Latest California Healthline Stories
State Considers Coverage Mandates
The deadline to pass legislation left over from last year has come and gone, with single payer, insurance rate regulation and the basic health plan all temporarily halted. The next big legislative push is coming up fast, as all new bills for 2012 have to be introduced by the end of next week, on Feb. 24.
A number of health-related laws recently were passed by the state Senate or Assembly. Many of them call for coverage mandates by health insurance providers.
Health Reform Shifting From Planning to Action
California’s Health Benefit Exchange is about a year from testing, and the state is pushing ahead with changes to Medi-Cal, Medicare and Healthy Families. Participants at a conference last week in Sacramento tried to put all the health care reform action into perspective.
Report Looks at SHOP Exchange Viability
The first series of forums put on by Small Business Majority went to small towns and cities across California to raise the notion of a business-specific health insurance exchange — the Small Business Health Options Program, known as SHOP. The idea is to pool small business resources and buying power — separate from the California Health Benefit Exchange’s individual market — so business owners can get a better, more financially stable option for health insurance.
Now, a second set of forums — with experts from California, as well as from other states that have tried similar projects — has finished. This week the Small Business Majority released a report summarizing the points brought up in those forums.
“Affordability is the number one issue to small business owners,” according to Terry Gardiner of Small Business Majority. “Most companies who have not offered insurance say it’s because it’s too expensive, they cant afford it. And the ones who actually are providing coverage, they are struggling.”
Same Providers in Healthy Families and Medi-Cal?
Yesterday’s distribution of a summary of new Healthy Families data by the state Department of Health Care Services caused some advocates to scratch their heads.
The state wants to move 875,000 children out of Healthy Families and into Medi-Cal in the next 16 months. It’s an idea that has been floated before, and has been vigorously opposed by providers, who would rather have the higher reimbursement of Healthy Families. California’s Medi-Cal reimbursement rates are among the lowest Medicaid rates in the nation.
The new data indicate most providers and health plans in the Healthy Families program also serve Medi-Cal beneficiaries.
Health Care May Play Part in California Political Makeover
With retirements on both sides of the aisle, new congressional districts and new voting rules, California’s political makeup is headed for change in both Washington, D.C., and Sacramento. A couple of health care issues — a controversial Medicare plan in Congress and a state ballot proposal to regulate health insurance premiums — could play a part in how those changes happen.
Douglas: Healthy Families Similar to Medi-Cal
State Department of Health Care Services Director Toby Douglas explained the reasoning behind the state’s plans for the Healthy Families program during the Insure the Uninsured Project’s 16th annual statewide conference in Sacramento yesterday.
Acknowledging that the proposal to shift 875,000 children out of Healthy Families and into Medi-Cal on a relatively fast timeline is a little controversial, Douglas said it’s part of a bigger plan.
“It’s all about delivery system reform,” Douglas said. “It’s about moving toward organized delivery systems.”
State Choices on Essential Benefits May Become More Complicated
Stakeholders are responding to HHS’ recent bulletin giving states a large hand in determining “essential health benefits” to be offered through insurance exchanges in 2014. In California, officials are trying to determine how to handle a growing list of state-mandated benefits within the exchanges.
Study: Uninsured Face Similar Debt as Medi-Cal Beneficiaries
More Californians are borrowing money to pay for health care services — and two-thirds of them have medical insurance, according to a new study by the UCLA Center for Health Policy Research.
“When you think you’re insured, you still end up paying a percentage and that adds up, into thousands of dollars,” report author Shana Alex Lavarreda said. “So having insurance doesn’t mean you will have things paid for.”
Another surprising finding, Lavarreda said, is that uninsured Californians face a similar medical debt level to those who have insurance through Medi-Cal.
New Report Offers Healthy Families Alternatives
The state wants to shift 875,000 children in the Healthy Families program into Medi-Cal over a nine-month period, beginning in October. The state estimates the move will save $156 million over the next two fiscal years.
But according to a soon-to-be-released study, that plan could limit access to care for California’s children, and the state might be better served to move more slowly.
A report commissioned by the Urban Institute looked at four possible directions for the Healthy Families program. Report author Stan Dorn said the move to Medi-Cal has some definite advantages for California children — particularly for those at or below 133% of the federal poverty level. Those children will make that transition in 2014 anyway, as required by the Affordable Care Act.
Do Long-Term Care Patients Need a Stronger Advocate?
Change may be coming to the state ombudsman’s office for long-term care, whether it likes it or not. Proposed legislation to strengthen advocacy and increase the independence of that agency has been greeted with stern resistance from the agency itself.