Office of Affordability next step in CA’s march toward universal, affordable health coverage

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OPINION – This month, California launches the Office of Health Care Affordability, a milestone that makes us a leader in ensuring that every resident has access to high-quality, equitable, affordable health care.

The ever-increasing cost of health care affects us all, and it’s time we did something about it. I’m proud to be from a state willing to take on this issue.

California’s status as an innovator in health care didn’t happen by accident. As California’s Health and Human Services Secretary under Governor Gavin Newsom, I have helped drive some of this innovation, but the work began a decade ago when California embraced the Affordable Care Act, expanding affordable coverage for low- and middle-income Californians.

In the Newsom Administration, we have reimagined Medi-Cal, California’s Medicaid program for low-income residents, which covers about a third of all Californians.  California expanded Medi-Cal for income-eligible undocumented immigrants, starting first with children, then young adults, older Californians, and all undocumented adults. And now, through California Advancing and Innovating Medi-Cal – or CalAIM – we are not only improving the quality and accessibility of core health services in Medi-Cal, we are addressing social drivers of health, like access to housing and food, so that Californians have what they need to get and remain healthy.

What’s more, California is working to manufacture our own low-cost insulin, prodding two of the big three pharmaceutical manufacturers to recently announce they would cut the exorbitant cost of the drug.

We have anchored our reforms in equity, seeking to use policy and practice to erode systemic racism in health care that leads to worse health outcomes for black and brown communities.

The ever-increasing cost of health care affects us all, and it’s time we did something about it.

Now California is taking the next step in our march toward universal, affordable, high-quality, and equitable health coverage by creating the Office of Health Care Affordability. We are tackling the health care affordability crisis that currently forces just over half of Californians to delay or altogether skip medical care because they can’t afford it, according to the latest survey from the California Health Care Foundation.

This is personal to me. It’s something I saw in my practice as a pediatrician – loving parents struggling with scheduling appointments or filling prescriptions for their kids because they couldn’t afford it. Californians deserve better.

This is probably personal to you too. If you’re an employer, you’ve doubtless noticed that it costs more to cover your employees, taking away opportunities to raise wages. If you’re an employee, you may be facing higher deductibles or co-pays. It’s not your imagination: Overall health care spending is increasing at a rapid clip in California: It was up about 30 percent between 2015 and 2020.

The Office of Health Care Affordability aims to slow ever-spiraling health care spending over time. Its Board will set a statewide target to slow the growth in total health care spending and take progressive actions to enforce the target.

What’s more, California will promote high-value care by measuring quality and equity performance, setting benchmarks for the adoption of innovative payment models, and promoting investment in primary care and behavioral health.

And the Office of Health Care Affordability will monitor workforce stability so that efforts to slow health care spending are not made on the backs of our tireless health care workers.

Taken together, this comprehensive approach aims to ensure we achieve a high-value system rather than a system that is just low cost.

California is by far the largest of the handful of states focusing on making high quality, equitable care affordable to make a difference for people who are struggling to pay for coverage and care.

It’s the right thing to do, and the right time to do it.

Dr. Mark Ghaly is California’s Health and Human Services Secretary and a pediatrician. He lives in Pasadena.

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