Latest California Healthline Stories
Healthy Interest in Reform from Small Businesses
California’s small businesses are embracing the tenets of health care reform, according to John Arensmeyer, CEO of the Small Business Majority.
“The more people learn about it, particularly about the tax credits [offered by the Affordable Care Act], the more interested they are,” Arensmeyer said. “The real problem is that it’s a little unknown, so it’s important to get people to understand what’s in it.
According to a recent report by Bernstein Research in New York, more small-business employers — those with three to nine workers — are offering health insurance this year. Nationally, the number of small businesses offering insurance increased by 13 percentage points in a year, from 46% to 59%.
Primary Care Might Get its Due With Health Reform
It’s hard to delineate the possible progress being made in fixing the primary care problem in California and the nation, without first looking at how bad that problem is, according to Kevin Grumbach of the UCSF Department of Family and Community Medicine, who addressed an audience of health professionals at UC Davis Medical Center in Sacramento this week.
“Health systems and regions built with primary care have better outcomes, better quality of care, lower costs and more equitable care,” Grumbach said.
“The trouble is, we’re finding that the whole foundation of primary care is crumbling.”
New Commissioner Eager To Get Started
The role of California’s insurance commissioner will change quite a bit during the current term. It’s a job that oversees a huge agency, with 1,300 employees charged with evaluating, regulating and policing the home, car and other insurance industries in California. Its approach to health care insurers, though, historically has been different than its authority over other insurance industries. That is about to change and expand in several ways.
After Tuesday’s election, the new commissioner, Dave Jones, said he is “eager and excited” to oversee those changes.
“I’m looking forward to all of it,” Jones said. “I’m excited at the prospect of making this office the state’s most important consumer protection agency. And I’m excited at the prospect of playing a leadership role in implementing health care reform in California.”
New Waiver Sets Bar High for Other States
“It was a long wait,” Norman Williams of the state’s Department of Health Care Services said with a slight sigh. “But it was worth it. This is a good day for California.”
Williams is talking about the Medicaid waiver, which sets the structure and facilitation requirements for California’s Medi-Cal program. The waiver is worth up to $2 billion a year in federal funding to California for the next five years. This waiver is a huge accomplishment, Williams said, because it takes all the elements of national health care reform, and puts them into practical use.
“This is such an important step,” Williams said, “because it allows us to completely restructure California’s health care system, and to rein in costs in Medi-Cal.”
Insurance Commissioner Race Generates Direct, Indirect Funding
So far, the two main candidates for insurance commissioner in California have spent a total of about $4 million in direct money on this campaign, according to the Secretary of State’s office, with another estimated $3 million coming from independent expenditures, or IEs — ads produced independently but that support a specific candidate or attack his opponent.
According to government expenditure records, Republican Mike Villines, a member of the Assembly from Clovis, has about $850,000 to spend on this election. He also has benefited from about $2.2 million in spending by JobsPAC, the political action committee of the California Chamber of Commerce.
In contrast, the campaign of Democrat Dave Jones, Assembly member from Sacramento, has raised almost $3 million. He has received another $590,000 in spending by various special interest groups, mostly labor and law interests, with most of it coming from the California Alliance.
Friday Is New Deadline for Waiver
State health officials get another few days to fine-tune the complex and multi-faceted Medicaid waiver, a plan that is expected to revamp and expand California’s Medi-Cal program. The waiver is worth about $10 billion in federal money over the next five years.
On Friday, CMS granted the extension in a letter to California’s Department of Health Care Services, saying that the agreement was close to finalization and that the extra few days are necessary to finish the “Bridge to Reform” demonstration.
“With these extra few days, we are confident we can finalize the documentation and provide the State with an approval of the Demonstration,” the extension letter said.
Agreement Expected Today on Medicaid Waiver
The formal deadline for wrapping up negotiations on the federal Medicaid waiver for California is Oct. 31, and state officials say it might go right up to the deadline. But since that deadline is on Sunday, health care policy experts are expecting an agreement to be formalized and announced two days earlier than that — by today.
The Medicaid waiver is a complex and multipronged plan to revise the state’s Medi-Cal program and prepare California to implement national health care reform.
California stands to receive about $2 billion a year in federal money over the next five years in the agreement. Roughly half of that is in new money — money beyond what the federal government currently pays per year to help fund Medi-Cal, California’s Medicaid program.
More Oversight Ordered for California’s Nursing Homes
California is going to get 70 more investigators to monitor conditions at nursing facilities around the state, according to state officials.
The Department of Public Health, along with the state legislature, has made an increasing push to raise levels of monitoring and enforcement for California nursing facilities.
From the legislative side, recent passage of SB 853 (a trailer bill passed during budget finalization and recently signed by the governor) pushes for more nursing home inspections.
Ripple Effect Might Hit Non-Medicare Patients
The poll numbers were not good. About 67% of physicians in America said they’ll likely see fewer Medicare patients, and well over half of American physicians said they intend to cut administrative or clinical staff, if the roughly 30% cut in Medicare reimbursement goes through at the end of this year.
That’s according to a national report this week from the Medical Group Management Association.
“I think you’d find similar answers in California,” Andrew LaMar of the California Medical Association said. “Physicians will be in tough financial straits if they have to take a 30% cut in Medicare. And it will have a huge effect on access to care in California.”
Coverage Begins for High-Risk Enrollees
After setting an ambitious timetable for startup and then hitting delays for almost a month after its scheduled launch, the state’s Pre-Existing Condition Insurance Plan officially started enrolling patients yesterday.
The program will use $761 million in federal money to help insure Californians who cannot get health insurance coverage because of pre-existing conditions. So PCIP helps provide coverage to people who would not otherwise get it.
“We’re very happy for the people of California who need this,” Jeanie Esajian of the state’s Managed Risk Medical Insurance Board said yesterday.