Town Hall with Assemblymember Bill Monning

bill MonningYou will be giving the keynote address at the first-ever Central Coast regional health summit, the “Health from Field to Sea” event on March 9. What will your message be, and what are your near-term hopes for health policy and action in the Santa Cruz area?

The regional “Health from Field to Sea” Summit is a new collaborative effort to support healthy eating and active living, and my keynote address will be to provide an update on the state budget, Medi-Cal, federal healthcare reform implementation in California, and the promotion of health and wellness.  

With a 2012-13 Budget shortfall of $9.2 billion, the governor has proposed $4.2 billion in funding reductions, including cuts to CalWORKs, Medi-Cal, In-Home Supportive Services, childcare and Cal Grants.  As a member of the Assembly Committee on Budget, my goal is to find alternatives to further cuts in programs that serve children and working families.  

The implementation of federal health reform will have the most significant impact on healthcare finance and delivery since the creation of Medicare and Medicaid in 1965. Part of this implementation includes the establishment of the California Health Benefit Exchange. The exchange will make it easier for individuals and small businesses to compare plans and buy health insurance in the private market beginning in late 2013. In addition, consumers will be provided with more information about health plans in an objective, easy-to-understand format on a website and a toll-free consumer assistance hotline.  

Disease and illness prevention are the most cost-effective, common sense means to improve health. Too often, however, the healthcare system focuses more on treating disease and illness rather than on preventive health promotion. Federal health reform presents a historic opportunity for California to prioritize preventive health programs and save valuable healthcare dollars. Education, prevention, and disease management improve the health of Californians and I look forward to promoting community health collaboration at the summit.

In 2014, federal healthcare reform will prohibit health insurance companies from discriminating against consumers with pre-existing medical conditions. In the meantime, California has two programs that offer subsidized health insurance to individuals that have been denied coverage due to a pre-existing condition: the state-only program named Major Risk Medical Insurance Program (MRMIP) and the federal program named Pre-Existing Condition Insurance Program (PCIP).

Who is eligible for these programs and what are you doing to make the MRMIP program more equitable?

To be eligible for the MRMIP program, a person must be a resident of California, unable to obtain health insurance in the individual market and be ineligible for other governmental programs such as Medicare. People eligible for this program have most commonly been denied healthcare coverage due to a pre-existing condition. The premiums are subsidized by tobacco tax funds. In Santa Cruz County, the MRMIP premium is between $260 and $1,700 per month, depending an individual’s age and whether they select Anthem Blue Cross or Kaiser. Coverage is also available for dependents.

Eligibility for the PCIP program requires that an individual be a U.S. citizen, or be a lawful resident unable to obtain coverage for the six months prior to the application, and have a pre-existing condition. The premiums for PCIP in Santa Cruz County range from $118 to $530 per month and vary depending on the person’s age. Healthcare coverage is provided through a Preferred Provider Organization (PPO) network of physicians, hospitals and other medical facilities.  

I also introduced AB 1526 to authorize the MRMIP to eliminate the lifetime and annual limit on benefits which currently only applies to the MRMIP but not the PCIP. This will make the two programs more equitable and reduce the out of pocket costs for those who cannot qualify for the PCIP.

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