David Gorn

What’s in the Exchange Name?

A few ideas for a new name — ranging from the expected, traditional options to the less expected, non-traditional  — were floated at yesterday’s Health Benefit Exchange board meeting.

The board’s executive director, Peter Lee, also announced yesterday that the federal government just approved the exchange’s Level 1.2 grant request for $196 million. The exchange staff has already started working on the next grant request, a Level 1.3 establishment grant, which will be submitted to federal officials in November, Lee said.

The board had a full slate of issues to handle at yesterday’s meeting — from working out the details for how agents would be paid in SHOP exchanges to decisions about premium aggregation.  But the buzz in the room circulated around what name the exchange will have in 2014.

One Stage Down, Many More to Come

Health and Human Services Secretary Diana Dooley summed up the state of health care in California pretty succinctly at Tuesday’s health task force forum:

“With the economy down in California, there are more people needing services,” Dooley said, “and less money to provide it.”

That conundrum is at the heart of the creation of the Let’s Get Healthy California task force, which finished its first stage of discussions Tuesday.

Senate OKs Oral Chemotherapy Mandate

Health insurers will need to cover oral chemotherapy medication if a bill passed Monday by the Senate is signed by the governor.

Today, the Assembly is expected to concur on AB 1000 by Henry Perea (D-Fresno), a decision that would send the bill to the governor’s desk for a signature.

The mandate on oral chemotherapy coverage would not necessarily apply to coverage within the Health benefits for the exchange, but said he has not yet had conversations with the Benefit Exchange. Bill author Perea said he’s talking with legislators about the possibility of including oral chemotherapy medication among the essential health exchange staff.

Keeping Providers in the Loop

With so many changes in Medi-Cal services and reimbursement rates, the state has been working on a system to constantly update and alert physicians, nurses and other providers about the latest wrinkles in Medi-Cal administration.

“We’ve never offered this before,” said Dan Nand, web content lead at Xerox State Healthcare, which is working with the state Department of Health Care Services on the updating project. “Providers have never had a chance to do this before. Now they’ll be able to read all of the announcements by desktop, or by mobile phones.”

The idea is to have a series of networks, like an advanced kind of listserv system, Nand said, in which providers can sign up for specific specialty areas, such as acupuncture or long-term care.

Most Californians Support Reform, Poll Shows

A Field Poll released today shows that only 17% of Californians are aware of the state’s nascent Health Benefit Exchange but a a high percentage of Californians like the basic tenets of health care reform and the exchange, according to Mark DiCamillo, director of the Field Poll.

“It’s definitely low, and that is somewhat to be expected, given that they haven’t done any outreach or marketing yet,” DiCamillo said. “What will really be interesting is how much we see that change over time, whether there is greater awareness among certain subgroups later, as the exchange gets closer to actual operation.”

In general, DiCamillo said, opinions about the exchange and reform mirror political affiliation. Favorable opinions about health care reform tend to run higher in California.

Basic Health Plan Not Among Slew of Approved Bills

The demise of the Basic Health Program in California came quietly.

When SB 703 by Ed Hernandez (D-West Covina) came before the Assembly Committee on Appropriations and committee yesterday, chair Mike Gatto (D-Los Angeles) had seven words for it: “That bill goes to the holding committee.”

Those seven words effectively ended BHP for this legislative session, though it may come back again in 2013.

Amendments Could Move Basic Health Program to Floor Vote

Today a bill to create a state Basic Health Program comes before the Assembly Committee on Appropriations, with the intention of getting sprung out of committee and to the legislative floor for a vote.

SB 703 by Ed Hernandez (D-West Covina) is currently “on suspense” — a kind of legislative limbo for bills with significant potential fiscal impact on California.  All bills with a financial impact of $150,000 a year or more have to be put on the suspense file. The appropriations committee can then evaluate all of those bigger-ticket items collectively, so that the committee can better regulate how much spending it approves.

Hernandez has been proposing amendments that would lessen the potential financial impact of SB 703, and today the committee will decide whether or not to remove the bill from suspense.

Task Force Tackles Access, Coverage, Workforce Issues

The state’s health care task force met yesterday with an ambitious end goal and a complex agenda that broached access and coverage issues, as well as health workforce concerns.

The end goal, according to Diana Dooley, HHS Secretary and a co-chair of the task force, is embodied in a single question: “What will it take for California to be the healthiest state in the nation?”

Getting to that simple question is a complex, multi-layered, 10-year effort. Yesterday’s meeting was the third of four opening workshops of the Let’s Get Healthy California Task Force, formed by executive order of Democratic Gov. Jerry Brown.

Will Basic Health Program Hurt, Help Exchange?

An analysis of a proposed Basic Health Program and its impact on the Health Benefit Exchange offers a mixed bag of pros and cons for exchange leaders and legislators.

The nascent Basic Health Program, if passed by the Legislature, would target a large percentage of possible exchange participants. So the question lawmakers have been wrestling with is: Would that be a good or a bad thing for the exchange, and for Californians?

That’s the question tackled by the exchange itself. On Monday, it released an independent analysis by the UC-Berkeley Labor Center and the UCLA Center for Health Policy Research, which was commissioned by the exchange board.

Ombudsman, Immunization Bills Up for Floor Vote

Dozens of health-related bills passed through committee last week, setting up pending floor votes starting this week.

The last hurdle for many bills is the appropriations committee of each house. Those committees ran at high speed last week, churning out approvals for hundreds of bills.

The Legislature has until the end of August to vote on all bills.

Some of the health-related bills that cleared committee last week: