Latest California Healthline Stories
Geographic Regions Set at Six, But Only for Now
Floor votes in the Assembly and Senate yesterday approved the first bills of the special session on health care. The bills would eliminate pre-existing conditions as a means for denying health insurance coverage. They also would establish new geographic rating regions to help determine variable rates by area in California, one provision in the bills that recently has become contentious.
The Assembly passed ABX1-2 by Assembly member Richard Pan (D-Sacramento) on a 53-25 vote. The Senate passed its version of the bill, SBX1-2 by Ed Hernandez (D-West Covina), where the vote was 26-10-1.
Most of the objections raised yesterday on the Senate and Assembly floors to the two bills came from Republicans who oppose the Affordable Care Act. No one raised objections to the number of geographic rating regions, but that’s one detail in both bills that’s still wide open to change.
Uncertain Assumptions in Health Care Budget Estimate, LAO Says
Two reports released yesterday by the Legislative Analyst’s Office analyzing Gov. Jerry Brown’s proposed health care budget for 2013-14 found a number of points of concern, according to Mark Newton, deputy legislative analyst at the LAO.
“What we wanted to do is lay out that there are some budget risks here,” Newton said. Many of those risks, he said, should still be in the budget, but they remain important fiscal unknowns, rather than dependable income sources.
“[Some of this] is not meant so much to be a critique, but more a recognition of budget uncertainty,” Newton said.
Bridge Plan Approved by Exchange Board
California’s Health Benefit Exchange board yesterday approved a plan to seamlessly allow low-income Medi-Cal managed care beneficiaries to choose a health plan offered by the exchange, now known as Covered California.
The idea is to allow movement between Medi-Cal and Covered California when beneficiaries’ circumstances change, so more people can stay insured without disruption. The exchange plans to launch the program in April 2014.
Up to 840,000 Californians could be eligible for it, according to David Panush, director of government relations for Covered California.
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.”
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.
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.
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.
Race, Gender, Age Lead to Disparities in Care
Health care providers from around the state gathered in Sacramento this week to examine disparities in medical care. They started by examining their own treatment of patients.
The annual conference of the California Association of Physician Groups took an unusual approach Wednesday to improving care, focusing on possible misconceptions or biased treatment by physicians of some patients.
The conference looked at possible disparities in treatment of Muslims or other culturally different patients, bias based on appearance and even bias toward patients who can’t be cured.