Patrick Johnston, chief executive of the California Assn. of Health Plans, said state officials must resist adding unnecessary requirements for health benefits that make policies offered through the exchange unaffordable.
Zig Fayant, a 59-year-old gas station attendant in Los Angeles, said he routinely ended up in the emergency room when his diabetes flared out of control before he found help at a county-run medical clinic.
"I really can't afford to pay for insurance on my own," Fayant said. "I won't be able to see the doctor without some kind of help."
There are also concerns about whether California will have enough primary-care doctors willing to treat patients like Fayant. There are shortages of primary-care physicians in 74% of California's counties, according to the California Medical Assn.
State leaders say they want to see nurse practitioners and physician assistants take on a bigger role in primary care. The federal law seeks to address the issue by boosting annual reimbursements by an estimated $700 million for physicians treating Medi-Cal patients.
That should attract more doctors to Medi-Cal, but at the same time patient demand will increase significantly, said Howard Kahn, chief executive of L.A. Care Health Plan, which covers more than 1 million lower-income patients.
"You couldn't accomplish both coverage expansion and full cost containment at once" under the federal law, Kahn said. "This moves us in the right direction."
