Latest California Healthline Stories
Committees Move Host of Bills, Including Rate Regulation
The Senate and Assembly appropriations committees moved fast and furiously yesterday, sending a range of health-related bills out of committee and onto the legislative floor.
That includes the most controversial item on either docket, AB 52 by Assembly members Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael), which would authorize the state to regulate health insurance rates.
In other news, the state controller yesterday reiterated his strong request to the Department of Health Care Services to back off from expanding a relationship with a provider of ADHC-like services, because he says that provider owes the state $339 million. Details are further below.
Did the Democrats Miss Chance To Protect Reform Law?
The 11th Circuit Court’s decision to strike down the Affordable Care Act’s individual mandate raises questions for the law’s future, but also its past. Could the White House have better constructed its sweeping health law to avoid constitutional challenges?
Rate Regulation, Basic Health Headed to Floor?
The state Legislature reconvenes today, starting with a Senate Committee on Appropriations hearing with 167 items on the agenda. The Assembly’s Appropriations Committee meets Wednesday, with 184 items to consider.
Those numbers will be whittled down for this week’s hearings, but generally Appropriations is the final destination before an actual floor vote for any bill that might spend money. That’s why the two committees will have so many menu items from which to choose.
Among the bills that still need to clear the Appropriations hurdle is AB 52 — by Assembly members Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael) — which is the health insurance rate regulation bill. Also up is the bill to create a Basic Health Program, SB 703, by Sen. Ed Hernandez (D-West Covina).
Should State Consolidate Health Plan Regulation? How, When?
California is the only state with two bureaucracies keeping tabs on health insurers. Should California consolidate health care regulation in one agency? If so, how and when? We asked experts and stakeholders to weigh in.
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.