Individuals Fall Through Policy Cracks
Is this a case of not seeing the trees for the forest?
A year after the Department of Managed Health Care concluded that at least 90 sick people had their health coverage improperly canceled, state regulators have not ordered those policies to be reinstated.
That raised the eyebrows of some members of California's Senate Health Committee, when the panel called a hearing last week to discuss the state's investigation of cancellations by Blue Cross of California -- now know as Anthem --and other insurers.
According to DMHC, following through to make sure those policies were reinstated is not the main objective.
Amy Dobberteen, the agency's enforcement chief, told the Senate Health Committee the main goal of the investigation of Blue Cross was to identify "system failures," not review individual cancellation cases.
"Remedial action remains to be determined" in the Blue Cross cases and other cancellation cases being reviewed by the department, according to Cindy Ehnes, DMHC's director.
But that didn't fly with Sen. Sam Aanestad (R-Grass Valley), vice chair of the Senate Health Committee.
"It just seems to me the priorities here seem to be reversed," Aanestad said. "If we're into consumer protection, the first priority would be to reinstate the insurance coverage for the patient who needs the health care. The second priority in my mind is to fine the plan and make the big headlines and change the industry."
The issue remains a big concern for lawmakers this year as they consider legislation to tighten regulation of health plans in California.