Latest California Healthline Stories
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.
Daunting Challenges Await Exchange Board
The five-member board directing the California Health Benefit Exchange will need to navigate a complex path as it takes steps to set up a statewide marketplace for health insurance coverage. Experts already are predicting a few pitfalls that will be especially challenging.
Medical Loss Ratio Threshold Goes to 80%
The Department of Insurance already regulates a 70% medical-loss ratio on insurers of individual health plans so it was not a huge leap to bump that limitation to 80%, given the new federal standard at that level, according to Janice Rocco, deputy commissioner of health policy for the DOI.
“We maintain the [current state requirement of a] 70% medical-loss ratio,” she said, “and we also need to comply with the federal 80% ratio, which is calculated in a different way than the state ratio.”
The state Office of Administrative Law agreed, and yesterday granted the Insurance Commissioner and his department the authority to enforce those federal standards.
Mandate Bills Merit Independent Review
Maternity care. Tobacco cessation. Mammograms. HPV vaccinations. Hearing aids for children.
These are just a few of the legislative attempts at mandates for health insurance coverage in California. Each of those proposals needs to be evaluated before it hits committee. The under-the-radar group that does those evaluations — the California Health Benefits Review Program — has issued 68 CHBRP reports since 2004.
The CHBRP held its annual legislative briefing yesterday in Sacramento. And, honestly, it was worth attending just to hear men in suits say the acronym “Cha-BURP” over and over again.
Who Wins if Republicans Repeal Health Reform Law?
The debate over the nation’s health care overhaul has reached its highest pitch in months, but most industry stakeholders are sitting out of Republicans’ fight to repeal the law. The industry’s silence illustrates an emerging consensus: with the exception of a few groups, even former opponents of the overhaul now want the law to stay.