California is the most populous state in the nation and yet the state boasts one of the lowest uninsured rates. Is this success that can be replicated across the country? On the newest episode of Hospitals In Focus, FAH President and CEO Chip Kahn sits down with Covered California Executive Director Peter Lee to discuss how California has achieved health coverage expansion under the Affordable Care Act (ACA) and what other states can learn from this progress.
The passage of the ACA dramatically changed the landscape of American health care. From expanding Medicaid to covering millions more Americans, the ACA is the most comprehensive piece of health legislation in more than 50 years. For one, Peter Lee says the ACA “totally reform[ed] insurance markets. Before the Affordable Care Act, insurance companies won by either avoiding sick people – why do I want a sick person and have to spend all that money on – or by avoiding paying for care. That was the business model of many large insurers. The ACA threw all that out.”
Through his work at Covered California, Peter Lee works to “not only provide as much coverage as possible but to try to address the underlying health care system. The ambition we had was to make higher quality health care available to all and also to affect the entire health care system in California.” The groundwork to help achieve that goal was put in place by the ACA. The law provides subsidies that help people afford health coverage, but Lee believes they aren’t enough and that more financial aid is needed – both in California and nationally.
President Joe Biden’s election ushers in a new era of the ACA, one where more states will be encouraged to embrace the law of the land and use its framework to expand health coverage. In the episode, Lee and Kahn discuss the next generation of issues that the Biden administration will tackle, which likely includes making sure employer-sponsored coverage is “meaningful and adjusted for income.” Lee continued by saying, “as we start looking at things through an equality lens, we’re going to rightly see a fresh look at some of the flaws of employer-based coverage, not for all people with employer-based coverage – some people have great coverage, but a significant portion have coverage that calls into question their ability to get care at the right time.”
This episode of Hospitals In Focus also explores what happens when a state not only fully embraces the ACA but keeps harmful regulations at bay – regulations that ultimately hurt marketplaces and patients. Notably, Peter Lee argues “we don’t need a Cadillac tax, we need a Pinto tax – a tax on employers offering crappy coverage.”
Interested in learning more about Biden’s health agenda? Check out Building Biden’s Health Agenda with Chris Jennings and Doug Badger.