Wednesday, January 16, 2019

Legislative Alert: Urge Your Assembly Member to Support Bill to Close ACA Loophole

Please contact your legislators today and urge them to support this important bill, which would increase funding for Medi-Cal providers and incentivize large companies to provide adequate employer-sponsored coverage.
Additional information, including talking points, is available below.

Call (877) 362-8455 to be connected with your legislator

Click Here to Take Action!

 Click Here if you Made the Call!

AB 880 (Gomez) would address a loophole in the Affordable Care Act (ACA) by requiring large employers (500 or more employees) to pay a penalty for each employee enrolled in Medi-Cal. The funding generated would be used to expand access to care by increasing Medi-Cal provider rates and to pay for the nonfederal share of Medi-Cal costs.

The ACA requires individuals, employers and government to share responsibility for health coverage.  Individuals must have health coverage or pay a penalty. The government, through the “optional” Medicaid expansion and other efforts, will increase eligibility to millions of uninsured. Employers with an average of at least 50 full time employees will either provide affordable health coverage or pay a penalty for each employee who accesses subsidized coverage in the state exchange. However, nothing in the ACA or current law discourages large employers from reducing the hours or wages of their employees in order to make them Medi-Cal eligible.

Given that Medi-Cal pays some of the lowest provider rates in the country, coupled with the increased demands on the system as the state expands eligibility to 138 percent of the federal poverty level, the system simply cannot survive if large businesses begin shifting the costs of their employees' health care onto taxpayers. California already pays its Medi-Cal providers the lowest rates of all Medicaid programs in the nation. Although California has taken major steps to make health care coverage a reality for many people in our state by reducing the number of uninsured, the true test of our commitment will be improving Medi-Cal provider rates to ensure access to care.

We ask that you and your colleagues call, fax or email your legislators TODAY and urge them to protect access to care.   

Phone calls and office visits are most effective, but faxes and emails are important too. If you choose to fax or email your legislators, we strongly encourage that you personalize the letter (provided below), which will greatly increase its impact.

If you are logged into the CMA website, your legislators should automatically be displayed. If not, you can click here to locate your legislators by zip code.

You can also call CMA's legislator connect hotline at (877) 362-8455 to be easily connected to your legislator.  You will be asked to enter your zip code and select your legislator.

Give your name, specialty and let them know that you are their constituent.

Talking Points

  • The Affordable Care Act is built on a foundation of individual, employer and government responsibility. Individuals must have health insurance or pay a penalty. The federal government provides subsidies and an expansion of Medi-Cal. Employers are required to provide affordable coverage or pay a penalty to offset the cost of public subsidies for their full-time employees who go into the exchange.
  • The ACA, however, does not extend the employer responsibility penalty to employers that have workers enrolled in Medi-Cal. As a result, there have been widespread reports of employers dropping coverage for their low-wage employees as a cost-saving measure, anticipating that taxpayers through Medi-Cal will pick up the tab.
  •  Although Medi-Cal is intended to provide essential health care services to many of the poorest and most vulnerable Californians, it has unfortunately become a broken promise for access to health care.
  • Largely due to low reimbursement (ranking 50th out of 50 states), physician participation in Medi-Cal is lower than it should be as we prepare to fully implement the ACA.
  •  As a result, more than half of Medi-Cal patients report difficulty finding a provider. When they are unable to find a provider, many Medi-Cal patients seek preventive and other non-urgent care in the hospital emergency department, the most expensive kind of care.
  • The funds generated by AB 880 will be used to support the Medi-Cal program by paying the non-federal state share of the program costs for workers, increasing the reimbursement rate for providers and shoring up the safety net for all Californians who need care.

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