Insurance

Latest California Healthline Stories

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.

Health Insurance Rate Regulation May Be On November Ballot

The contentious issue of regulating California’s health care insurance industry is back.

After AB 52 by Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael) was shelved at the end of the last legislative session, that looked like the final word on the prospect of regulating health insurance rates.

Yesterday, Consumer Watchdog filed paperwork to take health insurance rate regulation to the voters.

New Cost Tool Aims To Boost Pay-for-Performance Model of Care

In an effort to measure value in health care transactions, the Integrated Healthcare Association is introducing a “Total Cost of Care” metric to be used in its pay-for-performance program.  IHA hopes the new tool will speed up improvements in clinical quality by providing financial incentives to physicians.

Extra Year of Operation for PCIP?

A big topic at yesterday’s meeting of the Managed Risk Medical Insurance Board (MRMIB) was the agency’s interaction with the state’s Health Benefit Exchange.

Programs MRMIB administers will eventually disappear, absorbed by the introduction of health care reform and the Exchange in 2014. That is fine with the board members at MRMIB, but they gently raised the idea yesterday that programs such as the Pre-existing Condition Insurance Plan might be continued for a year.

“This population will migrate to the Exchange, and that’s what we want,” board member Richard Figueroa said. “But also, we do have some things to offer, in terms of what we’ve learned about running a transparent process, the single rules engine, and how to get people into these programs and keep them there.”

Ruling Raises Questions for Mental Health Coverage

An appellate court ruling in favor of a Blue Shield of California policyholder with anorexia could change how health insurers cover mental illness. However, health plans and advocates are divided on the ruling’s effects.