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Rethinking the State-Local Relationship: Social Services

By Caroline Danielson

California lawmakers may soon consider realigning some of the state’s largest social safety net programs. Their deliberations are being driven in part by federal health care reform—which will reduce the number of uninsured residents and reshape the county-run health safety net. This report examines federal, state, and local relationships in the social services arena and outlines key issues for policymakers to consider.

Report

Expanding Medi-Cal: Profiles of Potential New Users

By Helen Lee, Shannon McConville

Millions of Californians will gain access to Medi-Cal under upcoming federal health care reform. This report finds that the majority of today’s uninsured poor are relatively young and healthy – good news from a cost perspective. But at least 25 percent could have substantial health issues. Understanding their needs is critical to preparing for health care reform. Survey data and focus group interviews round out this portrait of California’s potential new users of Medi-Cal.

Supported with funding from the California Program on Access to Care.

California Counts, Report

Emergency Department Care in California: Who Uses It and Why?

By Helen Lee, Shannon McConville

Californians make more than 10 million visits to hospital emergency departments annually. Many of these could be avoided with timely care from family physicians or outpatient clinics. This issue of California Counts presents a comprehensive portrait of emergency department care from several perspectives. Among its findings: The Central Valley and Los Angeles are home to some of the most crowded emergency departments in the state; patients with Medi-Cal coverage visit emergency departments more than do the uninsured; and Hispanics and Asians are less like to use emergency care than whites.

California Economic Policy, Report

Pay-or-Play Health Insurance Mandates: Lessons from California

By Aaron S. Yelowitz

In 2003, Sacramento enacted one of the first "pay or play" laws, mandating that employers either provide health insurance to California workers or pay a fee. Although the law was never implemented, the pay or play idea has since caught the attention of many other states’ legislatures. In this issue of CEP, the author examines the probable outcomes of California’s version of pay or play and concludes that it was seriously flawed: Employment and wages would have stagnated as employers passed on their increased costs, and many in the population would have remained uninsured.

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