One person who's watching California's evolution closely is Christopher C. Ohman, president and CEO of the California Association of Health Plans (CAHP), headquartered in Sacramento, which represents nearly every plan in the state. Ohman says Gov. Arnold Schwarzenegger has created a proposal for California that leverages the core strengths of the health plans, their networks, their relationships with members and their cost-management strategies.
In his State of the State Address in January, Gov. Schwarzenegger proposed a radical plan to mandate health coverage and reform California's healthcare system to one that covers everyone and relies on a variety of funding streams and reallocations. Currently, between 6 million and 7 million California residents are uninsured; nearly one in three have family incomes of $50,000 or more. Those who do have insurance tend to be in HMOs, and a surprising amount are enrolled in individual plans not associated with an employer.
"Governor Schwarzenegger has painted a very large canvas of the right size for what it will take to cover all Californians," Ohman says. "Now getting from an appropriate-sized plan to the result is an enormous challenge. He has structured his plan to be based on shared responsibility, which, for the stakeholders, means there's some bitter and some sweet. The way that this will all come together is if we all accept our share of responsibility."
According to Ohman, the governor's plan for universal coverage does not put health plans out of business or force a single-payer system, and for the 40 plans that comprise CAHP, that's good news. So far, healthcare reorganization proposals coming from various governors' offices nationwide have included health plans as part of the solution.
Certainly the driving force behind states' aggressive reorganization attempts is the need to better manage healthcare costs and to have the wiggle room to serve residents' needs for the long-term. It seems the time is right for states to expand public programs and get all the stakeholders involved in the big picture.
Under California's introduced proposal:
Critics say the governor ruffled some feathers among small- and medium-sized business, but polls indicate that as many as 80% of Californians support the shared-responsibility approach.
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