California: $6.2 Billion Medicaid Waiver Receives Federal Pre-Approval

CMS officials “agreed in principle” to a five-year, $6.2 billion section 1115 Medicaid waiver, "Medi-Cal 2020", which will support a variety of delivery system and payment reform initiatives in Medi-Cal, California’s Medicaid program. The bulk of the funding would go toward a public hospital incentive program, though other initiatives include improving the State’s dental health programs and launching a whole-person care pilot program. Subject to CMS approval, the State may also be eligible to receive additional funding to support caring for its uninsured population after the demonstration's first year. The new demonstration will replace the State's previous waiver, the "Bridge to Reform," which was set to expire on October 31 but was extended until December 31 to allow for a smoother transition to Medi-Cal 2020.

Colorado: Single Payer Option Likely to Be on November 2016 Ballot

State residents will have the option to vote on replacing their State-based Marketplace with a single payer health system next year, if the signatures collected to support this initiative are verified by the Secretary of State’s Office. Supporters of the single payer initiative, called ColoradoCare, submitted 156,107 signatures, far more than the 98,492 required to put the initiative on the November 2016 ballot. ColoradoCare would be administered by a nonprofit cooperative, run by a 21-member board, and would cost the State approximately $25 billion, paid for by a 10% increase in the payroll tax. Employers would be responsible for two-thirds of the tax increase, while employees would be responsible for the remaining one-third.