Latest California Healthline Stories
How Should the Exchange Adjust Risk?
William Dow, a professor of health economics at UC-Berkeley, said the idea is relatively simple.
“In theory, each individual patient comes with a dollar amount representing their gain or loss to the insurance company,” Dow said at a recent forum in Sacramento. “And that means every enrollee should have the same profit amount.”
If higher risk patients, such as those with diabetes, pay a slightly higher premium, Dow said, that balances the risk that companies take in insuring them.
Cost Drops for Patients with Pre-Existing Conditions
Enrollment for the Pre-Existing Condition Insurance Plan (PCIP) just got a big boost.
Cost has long been suspected as one of the limiting factors to signing up people to the federally funded PCIP program. Now, according to officials of the Managed Risk Medical Insurance Board (MRMIB), the cost of premiums in the plan are about to drop by an average of 18%.
“We have new premiums now with a significant reduction in cost,” MRMIB chair Cliff Allenby said, “at an average of 18%, which is anywhere from 8.2% to 24.3% lower cost.”
Children’s Programs Slowly Moving Forward at MRMIB
Reports of the demise of the Managed Risk Medical Insurance Board were a little premature. There it was, alive and well at its monthly meeting last week, discussing expansion of existing programs and establishment of new ones.
MRMIB runs four programs: Healthy Families, Access for Infants and Mothers (AIM), the Pre-Existing Condition Insurance Plan (PCIP) and the Major Risk Medical Insurance Program (MRMIP).
The agency was slated for elimination under the governor’s May budget revision. The current plan still is to phase out MRMIB’s activities by 2014, when much of its mission will be taken over by the new federal health care reform law. But when the Gov. Jerry Brown (D) announced in May that he wanted to move 900,000 children from the Healthy Families program to a Medi-Cal managed care plan, Brown also proposed the quick elimination of MRMIB, since Healthy Families is such a large part of what MRMIB does.
Federal Officials Take Non-Stance on Rate Regulation
This year, few bills have stirred as much vitriolic rhetoric as the proposed health insurance rate regulation law, AB 52 by Assembly members Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael).
Now the statewide spat threatens to draw in federal officials, and they’re having none of it.
It all revolves around a recent report from HHS, which concluded that California’s current health insurance rate review is “effective.”
Caveats, Proposed Amendments Clear Way for Rate Regulation Bill
The bill to regulate health insurers’ rate hikes cleared a key hurdle yesterday, as the Senate Committee on Health voted 5-3, with one abstention, to approve AB 52 by Assembly member Mike Feuer (D-Los Angeles).
Passage came with many caveats and even more proposed amendments. Sen. Ed Hernandez (D-West Covina), the committee chair and the swing vote on the bill, suggested a raft of changes to the bill before it could garner his support.
“Primarily it’s important to depoliticize the decision process [around rate assessments],” Hernandez said. “It’s also very important to insert additional transparency in the process.”
Experts: Merging Regulators a Good Idea, but When?
Although no legislation or formal proposal is in play, California stakeholders are debating the merits and likelihood of consolidating health insurance regulation under one bureaucratic roof. Health care reform may offer an opportunity to merge the departments of Insurance and Managed Health Care.
Opponents Square Off on Rate Regulation
In the shadow of the elephant that is budget passage, the Senate held a hearing yesterday on legislation that also holds a lot of political weight — health care rate regulation.
“Of all the bills this year, and we’ve been involved in a lot of them, this one is the most important to us,” Gary Passmore of the California Congress of Seniors said at the hearing. “This one really matters.”
AB 52 by Assembly member Mike Feuer (D-Los Angeles) would take a step beyond the health insurance rate review that the state currently conducts. It would allow the state’s Department of Insurance and Department of Managed Health Care to alter or reject health insurers’ rate increases.
Trying to Quiet Rate Regulation Debate
The loud collision expected at today’s Senate hearing — between health insurers and those who want to regulate them — was expected to generate some serious verbal wreckage, and more than its share of media rubbernecking at the impact crater.
But committee chair Sen. Ed Hernandez (D-West Covina) put the brakes on the rhetoric a bit, by making it a testimony-only hearing.
It’s an unusual move, hearing testimony one week and expecting to put the vote over to the next week. “It’s a little unusual to do that in advance,” Patrick Johnston of the California Association of Health Plans said. “Bills do get put over, of course, but doing it as a planned two-stage process is different.”
Basic Health Plan’s Future Unclear in California
Although approved by the state Senate, a plan for the state government to offer low-cost health insurance faces several hurdles on its way to becoming law. The basic health plan could offer coverage with premiums as low as $30 a month to low-income Californians.
Senate Vote Could Be Swayed by AMA Stance
On Monday, the American Medical Association came out against use of bisphenol-A (BPA) in consumer products, citing the chemical’s effect as an endocrine disruptor. That specifically includes endorsement of a ban on use of BPA in baby bottles and baby “sippy” cups, and that ban is at issue in today’s Senate Committee on Health.
AB 1319 (Betsy Butler, D-Marina del Rey) would limit BPA use in baby bottles and cups, infant formula and baby food sold in California. It passed the Assembly at the end of May, and now is up for a vote in today’s Senate health committee hearing.
“The AMA has found that BPA is an endocrine disruptor and it would like to ban products that contain it,” Butler said. “It’s all about the science. There are many medical and health organizations promoting this idea [of banning BPA in baby products]. The opposition to BPA has grown stronger and stronger from the health community.”