Insurance

Latest California Healthline Stories

Insuring a Better Future for the State?

State officials and health care experts yesterday said the governor’s decision to sign on to optional expansion of Medi-Cal could be a huge step forward for California’s health system — and a huge challenge, as well, they said.

More than 700 stakeholders gathered in downtown Sacramento for the  annual conference of the Insure the Uninsured Project heard dozens of experts evaluate how far California has come in implementing health care reform, and how far it still has to go.

Adding roughly 1.4 million Californians to Medi-Cal eligibility in the optional expansion (adding adults up to 138% of federal poverty level) may be fully funded by the federal government for the first three years, but it also brings a boatload of work to the state. It’s worth the extra effort for the sake of beneficiaries and for the savings the state stands to make in reduced hospital and emergency department costs, said Diana Dooley, state Secretary of Health and Human Services.

Exchange Readies Its New Website

Covered California, the new brand name for the state’s health benefit exchange, will unveil its new website next week, according to Oscar Hidalgo, director of communication and public affairs at the exchange.

Hidalgo spoke at last week’s exchange board meeting, presenting one of the first building blocks of the marketing structure, an informational website.

“We are just about to launch a consumer-friendly website at the end of the month,” Hidalgo said. He said the unveiling is expected to be Wednesday or Thursday next week.

Assembly Hearing Addresses Issues of Risk

It was not your usual subject for an Assembly hearing in the Capitol Building.

Yesterday’s hearing convened by the Assembly Committee on Health took on the arcane and important subject of adverse selection and risk pools. The nerdy-tech tone of the hearing was not lost on its participants.

“I have to applaud the committee — for taking on such a dry topic,” said David Panush, director of government relations for Covered California, the state’s health exchange. “But it is so important. I’m really glad to see it.”

Anthem, Jones Spar Over Premium Rate Hikes, Reinsurance Fee

California Insurance Commissioner Dave Jones yesterday said a recent rate submission by Anthem Blue Cross was “unreasonable” and took particular issue with Anthem’s plans to charge a reinsurance fee which Jones said forces small businesses to pay for a 2014 fee a year early, in 2013.

Anthem Blue Cross officials said Jones’ numbers are off and that the reinsurance fee is a benign and standard business practice which has been used for many years without complaints from government or advocates.

“I’ve concluded that the rate increase imposed by Anthem Blue Cross on its small employers customers is unreasonable,” Jones said. He said the average rate increase of 10.6% is not justified given the data submitted to the Department of Insurance by Anthem.

Five Things To Watch in Health Care in 2013

If 2012 was a high-wire political act, and 2014 will bring a rush of implementation, will next year be an intermission or sprint for health care? Here are five indicators to watch in the coming months.

Call for MLR Regulation Gets Mixed Reaction

The Commonwealth Fund on Wednesday released a study on the federal medical-loss ratio rule, which concluded that regulation may need to be introduced to maximize the effect of the MLR.

“In future years, the MLR rule may need to be coupled with regulatory pressure in order for any further reductions in administrative costs to be reflected in reduced premium rates,” the study said.

That squares with the opinion from the state insurance commissioner, but the medical insurance industry does not agree.