Latest California Healthline Stories
FTC Emerges as Another Obstacle to Health Reform Law
The Affordable Care Act pushes new efforts at health care provider integration, like accountable care organizations, that may lead to more market concentration. The Federal Trade Commission is stepping up efforts to stop provider consolidation. Which approach will win out?
Bundled Payments and the Scars of Capitation
Health care organizations are grappling with a new CMS plan to realign payment along episodes of care. California’s experience with capitation and other payment models will give state providers a unique vantage point on the initiative.
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).
Uninsured Healthier Than Current Medi-Cal Beneficiaries
Helen Lee was surprised by a few of the findings in a study released last week by the Public Policy Institute of California.
“We find a relatively young population among the uninsured,” the PPIC policy fellow said. “In fact, more than half were in the 19 to 40 group.”
Up to three million Californians will join the ranks of the insured under the expansion of coverage in 2014 mandated by the federal Affordable Care Act. So it’s important to know the demographic makeup of all of those potential enrollees, Lee said.
Fixing U.S. Workforce May Be a Job for … Health Reform
Health care remains the standout amid the nation’s flagging jobs numbers. Do the sector’s latest employment figures put to rest the “job-killing ObamaCare” argument once and for all?
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.
Lessons Learned From PacAdvantage Failure
The Pacific Business Group on Health (PBGH) has had some experience in running a small group purchasing pool. It’s the organization that took over the Health Insurance Plan of California (HIPC), which was renamed the Pacific Health Advantage or PacAdvantage and operated for a total of 13 years, ending in 2006.
That organization was similar in concept to California’s Health Benefit Exchange. A new report from PBGH outlines some of the lessons the exchange might learn from PacAdvantage’s slow demise.
“The biggest lesson is, exchanges are naturally vulnerable to adverse selection,” according to report co-author Bill Kramer, the executive director of national health policy at PBGH. “When the Pacific Business Group on Health took over HIPC, it was inheriting an adverse selection problem. At a certain point, the adverse selection becomes irreversible and there’s no way to get out of it.”
Remember the Co-Ops? Overlooked Plan Raises Questions
Two years after lawmakers and activists battled over the fate of the public option, its erstwhile replacement — a plan to create health cooperatives — was finally unveiled last month.
Exchange Board Handles New Move Quietly
During the most recent board meeting of the California Health Benefit Exchange, board members gingerly approached the last item on the agenda — would the board stick its toe in political waters?
“I don’t know that it’s the board’s place to do this,” board member Paul Fearer offered at one point. Chair Diana Dooley, secretary of the state HHS agency, announced right at the start of the meeting she would abstain from legislative issues.
But clearly the board felt it was the board’s place to get involved in legislative waters — past the toes and ankle and maybe up to the knee — as it voted 3-0 on several motions to involve the exchange board’s input and opinion on half a dozen legislative bills.