Latest California Healthline Stories
State Considers Coverage Mandates
The deadline to pass legislation left over from last year has come and gone, with single payer, insurance rate regulation and the basic health plan all temporarily halted. The next big legislative push is coming up fast, as all new bills for 2012 have to be introduced by the end of next week, on Feb. 24.
A number of health-related laws recently were passed by the state Senate or Assembly. Many of them call for coverage mandates by health insurance providers.
State Choices on Essential Benefits May Become More Complicated
Stakeholders are responding to HHS’ recent bulletin giving states a large hand in determining “essential health benefits” to be offered through insurance exchanges in 2014. In California, officials are trying to determine how to handle a growing list of state-mandated benefits within the exchanges.
Study: Uninsured Face Similar Debt as Medi-Cal Beneficiaries
More Californians are borrowing money to pay for health care services — and two-thirds of them have medical insurance, according to a new study by the UCLA Center for Health Policy Research.
“When you think you’re insured, you still end up paying a percentage and that adds up, into thousands of dollars,” report author Shana Alex Lavarreda said. “So having insurance doesn’t mean you will have things paid for.”
Another surprising finding, Lavarreda said, is that uninsured Californians face a similar medical debt level to those who have insurance through Medi-Cal.
Few People Aware of Medical Review Program
It has been 11 years since California launched its Independent Medical Review program, an appeals process that allows Californians to challenge denial or delay of coverage by private health care insurers.
In the Capitol Building in Sacramento yesterday, a policy briefing laid out the findings of a new report on IMR that includes praise for its effectiveness and some recommendations on how to make the program stronger.
The briefing was sponsored by the California HealthCare Foundation, which commissioned the report and publishes California Healthline.
Personal Stories Highlight Oral Chemotherapy Bill
New legislation proposed by Assembly member Henry Perea (D-Fresno) would require health plans to provide chemotherapy in pill form, in some cases.
“This bill will provide greater access for oral chemotherapy treatment,” Perea said on the Assembly floor late last week. “This is the right thing to do, to allow people access to lifesaving drugs.”
Perea introduced the measure with his personal account of caring for his mother, who he said was diagnosed with stage 2 lung cancer just over a year ago. During the long, eight-hour chemo infusion in the hospital, he learned quite a lot about cancer and chemo from patients and professionals.
‘Value’ in Health Insurance Acquires New Meaning
Insurers and employers are expanding the scope of value-based insurance design, leaving their mark on customized programs that challenge the typical cost-sharing arrangements adopted by many payers.
Ateev Mehrotra of RAND Corporation Talks About the Growth Potential of Retail Clinics
Ateev Mehrotra, a policy analyst at the RAND Corporation, spoke with California Healthline about how the demand for retail clinics might increase in response to a growing shortage of primary care providers and a nationwide push to lower health care costs.
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.”