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Latest California Healthline Stories

Rating Regions Headed for Floor Debate

The debate over geographic rating regions has not ended, despite being approved by the Assembly and Senate health committees last week and by the Senate Committee on Appropriations on Friday.

Competing interests want to change it — in different ways.

At the appropriations committee meeting Friday, two groups took oppose-unless-amended positions on the six-region legislation, but were not in agreement on how to divide the geographic rating regions in California.

Officials Dispute Suggestion of ‘Wrong’ Estimate

Managed Risk Medical Insurance Board officials last week bristled at the suggestion that MRMIB somehow made a bad estimate of its budget that resulted in a $116 million general fund shortfall in the Healthy Families program. With an additional $216 million in federal money that hasn’t come to California because of the shortfall, the total deficit now amounts to $332 million, according to MRMIB executive director Janette Casillas.

Casillas, at a MRMIB board meeting last week, responded to state officials’ comments that the shortfall stemmed from a mistaken estimate for how much money would be needed for the Healthy Families program in 2013.

“Our forecasting and budget assumptions have been right on every time,” Casillas told the board. “But what has occurred here is not a challenge with budgeting or forecasting, but with the budget process itself. We know what we need, it’s not about making wrong assumptions.”

Individual Market Reforms Called ‘Historic’

Two bills in the California Legislature are reshaping the state’s individual insurance market by “fundamentally changing the rules that insurers play by,” according to consumer advocates.

Historic Week in Health Care Reform

California has been working on health care reform for years, but this week’s legislative special session had that distinctive sound of a starting gun for the last, big dash toward the Affordable Care Act finish line.

On Tuesday, when Assembly Committee on Health chair Richard Pan (D-Sacramento) convened the opening hearing for the special session on health care, it clearly meant a lot to him.

“Welcome to the first extraordinary session of 2013,” Pan said. “As you know, California has been the first in the nation to establish a health benefit exchange under the Affordable Care Act. … We are bringing California in line with the new culture of care.”

Deadline Set to End Federal High-Risk Pool

Managed Risk Medical Insurance Board officials yesterday outlined plans to deal with the federal announcement that the Pre-existing Condition Insurance Plan will not accept new applicants after March 2.

The federal PCIP program will continue to provide coverage for enrollees through the end of the year. The program will no longer be needed in 2014 when the Affordable Care Act provision that insurers may not deny coverage because of pre-existing conditions takes effect.

Janette Casillas, executive director of MRMIB, which runs the federally funded plan, said some prospective enrollees could apply for a similar, state-funded program called the Major Risk Medical Insurance Program.

Campaign Against ‘Junk Drinks’ Will Grow, Experts Predict

Two new studies released last week — one showing that anti-tobacco efforts saved California money over the past two decades and the other showing growing support for a tax on sugary drinks — may foreshadow new health care policy on the horizon.

State-Based Expansion Makes More Sense, LAO Says

After conducting a review of the two choices California officials are considering for optional Medi-Cal expansion, the state Legislative Analyst’s Office yesterday strongly recommended the state-based option, rather than a county-based plan.

On a busy Tuesday for health care policy in Sacramento, the Assembly Committee on Health yesterday convened the first hearing of the legislative special session on health care reform and passed the first component of it, AB 1X-1 by Assembly Speaker John Peréz (D-Los Angeles).

The proposed bill establishes the framework to expand Medi-Cal to childless adults under age 65 in California, up to 138% of federal poverty level. It would streamline the eligibility and enrollment process to follow the mandate of the Affordable Care Act, and offer California’s version of federally-required essential health benefits.

Higher Cost, Inferior Care: Dental Health in Emergency Departments

More people are seeking dental care in emergency departments as dentists turn away Medicaid patients. Does the Affordable Care Act present a solution to this costly trend, or must states look elsewhere?

UC System May End Health Care Caps, Making New Bill Moot

A bill introduced last week, AB 314 by Assembly member Richard Pan (D-Sacramento), would eliminate fiscal caps on medical care for University of California students.

UC officials said they’re considering their own internal proposal to erase the caps, which would make the proposed legislation moot, but bill author Pan said he plans to go ahead with the legislation to ensure the rule is changed.

“It’s only fair that [UC students] should have the same protections as the rest of California,” Pan said, referring to provisions in the Affordable Care Act that prohibit lifetime caps on care. Even people in high-risk insurance pools had lifetime caps lifted last year.

New Navy Hospital in San Diego Sign of the Changing Times

San Diego’s new Navy hospital, which will have relatively few inpatient beds but a busy flow of outpatients, is described by one consultant as “a great example of what everybody else should be looking to do in their communities.”