Latest California Healthline Stories
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.
Coverage Begins for High-Risk Enrollees
After setting an ambitious timetable for startup and then hitting delays for almost a month after its scheduled launch, the state’s Pre-Existing Condition Insurance Plan officially started enrolling patients yesterday.
The program will use $761 million in federal money to help insure Californians who cannot get health insurance coverage because of pre-existing conditions. So PCIP helps provide coverage to people who would not otherwise get it.
“We’re very happy for the people of California who need this,” Jeanie Esajian of the state’s Managed Risk Medical Insurance Board said yesterday.
Reform Rollout May Waver if More Seek Exemptions
HHS’ recent decision to grant waivers for health plans that would not meet a key provision of health reform exposes how stakeholders can weaken implementation by simply resisting its measures.
High-Risk Insurance Plan About To Start
Originally, the Pre-Existing Condition Insurance Plan was going to cover high-risk patients by the end of September. That start-up date was pushed forward to Oct. 7, and now it’s on an any-day-now status.
“We’re still working with vendors to finalize the contracts,” Jeanie Esajian of the PCIP said. “It’s a very complex process. All I can tell you is, it could be any day now that we announce coverage to begin.”
PCIP is a state-run, federally funded high-risk insurance plan for patients who have been unable to obtain health care coverage because of pre-existing conditions. Under the rules of national health care reform, due to go into effect by 2014, insurance companies will no longer be allowed to prevent individuals with pre-existing conditions from obtaining coverage.
Insurers Called ‘Essential Partner’ in Reform
Jay Angoff, the federal government’s health care point man for consumers and insurers, told health insurers that they are “an essential partner” in reform. “You’ll have a profound influence on the direction our country takes,” Angoff said at a meeting of America’s Health Insurance Plans last week in Washington D.C.
Jon Kingsdale on Lessons from Massachusetts’ Experience With a Health Insurance Exchange
Jon Kingsdale, independent consultant and former executive director of the Massachusetts Health Connector, spoke with California Healthline about how California could learn from Massachusetts’ health benefit exchange.
Few Sources of Care for Uninsured in Inland Empire
A shortage of federally qualified health centers in the Inland Empire is posing a challenge for local health officials who are coping with a growing uninsured population. Overall, more than one million residents do not have insurance in the region, which spans a vast territory approximately the size of Maine.