The nation’s second-largest insurer is shrinking its presence on Obamacare exchanges and in the broader individual market in response to prevailing uncertainty. California is just the latest — and the biggest — example.
In the first case of its kind in the U.S., the company was ordered to pay damages to the hospital where a patient died of an infection linked to a contaminated scope. But jurors also found the hospital negligent, and it was ordered to pay the patients’ family $1 million.
The failure this week of the U.S. Senate’s ACA repeal effort was one more twist in the ongoing political drama that has complicated routine rate setting for insurers and state officials.
The Seattle case, the first to reach trial in the U.S., offers possible glimpse into fate of some two dozen lawsuits against manufacturing giant Olympus, accused of failing to address scope contamination linked to numerous deaths. The company faults poor hospital cleaning practices.
The legislation would revive the age-old practice of paying providers for every service they perform — a recipe for a busted budget, some experts say. Backers say the bill is a work in progress.
“It’s unconscionable that such a basic, security 101 flaw could still exist at a major health care provider,” says one cybersecurity expert.
A state Senate panel considering the measure said money for existing public programs could cover half the cost. But the rest might have to come from new taxes — a serious political obstacle.
Covered California enrollees continue to be among the healthiest in the nation, which exchange officials hope will hold down rate hikes next year.
The health care industry thrives on ordering up tests and treatments, but some hospitals are urging restraint.
With limited federal subsidies under the GOP health care bill, experts say states like California and New York would be under pressure to cut costs. That could mean shrinking benefits and dropping the prohibition against charging sicker patients higher premiums.