Latest California Healthline Stories
Waiver, Medical Home Bills Linger on Agenda
The Legislature, expected to reconvene soon to pass the budget, will also deal with some legislative leftovers.
Two bills relating to the Medicaid waiver are expected to be approved in both houses.
The fate of a another bill dealing with medical homes is harder to predict.
Can Health Care Reform Rein in Costs?
One of the main goals of health care reform — lowering the cost of care — was a major focal point last week at a policy forum in San Francisco hosted by the New America Foundation.
“There are a huge set of provisions in [the national health reform law] that are already working to make coverage more affordable,” Herb Schultz, regional director of the U.S. Department of Health and Human Services, said. “The truth is, it’s not a 2014 thing,” Schultz said. “There are a heck of a lot of things happening in 2010 and 2011.”
Schultz pointed to the recent enactment of provisions to extend dependent health care coverage to age 26, and the elimination of pre-existing conditions as a basis for denying coverage to children under 19. In the past, taxpayers generally paid for treating those uninsured people, he said, rather than insurers.
“Everyone thinks that January 2014 is years away,” California HHS Director Kim Belshé said. “But 2014 is tomorrow.”
Belshé is referring to setting up the California Health Benefit Exchange, now that the governor signed two exchange bills into law yesterday.
The exchange has to be operational three years from its inception, on Jan. 1, 2014 — but that’s the blink of an eye for a project of this scope and importance, Belshé said.
State Officials Anxious for Word on Medicaid Waiver
At the bimonthly stakeholders’ meeting for the Medicaid waiver yesterday, all eyes turned to the front of the room, where David Maxwell-Jolly was about to speak.
Maxwell-Jolly is the director of the state Department of Health Care Services, and he had just been asked about the status of negotiations with CMS over California’s $10 billion Medicaid waiver. The state, facing a deadline of Oct. 31 to come to final agreement on the waiver, is stuck in idle until the federal agency comes up with a draft of what it likes and doesn’t like about California’s plan.
“We don’t have a draft at this point.” Maxwell-Jolly said. “Any day now, we should be getting it.”
The biggest of many decisons the governor faces this week involves creation of the California health care benefits exchange, and no one seems to know which way he’ll go on it.
One of the factors that has fueled the push toward a possible veto of the bill is a report that has many Capitol staffers hopping mad. It was written by Mike Genest, Gov. Schwarzenegger’s former director of the Department of Finance, and it was commissioned by the California Chamber of Commerce, one of the more vocal opponents of the exchange.
According to multiple sources, some of whom requested anonymity, the report promulgates several major fallacies about the power and scope of the proposed benefits exchange:
Powerful Move To Short-Circuit the Exchange
The biggest and most ground-breaking piece of the California health care reform puzzle might just stay in the box.
The health care benefits exchange that would be created if the governor signs two bills (AB 1602 and SB 900) that were approved by the Legislature would be similar to an exchange set up in Massachusetts, but would be the first of its kind in the nation established to conform to the national health care reform law.
The governor has been getting a big push from Anthem Blue Cross and the California Chamber of Commerce to veto those bills, according to government officials and health care advocates.
Decision Time in Governor’s Office
This is the week. After months of debates and votes by the state Assembly and Senate, hundreds of bills were passed and sent on to the governor for his signature.
And those bills are still waiting for a signature. In part, that’s due to the absence of a state budget. But now, the governor has just four more days to sign or veto the pile of bills in front of him. The deadline is Thursday, Sept. 30.
There are several dozen health care bills pending, including many that reinforce or help implement the national health reform law. The governor is expected to sign most of them — but that doesn’t mean there hasn’t been a behind-the-scenes battle raging over some of them.
Grant Money Funds New Online EHR Help
There is an enormous effort nationally and within California to get physicians — particularly primary care physicians — to convert to electronic health records. The group least equipped to make the switch are the cash-strapped, time-challenged, small-office family medicine practices.
That’s where Susan Hogeland of the California Academy of Family Physicians hopes to step in and make a difference.
CAFP just received a grant from the Physicians Foundation to try an interesting project — to reach physicians in California online, to remotely help them research, fund and implement EHR systems in their offices.
Trying To Beat Denials Before They Happen
Railing against the health insurance fates is just not Jayne Kroner’s style.
Kroner, VP of business development at the Cirius Group, a California health care financial consulting firm, said she’d rather deal with the reality of insurance denials.
“If you have the right mindset to know it’s a fact of life, it becomes like a wellness program for your hospital and physician claims,” Kroner said. “You want to prevent denials.”
Health Care Reform Eyes on California
As the CEO of the Small Business Majority, an advocacy group for small businesses in California, John Arensmeyer has traveled the state recently on a “listening tour” — and he’s been heartened by what he’s heard.
“We’re certainly hearing a lot of questions about health care reform,” Arensmeyer said, “but there is universal agreement across the board as to the whole concept of setting up the [California health benefits] exchange.”
The health benefits exchange is the centerpiece of health care reform in California, he said. Since California is the first to pass legislation to create an exchange in response to the national health care reform law, the rest of the nation is paying close attention to it, he said.