Latest California Healthline Stories
Lawsuit Raises Issue of States’ Ability To Cut Insurers’ Rates
Last week, the National Association of Insurance Commissioners filed a brief expressing concern over a Maine lawsuit that challenges the state’s authority over health insurers’ profits, arguing that a decision likely will affect how state insurance regulators can restrict rate increases. On Nov. 10, the state’s Supreme Court will hear oral arguments by Anthem Health Plans of Maine, which alleges that state insurance regulators violated state law and acted unconstitutionally in requesting reduced premium increases in the past three years. In siding with Maine regulators, NAIC said that the court’s decision “has the potential to destabilize a key aspect of insurance regulation and will have far-reaching effects impacting all states” if the court rules in favor of Anthem. Kaiser Health News/Washington Post.
Report: 2.5M Children in State at Risk of Exposure to Secondhand Smoke
Although California has the second-lowest smoking rate in the U.S., nearly 2.5 million children ages 12 and younger in the state are exposed to secondhand smoke at home, according to a UCLA Center for Health Policy Research study. United Press International et al.
Opinion: Federal Health Care Cuts Could Jeopardize Jobs
“Since the start of the Great Recession, California has lost 1.3 million jobs, [but] health care is one of the few sectors actually creating jobs, especially in hospitals,” Thomas M. Priselac — president and CEO of Cedars-Sinai Medical Center — writes in a Los Angeles Times opinion piece. “The congressional ‘super committee,'” tasked with reducing the federal deficit, is considering “a proposal reported to slash $500 billion” from Medicare and Medicaid, Priselac writes. The proposed cuts “may seriously jeopardize those jobs, threaten the availability of health care services in some communities and add to the challenge of making commercial health insurance more affordable,” he adds, concluding that “we must do everything we can to save the jobs we have, especially those that are so vital in taking care of the health of everyone in the community.” Los Angeles Times.
Brown’s Pension Reform Plan Receives Mixed Reaction
On Thursday, Gov. Brown unveiled a 12-point pension reform plan that would increase public employees’ contributions toward health care costs, raise the retirement age to 67 for most new employees who are not in public safety positions and implement a “hybrid” system featuring a traditional pension combined with a 410(k)-style investment. The California Chamber of Commerce, the California Business Roundtable and some Republican lawmakers praised the plan, while labor groups objected to key proposals of the plan. Brown acknowledged that his plan likely will encounter difficulty in the Legislature, which is controlled by Democrats who have close political ties to labor groups. Los Angeles Times et al.
California Hospital News Roundup for the Week of October 28, 2011
Kaiser Permanente is preparing to open its new $550 million, 386,000 square-foot hospital in Ontario on Nov. 1. Meanwhile, Mt. Diablo Health Care District recently retained an attorney, awarded grants and voted to hire a general manager as part of an effort to avoid dissolution.
Medicare Premium Increase To Be Less Than Expected
Monthly premiums for Medicare Part B, which covers physician visits and outpatient procedures, will rise by $3.50 next year to $99.90. Earlier this year, Medicare trustees projected that premiums would increase by $10.20. Obama administration officials attributed the lower rates in part to cost-cutting provisions under the federal health reform law and beneficiaries’ lower use of services. Wall Street Journal.
Federal Officials Approve State’s Plan To Slash Medi-Cal Payments
CMS has approved California’s request to reduce some Medi-Cal provider payments by 10%. The state has withdrawn other proposed cuts and is awaiting a decision on whether it can set copayments and cap doctor visits for beneficiaries. Sacramento Bee et al.
Mass. Plan Aims To Reduce Costs for Dual Eligibles’ Care
Massachusetts officials recently unveiled a proposal to create a managed care program for residents eligible for both Medicaid and Medicare as part of a broader effort to cut spending for dual eligibles’ care. The plan is projected save about 2% of the $4 billion the state spends annually on dual eligibles by shifting 115,000 beneficiaries into a managed care program. The plan calls for the state to employ “integrated care” organizations that could include private or other third-party insurers and hospital networks, as well as “care teams” that would provide and coordinate acute, behavioral and long-term care services. Wall Street Journal.
More Consumers Requesting Health Insurance Pricing Data
As more consumers choose high-deductible health insurance plans, they are seeking additional information on health care costs. As a result, many employers are pushing health insurers to provide details about costs so workers can select the least costly services. However, experts say some insurers have been reluctant to disclose pricing data because contracts with health care providers might require such details to be kept private. Wall Street Journal.
Pre-Existing Condition Health Plan Enrollment Still Well Below Capacity
The state’s Pre-Existing Condition Insurance Plan has enrolled 5,000 individuals after one year, but officials have estimated that the program could support enrollment of up to 25,000 individuals annually. Sacramento Business Journal, Managed Risk Medical Insurance Board release.