Insurance

Latest California Healthline Stories

Five Health Care Issues To Watch in 2012

Mark your calendars: A slew of ACA-related payment reforms, health IT changes and health insurance exchange updates will debut next year — even as constitutional questions over the law come to an end. (Maybe.)

PCIP Enrollment Numbers Rise a Bit

The federally funded, state-run Pre-Existing Condition Insurance Plan has always been a bit of a tough sell.

It costs money, for one thing (premiums vary according to age and geography). And eligibility can be challenging: you have to have a pre-existing condition and be uninsured for six months.

That last requirement may be the toughest hurdle because those people with pre-existing conditions that are severe enough to be denied private insurance would have a hard time going uninsured for half a year.

PCIP Program Gets Last-Minute Funding

Last month, it looked like the federally funded, state-run Pre-Existing Condition Insurance Plan was about to reach its beneficiary limit. The Managed Risk Medical Insurance Board, which oversees the program, was considering closing enrollment.

At yesterday’s board meeting, officials said 813 new enrollees had been added to the system in the past month — leaving fewer than 800 slots still open. But MRMIB had good news up its sleeve.

“We received the 2012 amendment for the PCIP contract from the feds,” MRMIB Executive Director Janette Casillas said, “and they have given us an increase.”

Clashing Views of Transition for Seniors, Disabled

Either the state’s transition to managed care is going great, or it’s a confusing mess.

That would depend on who’s talking. At a joint oversight hearing last week, convened by the Senate and the Assembly committees on health, government officials outlined a generally positive picture for the effort to move Medi-Cal seniors and people with disabilities (SPDs) from Medi-Cal fee-for-service to managed care.

“The transition of seniors and people with disabilities into managed care is part of the triple mandate from [the federal] HHS,” according to Jane Ogle, deputy director at the Department of Health Care Services. “Better health, better quality and more cost-effective care.”

Inland Empire Readies Low-Income Health Plans

Low-income individuals in San Bernardino and Riverside counties will have access to two new health insurance programs beginning in 2012. The plans have been developed in preparation for a larger expansion of Medi-Cal in 2014 as required by the Affordable Care Act.

Making Maternity Rules Count

Three new maternity coverage laws were passed this year in California, but that doesn’t necessarily mean the people who need that coverage will get it, according to experts who gathered at a recent meeting in the Capitol Building.

“Just passing a new law we found isn’t enough,” according to Jenya Cassidy of the California Work and Family Coalition, which co-sponsored the event. “It’s also really important that you need to empower people to use the rights they have.”

According to Cassidy, many women of reproductive age who qualify for services and protections under California law aren’t aware of them.

PCIP Enrollment Could Be Capped in Two Months

State officials may need to curtail enrollment in the federally funded Pre-Existing Condition Insurance Plan in as little as two months from now, if more federal dollars aren’t allocated to it.

That was the word last week from the Managed Risk Medical Insurance Board, which oversees the federal PCIP program. It was surprising news, given its history since the program launched last year.

Every month, at every board meeting, the report was always the same — that the flow of enrollees into the program was increasing, but at a surprisingly slow rate.

Premium Hikes Report May Be Kindling for California Initiative

Premiums for employer-based health insurance increased by 50% nationally in the seven years before passage of the Affordable Care Act, according to a new report from the Commonwealth Fund. The report comes at the start of a statewide campaign for a ballot measure to give California authority over health insurance rate hikes.