During the health reform debate, there was controversy and disappointment over the failure to include a public option in the Affordable Care Act. Not only did the public option idea not die, it is alive and well in California.
In northern California last week, Kaiser Health News correspondent Sarah Varney interviewed the CEO of the Alameda Alliance for Health, Ingrid Lamirault, about their intention to participate in the California Health Benefit Exchange when it goes live in 2014. The Alameda Alliance is a non-profit insurer (governed locally) that competes with private for-profit plans in the county to deliver health services to Medicaid beneficiaries (called “Medi-Cal”) and public employees.
California does not have a monolithic or centralized Medicaid program. There are a variety of innovative programs that deliver cost-effective high quality care to Medi-Cal beneficiaries. Alameda Alliance is one of fourteen “two plan” counties that serve 3 million beneficiaries. Alameda has to market to Medi-Cal members in competition with a commercial plan. These public plans have been competing with the private sector for over a decade, and despite initial concern from both the left and the right, Medi-Cal beneficiaries and providers are pretty satisfied with the program, which has been able to live within its budgetary limits.