Author: Callie Shanafelt

Planning for the Most Expensive Patients

Some of the costliest care in the nation goes to the nine million people who are enrolled in both Medicaid and Medicare. Dubbed dual-eligibles, these low-income seniors and younger people with disabilities qualify for the insurance program for seniors (Medicare) and the insurance program for the poor (Medicaid, called Medi-Cal in California). Dual-eligibles often have complicated illnesses. But that’s not the only reason why their care is so expensive, with yearly spending for their care exceeding $300 billion.

Promotoras bridge clinics and community

Elizabeth Luciano sits in her small office looking compassionately at the young mother complaining of stomach pain. She was undocumented and had no health insurance. They met at a community event a week before and the woman cautiously approached Luciano to see if she knew of anyone who could help with her Medi-Cal application.  Luciano, a former hospital nutritionist in her home country of Columbia, told her it was safe to come to her office at the Pittsburg Health Center.

LA Organizes Unprecedented Enrollment Campaign

As Obamacare outreach efforts ramp up around the country, the question on everyone’s mind is ‘who will enroll?’ But those who are especially in the know wonder if ‘hard-to reach’ people will even understand that there are programs that they can enroll in.

Counties build bridge to Obamacare

The Supreme Court decision that kept Obamacare intact made one major change to the legislation: the Medicaid expansion became optional. But California, one of the states leading on reforms, started the expansion of the state Medicaid program—known as Medi-Cal— three years ago. The early expansion in California and other states was intended to show the benefits and pitfalls of reforms before they were rolled out nationwide and to provide models for success.

What does Obamacare mean for young people?

Right now, young people are generally benefitting from protective changes ushered in by Obama care. But many advocates and experts wonder if the Affordable Care Act will actually make care more affordable for young people – or if the young will simply end up paying the price of lowering costs for everyone else.

Tribal courts aim to heal

Advocates for Native American survivors of intimate violence cheered when they won the right to prosecute non-Indian assailants in tribal court. That change came with a provision in the Violence Against Women Act earlier this year. On at least one slice of California sovereign tribal land, the change also means defendants will have to engage with a very different criminal justice system – one that is based on restorative justice.

New VAWA provides unprecedented protection for Native American women

Native American women are physically abused, raped and stalked more than women of any other racial group in the nation. A new provision in the Violence Against Women Act, passed in February, allows Native American courts to prosecute non-Native offenders for the first time since the 1970s. While most expect the provision to help address violence against Native women, particularly in Western states, it also poses challenges for California’s tribal courts, which work with far fewer resources than county courts.

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