is expected by June 1. 

The expansion of Medi-Cal Managed Care to the 28 fee-for-service rural counties was authorized last year via AB 1467 (Chapter Number 23, Statutes of 2012). The transition is slated to be complete by July 1. For a map of the counties and plans, plus additional resources and information, please visit the DHCS Rural Expansion page

Partnership Health Plan Counties: Del Norte, Humboldt, Lake, Lassen, Modoc, Shasta, Siskiyou and Trinity. 

Anthem Blue Cross Counties: Alpine, Amador, Butte, Calaveras, Colusa, El Dorado, Glenn, Inyo, Mariposa, Mono, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, Tuolumne and Yuba. 

ABX1 1 (Pérez) and SBX1 1 (Hernandez) – Support
As Introduced on January 28, 2013

ABX1 1, by Assembly Speaker John A. Pérez, and SBX1 1, by Senator Ed Hernandez, are identical measures that will implement provisions of the Affordable Care Act (ACA) to streamline eligibility and enrollment in the state’s Medi-Cal system. Both measures also assume a state-run Medicaid expansion to cover adults up to 138 percent of the Federal Poverty Level. 

Both the Assembly and Senate held floor debates yesterday on the measures and passed them. ABX1 1 passed the Assembly 53-22, while SBX1 1 passed in the Senate 24-7. The debate and votes occurred in the special session on health care reform. Both bills now go to the opposite house, but clearly significant policy decisions must be made before moving forward. CSAC continues to work with the Administration and the Legislature to determine the best policy path forward for the Medicaid expansion in California by Januarys 2014.

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