Guaranteed Access to Care

With over 6.6 million Californians without health insurance, covering the uninsured is a top priority for our state. Efforts to reform our healthcare system must be done in a way that does not damage, jeopardize or increase costs for California consumers and families who already have coverage.

Guaranteed affordable access to healthcare for all Californians is one important reform that we can implement to achieve our goal of covering more of our state’s uninsured while maintaining affordable coverage for Californians who already have coverage.

Access to healthcare for all Californians:

Safety Net
ALL Californians with pre-existing medical conditions should be able to purchase affordable, private health coverage through a purchasing pool.

We are supportive of Guaranteed Access – which would assist individuals in securing access to coverage by:

• Providing premium assistance to low-income families so they can afford coverage.

• Creating a safety net for those with pre-existing medical conditions so they would be eligible for affordable private health coverage through a healthcare purchasing pool.

Some other proposals, like AB1X, promote Guaranteed Issue – which would require that all health plans and insurers guarantee health coverage to individuals regardless of any pre-existing medical condition. While Guaranteed Issue sounds like a good idea, it has been tried in other states and has created many problems, including reduced consumer choice, higher premiums, and fewer individuals actually insured.

• Individuals are not likely to buy coverage until they get really sick. That means that people and businesses that have been paying for coverage will face much higher premiums to cover the high expenses of people who only buy coverage when they are sick.

• In the State of Maine, where they passed Guaranteed Issue, only one insurance carrier remains issuing coverage to individuals. And, since Guaranteed Issue was implemented, premiums have increased 124% over the last six years.

• The three most expensive states for individual health insurance are Massachusetts, New Jersey and New York, and they are all Guaranteed Issue states.

• Today, California has some of the lowest individual premiums in the nation, but if California becomes a Guaranteed Issue state, we should only expect premiums to increase as they have in these other states.

Expand Medi-Cal and Healthy Families Programs
California has multiple public healthcare programs that have been successfully delivering health coverage to millions of Californians who otherwise would not have access to coverage. We should build on the success of these programs rather than trying to create new, unproven programs.

By expanding California’s existing Healthy Families Program that covers 850,000 children to 300% of the Federal Poverty Line (FPL) – approximately $60,000 for a family of four – the program could provide health coverage to an additional 125,000 children.

In addition to keeping children healthy, it is vitally important that their parents stay healthy as well. By expanding eligibility to parents of children to 200% of the FPL, we can provide healthcare coverage to 585,000 parents.

Expanding access to individuals to 100% of FPL gives 745,000 younger and lower-income adults access to healthcare coverage they wouldn’t otherwise be able to afford.

New Guidelines
Require new guidelines so people cannot be turned away for minor pre-existing medical conditions.

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