Insurance

Latest California Healthline Stories

Exchange Premiums Closely Watched by Industry, Nation

“Everyone will be watching what goes on in California” this week, according to health insurance industry leaders. The state’s new health insurance exchange announced which insurers will offer coverage in Covered California and how much they’ll charge.

Administrative Change for High-Risk Subscribers

The Pre-Existing Condition Insurance Plan (PCIP), a federally-funded, state-run interim program, is moving from state to federal oversight for the rest of the year.

A high-risk pool for people unable to secure health care insurance under pre-Affordable Care Act rules, PCIP is temporary because the new federal reform law prohibits insurers from denying coverage based on pre-existing conditions.

Now the “state-run” part of that program is also on its way out, as California will shift control and management of the program to federal officials, according to administrators at the Managed Risk Medical Insurance Board (MRMIB), which currently runs PCIP in California.

Health Care Issues High on Latino Community Agenda

Health care was a focal point when leaders of Latino community organizations met in Sacramento last week to launch the “California Latino Agenda,” a statewide campaign to unite leadership, establish goals and lobby for policy positions.

Stop-Loss Bill Heads for Senate Floor Vote

The Senate Committee on Appropriations yesterday approved a bill to ban a certain type of selection criteria when insurers issue stop-loss health care coverage to small employers.

The bill was one of a small mountain of bills before the Appropriations committee yesterday. The policy committees have finished their legislative work for this session, and bills need to either clear Appropriations this week or be put on suspense to wait for next session. The committee yesterday put 76 proposed laws on the suspense file.

Managed Care Tax Decision Left Until New Budget Proposal Arrives

Distrust ran high yesterday during part of a budget subcommittee hearing  when the subject turned to reinstitution of a managed care organization tax.

The MCO tax instituted in 2009 had the singular distinction of being embraced by the ones being taxed because the money was matched by federal dollars and was used to support the Healthy Families program. In the long run, health insurers made their money back and the state had more federal dollars in its coffers.

The MCO tax expired in December. The Brown administration wants to keep it going with one big difference: Since the state eliminated Healthy Families, a transition that started in January and runs through the end of this year, the governor would like to put the MCO tax money into a rainy-day fund for the state.

Study: Insurers Are Palliative Care Innovators

Six major health insurers in California are expanding access to palliative care by providing more specialized case management and opening up the hospice benefit beyond its Medicare boundaries, according to a new study expected to be released today.

The study, “A Better Benefit: Health Plans Try New Approaches to End-of-Life Care,” is accompanied by a second paper in today’s scheduled release: “End-of-Life Care in California: You Don’t Always Get What You Want.” The two papers are funded and published by the California HealthCare Foundation, which publishes California Healthline.

The study of the six largest health plans was based on interviews with stakeholders and with health plan directors, as well as reviews of published studies and academic reports, to determine the extent of palliative care alternatives at those plans.

Are High-Risk Pools a Preview of Obamacare’s Failure?

Two months ago, the Obama administration suspended enrollment in an Affordable Care Act program that offers insurance coverage for sick residents. Some observers say the move is indicative of larger ACA snags to come, while others say the high-risk pools have isolated problems.