Latest California Healthline Stories
Suzanne Delbanco of Catalyst for Payment Reform Discusses Ideas on Paying for Care
Suzanne Delbanco, executive director of Catalyst for Payment Reform, spoke with California Healthline about a growing movement to improve the delivery of care by transforming health care payment structures across the U.S.
How Can California Exchange Minimize ‘Churning’?
We asked experts and stakeholders to suggest strategies in the building and operation of California’s new health insurance exchange that would minimize beneficiaries’ moving in and out of coverage — known as “churning.”
When California’s Managed Risk Medical Insurance Board decided to create a state-run, pre-existing condition insurance plan in October, 2010 instead of using the “federal fallback” program, it didn’t mean complete autonomy for California officials.
The high-risk insurance program is funded through 2013 by a $761 million allotment from the federal government and federal officials have some guidelines about how that money is spent.
To entice more enrollees, the federal HHS lowered premiums on the pre-existing condition plans in states using the federal fall-back program. HHS requested that all plans, including state-sponsored ones, create a new child-only age band, moving it from birth to 14-years-old to include children up to 18. Secondly, HHS reinterpreted the payment plans for subscribers in each of the nation’s PCIP — or pre-existing condition insurance plan — regions.
Blue Shield’s Rate Motives Explained
Could Blue Shield of California’s motivation for making an about face on its proposed May 1 rate increase have anything to do with California’s new Health Benefits Exchange, slated to launch in 2014?
Blue Shield officials say no.
However, whether intended or not, the decision probably won’t hurt the company’s relationship with the state’s Department of Insurance. Legislation creating California’s new exchange grants the state insurance commissioner authority to recommend insurers to the exchange based on the equity of their rate increases.
Blue Shield officials said retreating from the proposed rate hikes will allow the company to more freely address issues causing medical costs to rise.
Do Health Insurers Deserve the Latest Public Hit?
As California health insurers announce a slew of rate hikes, a new report criticizes insurers’ profits and suggests that the federal health reform law remains imperative to tamping down rising premiums.
Calif. Health Benefit Exchange Board Member Kim Belshé Discusses Potential of the Exchange
Kim Belshé — former secretary of the California Health and Human Services Agency and a member of the California Health Benefit Exchange Board — spoke with California Healthline about how the state’s health benefit exchange can expand coverage, boost care quality and reduce costs.
Physicians Are Insurance Consumers, Too
Since taking office less than two months ago, Insurance Commissioner Dave Jones has made it clear he wants to protect consumers from insurers — and he made moves to get the authority to curb excessive insurance rate hikes and enforce new federal medical loss ratios.
Jones still doesn’t have the rate-regulation authority he said the California Department of Insurance needs, but he does have the enforcement power to go after insurers who don’t meet medical loss ratio standards.
Now Jones’ office is targeting a new type of insurance: medical malpractice.
About 3 Million New Medi-Cal Enrollees?
The number of Californians who will be eligible to participate in the federal health care coverage expansion in 2014 is higher than previously thought, according to a new study from the UCLA Center for Health Policy Research, based on data from the 2009 California Health Interview Survey.
About 4.7 million people will be eligible for the new coverage options, and about 3 million of those people qualify for Medi-Cal, according to Shana Alex Lavarreda, lead author of the UCLA policy brief.
“We were surprised by the number of people eligible for Medi-Cal, about 3 million, under the federal expansion,” Lavarreda said.
Open Enrollment Window Closing
It’s open enrollment season and this year that means a little more in California.
Several state officials and health advocates gathered at UC-Davis Medical Center in Sacramento yesterday, to make sure parents understand there are some new rules about health care for children.
New federal and state legislation means that children with pre-existing conditions cannot be denied coverage, nor billed at excessive rates. And right now is the time to sign up children for coverage, according to Assembly member Mike Feuer, D-Los Angeles.
Maternity Mandate Bill Has Familiar Ring to It
According to the California Health Benefits Review Program, nine health-related mandate bills have been introduced as new legislation in this legislative session. They are undergoing analysis before they’re heard in committee.
Some of that analysis is going to be a bit repetitive. Many of those bills have already been heard, and some of them were passed in the Legislature last year.
For instance, SB 155 by Noreen Evans (D-Santa Rosa), which would mandate coverage of maternity care, has pretty much identical language and intent to last session’s AB 1825. That bill, which had been authored by former Assembly member Hector De La Torre, D-South Gate, was passed by the Legislature, and then vetoed by former Governor Schwarzenegger.