Calif. Health Exchange Delays Action on Model Health Plan Contract
On Tuesday, the board of Covered California -- the state's health insurance exchange -- announced that it plans to delay until next month any action on its proposed model health plan contract, the Sacramento Business Journal reports.
The board heard testimony from health insurers on various issues related to the model contract.
Collection of Data
At the meeting, health insurers expressed concern about collecting sensitive data on enrollees that health plans currently are not required to obtain. Such data include:
- Disability status;
- Gender identity;
- Race; and
- Sexual orientation.
Charles Bacchi -- executive vice president of the California Association of Health Plans -- said, "We're concerned we'll not be able to meet the requirements in time."
In addition, some health insurers objected to a portion of the model contract requiring all members of health plans in the exchange to be assigned to a primary care physician.
Members of the exchange staff proposed a revision to encourage assignment of primary care physicians when applicable or required by a health plan but to make automatic assignment optional.
Regulation of Health Plans
Meanwhile, some insurers expressed concern that the exchange will have too much regulatory power.
Exchange officials want stricter rules in certain areas to ensure access to care and program viability, but health plans worry that Covered California will assume regulatory authority already delegated to other state agencies.
The newest language in the model contract would defer to such agencies on certain issues, such as:
- Financial insolvency; and
- Utilization review.
Language of Insurance Information
Health insurers also discussed strategies for translating policy information into multiple languages to better serve a diverse group of new members.
The latest version of the model contract requires that website information and communication with enrollees be available in both English and Spanish.The board is expected to hold a special meeting May 7 to take final action on the model contract (Robertson, Sacramento Business Journal, 4/24). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.