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Obama looks to California for health law success

Republicans in most of the country are still fighting Obamacare tooth and nail, but President Obama Friday is in one state where the Affordable Care Act has escaped the GOP's obstruction tactics: California.

On his second day in the Golden State (where he's attending fundraisers and meeting with Chinese President Xi Jinping), Mr. Obama on Friday morning will make a statement about the ongoing implementation of his three-year-old health law and point to California as a model for the rest of the nation.

California is farther along than most other states in the process of setting up its health care exchange -- its online marketplace where consumers will be able to comparison shop for private insurance plans. Democrats are thrilled that the rates insurers plan on offering on the California exchange are lower than expected, seemingly undercutting concerns that insurance prices will spike as the new, state-based exchange system gets up and running. Every state is expected to have its own exchange ready for open enrollment by October, though several states have opted to let the federal government run their programs.

It's unclear, however, how the insurance marketplaces in California and across the country will evolve in the coming years. Experts say Obamacare's success will depend largely on getting young and healthy people to enroll through the exchanges. There are about 2.6 million to 2.7 million people across the country who are young, healthy and uninsured, and about a third of them are in California, Texas and Florida. While California's system appears primed for success, getting those young people on board could be much more of a challenge in places like Texas or Florida, where lawmakers have been less eager to see Obamacare work.

California's exchange, called Covered California, is awarding $37 million in grants to organizations expected to help the state conduct outeach to communities of uninsured Californians. That outreach will largely focus on Hispanic communities; there are about 2.6 million Californians who will be eligible for government subsidies to spend on the exchange, and nearly half are Latino.

To that end, the California Endowment (a private, statewide health foundation) is partnering with Spanish-language media in California like Univision and Telemundo to reach out to Latinos. The organizations plan on using all media platforms, including television, radio and social media, to conduct outreach.

"It is precisely this kind of community-based, on-the-ground community effort that is going to make the implementation of Obamacare a success," a senior Obama administration official told reporters Thursday.

Outreach, however, may prove more difficult in Texas and Florida, where Republican lawmakers have resisted the implementation of the health care law. Both states are opting to let the U.S. Health and Human Services Department run their respective exchanges.

Senior administration officials insist that HHS will be able to fund outreach in the 33 states where it is running exchanges. In addition to dispatching "navigators" -- community leaders trained to guide people through the enrollment system -- the federal government is spending $150 million in supplemental grants for community health centers. The administration says community health centers are "quite prevalent" in Texas and Florida, and have inroads in the communities they'll want to target.

"Even though there might not be support in some state capitals, this is going to be a very community-based and regional effort," a senior administration official said.

There are other factors that could impact the development of the exchanges, including regulation of the private insurers on the exchange. California, for example, is just one of six states with "active purchaser" policies, according to the Washington Post. That means the state is actively selecting which private plans are allowed onto the marketplace, rather than allowing any plan that meets certain thresholds to join. The "active purchaser" policy theoretically creates more competition among the insurers interested in getting access to the new customers on the exchange; thus, states without "active purchaser" policies could see higher prices.

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