Opinion: California ahead of the game in health care reform

In order to realize the promise of health care reform, states must be ready to hit the ground running with streamlined, user-friendly enrollment systems by January 2014. Luckily, California is ahead of the pack in offering online features for health care applications that will be instrumental in offering a streamlined eligibility system under the new law.  

A new report from the Kaiser Family Foundation shows California is among the top states in providing integrated and coordinated online access to children, families and individuals applying for Medicaid and the Children’s Health Insurance Program (known as Medi-Cal and Healthy Families, respectively, in our state). This report also points to yet another reason why California is well-positioned in comparison to many other states to successfully embark on health care reform.

The forward-thinking investments California counties have made in automating social services application systems can be used or built upon to meet the upcoming healthcare challenges, saving the state time in getting California’s health exchange up and running, and saving taxpayers hundreds of millions of dollars compared to creating new systems from scratch.

As the Kaiser Foundation reported, California already offers many highly-regarded technology features, including allowing applicants to create user accounts, report account changes and submit electronic signatures, as well as tailoring application questions based on a person’s answers to initial questions, known as “dynamic questioning” – all online.  What’s more, California was among just three states offering applications in English, Spanish and other languages. Most recently, counties launched the portal that allows people to apply from anywhere in the state by simply selecting their county of residence from an easy drop-down menu.

County social service agencies have worked tirelessly to keep up with advances in technology and offer a modern, efficient system to administer eligibility and enrollment for an array of health and human service assistance programs – and they did so even before the Affordable Care Act came about. More than 8.6 million Californians currently receive access to Medi-Cal, CalFresh (formerly Food Stamps) and CalWORKs benefits through a large-scale, automated system – which supports mail-in and online applications, paired with in-person customer service when needed. The system was thoughtfully designed and executed under a successful partnership between counties and the state.

With this experience already in hand, counties are working with our state partners to see that California is able to build on what works in implementing health care reform, and stay true to the “no-wrong-door” approach envisioned in the Affordable Care Act. Counties have the essential on-the-ground perspective to meet the needs of people where they are in their lives. This experience will be crucial to meeting the needs of the array of people who will be seeking affordable health coverage in the coming years, providing user-friendly access points for those who are Internet-capable, as well as through traditional phone and face-to-face settings as needed by others.

California has embraced the automation shift, while also recognizing the need to maintain a level of human contact for families with complex situations or a need to speak in person with a knowledgeable eligibility worker. As noted in the Kaiser analysis, even fully available online applications won’t meet the needs of all individuals, and “other application avenues and assistance for applicants will remain important.”

Being here for people when they need help is why county social service agencies exist – whether it is online, by phone or in person. And our agencies look forward to continuing to play an important role in health coverage for our residents in the coming years, both before and after 2014.

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