5 Things California: Improving children’s health, Upcoming 5 slides conversation, CDPH on California’s COVID turnaround

In this edition of “5 Things We’re Watching,” read about health leaders’ recommendations for improving California children’s health, CDPH’s response to the state’s significant turnaround in COVID transmission rates, and LA Care Health Plan’s significantly lowered 2022 rates.

Keep an eye out for the Detailed Agenda for our 2021 Southern California State of Reform Health Policy Conference, which we will release on Thursday. We’ve got an impressive list of speakers confirmed for Dec. 2nd so far — if you haven’t already, you can register for our first in-person conference since COVID here!

Thanks very much for reading! For tips, suggestions, or feedback, feel free to reach out!


Eli Kirshbaum
Health Policy Reporter
State of Reform

1. Leaders outline recommendations for improving children’s health

“In California, we likely don’t know today the full extent of the pediatric health crisis because so many children haven’t accessed the healthcare they need, and their records are incomplete,” write Claudia Williams and Kristen Golden Testa in a recent op-ed for State of Reform. The two health leaders offered insight on the state’s pediatric health crisis in the wake of the Delta variant and deferred medical care.

The authors praised California’s $4.4 billion Children and Youth Behavioral Health Initiative, calling it a “major area of progress.” They outlined five broad recommendations for the state to improve children’s health: make Medi-Cal coverage easier for parents, promote family-centered health homes, utilize health data more effectively, create a community health worker benefit for all Medi-Cal-enrolled children, and link health plans’ performance in children’s health to their payments.


2. Registration for “5 Slides: Gene therapy and the promise for rare disease” now open

Gene therapy has proven to be a promising treatment for rare diseases like muscular dystrophy. As these life-saving treatments enter the market, however, their high costs pose affordability challenges for individuals living with rare diseases.

In our upcoming virtual conversation, “5 Slides: Gene therapy and the promise for rare disease,” we will host Jennifer Hodge, PhD, US rare neurology medical team lead at Pfizer, Ryan Fischer, chief advocacy officer at Parent Project Muscular Dystrophy, and Angela Ramirez Holmes, founder of Cal Rare, to talk through gene therapy’s potential and some of the financial barriers patients face in accessing these treatments. Register for free here!

3. CDPH credits strict public health measures for California’s COVID turnaround

California now has one of the lowest COVID-19 transmission rates in the country, marking a major shift from being called the country’s “epicenter” of the pandemic just months ago. CDPH attributes this change in direction to the strict public health measures they enacted earlier this year, namely vaccination campaigns and mask requirements.

In a written statement to State of Reform, the department emphasized the effectiveness of vaccines and cited its indoor masking recommendations as well as mandatory vaccinations for health care workers, school and state employees, and visitors at health facilities as successful efforts to curb the spread of the virus. CDPH said they’ll be continuing this strong public health oversight in the coming months: “While California has administered more vaccines than any other state, we have more work to do.”


4. LA Care has price decrease in individual market

With California’s open enrollment period beginning this week, LA Care Health Plan recently announced that its LA Care Covered product offers the lowest rates across all tiers for the individual market in Los Angeles County. While the state’s average individual market rate saw a slight increase of 1.8% for 2022 — due to record enrollment and a healthy consumer pool — LA Care’s average rate will decrease by 2.9%.

Cristina Inglese, LA Care’s executive director of commercial products, told State of Reform Reporter Soraya Marashi that the health plan is committed to advancing its members’ quality of care along with affordability. She said members care a lot about what services are available to them, so LA Care partners with organizations like Optum and UCLA Health Care to increase care options and provide a large network of providers for its enrollees.

5. The health-related provisions of the revised BBB plan

With the release of President Biden’s scaled back “Build Back Better” plan last week, State of Reform columnist James Capretta broke down some of the health policy items that made their way into the president’s updated domestic agenda. He emphasized that more health-related items could be added to the plan in the near future as negotiations continue at the capitol.

The revised BBB plan includes Medicare coverage for hearing services and a permanent 6% FMAP increase for states offering HCBS. It also provides fully subsidized ACA marketplace coverage for individuals in the coverage gap from 2022-2025, dropping its previous provision of offering fully federalized Medicaid coverage to these individuals starting in 2025 over concerns that it was unfair to states that have expanded Medicaid and thus bear 10% of expansion costs. Read Capretta’s full analysis here.