Latest California Healthline Stories
How the Midterm Elections Could Shape Reform
The debate over health reform was heavily framed by the midterm elections. While Democrats had hoped the law’s passage would boost their prospects, Republicans appear likely to make significant gains and could further shape the overhaul’s implementation.
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.
Exchange Passage Raises Question: Now What?
When you’re the first to launch a new program, it is often greeted with a measure of fear and suspicion, according to Jon Kingsdale, former executive director of the Commonwealth Health Insurance Connector Authority in Massachusetts.
And one of the common misconceptions about the exchange in Massachusetts and the exchange-to-be in California, he said, has been the worry that somehow the exchange will be constantly at odds with health insurance companies.
“As a non-regulatory marketplace for insurance, with a mandate to serve the public, there is a strong interest in having long-term, value-based relations with health plans,” Kingsdale said. “Meaning, we want them to make a little money.”
California Exchange Compared to its Predecessors
California is the first in the nation to pass legislation to create a health benefit exchange in response to the national health care reform law. But that doesn’t mean it’s the first exchange in the nation.
Four other states implemented some kind of exchange ahead of the national reform law — Massachusetts, Connecticut, Utah and the newest exchange recently established in Washington state.
“In Utah, it’s more of a clearinghouse model,” according to Julie Sonier, deputy director of the University of Minnesota’s SHADAC (the State Health Access Data Assistance Center). “And Connecticut is different, in that it’s entirely a private model. It’s less like an exchange, and more like a set of insurance products for their members. They’re not trying to organize the market.”
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.
Has Reform Improved Health Care Yet?
The bulk of the federal health reform law’s provisions are slated to launch in 2014, but several incremental changes have already taken effect. An early look at those provisions shows mixed results for insurance access, services utilization and system improvements.
Silicon Valley Wrestles With Reform Implications
Silicon Valley health officials outlined Santa Clara County’s health care reform strategy at a recent conference, calling for outreach efforts and an expanded safety net to deal with growing numbers of uninsured residents who will soon become part of the system.
California Exchange Gets Lots of Attention at Conference
California’s new laws establishing a state health insurance exchange attracted plenty of attention last week at the National Academy for State Health Policy’s 23rd annual national conference in New Orleans.
Since the start of the reform debate, questions have swirled about Medicaid’s role and sustainability. New reports raise further concerns about the program’s long-term prognosis.
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.