Advocates Fault Governor’s Health Reform Plan for Reliance on Rulemaking
Health care advocates who are concerned that provisions of Gov. Schwarzenegger's revised health care reform plan would be caught up in the state rulemaking process got an example of how that process can run over everyone's expectations this week.
Officials from the Managed Health Care and Insurance departments on Tuesday released new rules aimed at clarifying the circumstances under which health insurers can cancel individual policies. DMHC Director Cindy Ehnes had expected the rules to be out in spring 2007.
The issue came up in December 2006, following complaints from patient advocates and consumers that California insurers were retroactively canceling policies after members submitted claims. DMHC officials in September said that the process had been delayed by longer-than-anticipated investigations of five insurers and efforts to make sure that the rules would apply broadly to California health plans.
In his revised health plan, the governor called for the Secretary of the Health and Human Services Agency to use the regulatory process to define the minimum benefits that health plans would have to offer. The change in how that definition will be made isn't expected to draw much support next week when lawmakers begin hearings on the governor's updated overhaul plan.
Meanwhile, a key workers' compensation insurance industry group revised its rate recommendations for policies issued or renewed in 2008 after analyzing legislation (AB 338) signed by Schwarzenegger that extends the period for paying disability benefits from two years to five years.
The group initially advocated a rate increase of 4.2% but pushed that up to 5.2% after taking into account the extended payment period for disability benefits.
Here's an overview of how other workers' compensation legislation fared with Schwarzenegger.