Latest California Healthline Stories
Changing Health Care Role for California’s Businesses?
It’s an alarming lead statistic in a report out this week: About 20% of working Californians don’t get health care insurance through their employer.
What that means is that it’s not just the unemployed and disabled who are struggling to find health care coverage. It’s also a large number of people with jobs.
But will any of that change under the pending national health care reform law? Businesses with fewer than 50 employees won’t be required to provide health insurance. So will state lawmakers need to enact some kind of legislation to address it?
Going From No-Show to Showing Teeth
It was two weeks ago that the California Department of Managed Health Care was a sort of agency-non-grata at a legislative oversight hearing. The Assembly budget subcommittee hearing was targeted at the DMHC’s perceived lack of response to complaints that the insurance industry was short-changing emergency departments across the state.
When the DMHC didn’t show up to that oversight hearing, it prompted a fair share of derision and antipathy — and it confirmed emergency department officials’ fears that the agency was ignoring their complaints.
Yesterday, the agency showed that it has been listening, by levying nearly $5 million in fines on seven health care insurers.
Emergency Departments Chafe at Low Payments, Lack of Help
Emergency departments in California often struggle to get paid for treating patients with a certain type of health insurance. In those cases, reimbursement is routinely delayed or denied, physicians say. Doctors complain that state officials are refusing to address the problem.
Report Looks at Money and the Uninsured
More need, less money — that seems to be the summary of every report on health care in California. So researcher Kiwon Yoo was somewhat surprised to see in her own report for Insure the Uninsured Project that funding for counties was not in steep decline in the years she studied, 2006 to 2009.
“There is rising unemployment and a rising number of uninsured during that time, but funding streams remain somewhat stagnant,” Yoo said. “So it was not a precipitous fall, as people thought it would be.”
In fact, the total county funding match rose 1.6 percent — that is, funding from state and federal sources actually rose slightly. “That includes money from vehicle license fees, tobacco settlement funds” and other temporary funding sources, she said. “And these numbers only go up to 2009, and some of the budget measures don’t take effect till 2011 or 2012.”
DMHC Not Listening to Complaints?
What if you gave a legislative oversight hearing, and the object of that hearing didn’t show up?
That was the case last week, when the Budget Subcommittee on Health and Human Services conducted an oversight hearing to deal with complaints about the Department of Managed Health Care. Emergency department officials, who feel they’ve been grossly and routinely underpaid by some insurance organizations, say the DMHC is supposed to adjudicate those conflicts, but has instead been ignoring them.
“This is extraordinarily disrespectful. I’m extraordinarily displeased they decided not to participate,” Assembly member Dave Jones (D-Sacramento) said.
Mapping Out Future for Rural Health Care
The problems faced by rural health providers go far beyond whether or not patients have insurance coverage, according to Danny Fernandez, legislative advocate for the National Rural Health Association, who spoke at the 10th annual conference of the California State Rural Health Association this week in Sacramento .
“At some point, ‘national health reform’ morphed into ‘national health insurance reform,’ ” Fernandez said. But it’s not just about making sure everyone’s insured, he said. “Our overall message to Capitol Hill was, if you don’t have access to a provider, then it doesn’t matter if you do or don’t have insurance coverage.”
That is probably the number one problem in rural areas throughout the state and nation, he said, along with a general lack of funding for rural health care. National health care reform, Fernandez said, might be able to address both concerns — by increasing funds through better insurance, and by offering incentives and programs to get medical providers into rural areas.
Policy, Not Punditry: Update on Three Key Provisions
Speculation over the midterm elections’ effect on health reform has threatened to overshadow recent regulatory developments. Work to date on high-risk insurance pools, medical-loss ratios and accountable care organizations shows there are roadblocks beyond politics that could hamper reform.
Overuse of Health Services May Be a Myth
This week, at the annual meeting of the American Public Health Association in Denver, researchers analyzed survey data from California — investigating the concern that immigrants are a major drain on health care services.
“People looked at immigrants and undocumented workers and their use of emergency services and preventive care, and found that those groups are actually less likely than other groups to use health care services,” according to David Grant, director of the California Health Interview Survey.
“The data show [lower usage] of emergency services, as well as lower usage of preventive medicine, even among immigrants who have insurance,” he said.
New Commissioner Eager To Get Started
The role of California’s insurance commissioner will change quite a bit during the current term. It’s a job that oversees a huge agency, with 1,300 employees charged with evaluating, regulating and policing the home, car and other insurance industries in California. Its approach to health care insurers, though, historically has been different than its authority over other insurance industries. That is about to change and expand in several ways.
After Tuesday’s election, the new commissioner, Dave Jones, said he is “eager and excited” to oversee those changes.
“I’m looking forward to all of it,” Jones said. “I’m excited at the prospect of making this office the state’s most important consumer protection agency. And I’m excited at the prospect of playing a leadership role in implementing health care reform in California.”
Insurance Commissioner Race Generates Direct, Indirect Funding
So far, the two main candidates for insurance commissioner in California have spent a total of about $4 million in direct money on this campaign, according to the Secretary of State’s office, with another estimated $3 million coming from independent expenditures, or IEs — ads produced independently but that support a specific candidate or attack his opponent.
According to government expenditure records, Republican Mike Villines, a member of the Assembly from Clovis, has about $850,000 to spend on this election. He also has benefited from about $2.2 million in spending by JobsPAC, the political action committee of the California Chamber of Commerce.
In contrast, the campaign of Democrat Dave Jones, Assembly member from Sacramento, has raised almost $3 million. He has received another $590,000 in spending by various special interest groups, mostly labor and law interests, with most of it coming from the California Alliance.