Latest California Healthline Stories
Reform Bill Pushes Insurance Buttons
The California Legislature is working on many bills dealing with national health care reform — from major undertakings like setting up a health benefits exchange to more esoteric ones, like guaranteeing timely response to autism grievances.
Some generate hot debate, such as the give-and-take over proposed insurance changes during an Assembly Health Committee hearing this week.
At issue was SB 890 by Elaine Alquist (D-Santa Clara), which has three main provisions.
How Small Businesses Can Make Most of Health Care Reform
We asked small business experts and insurers to share insights about how California small businesses can make the most of health care reform while dealing with new administrative burdens it brings.
Law Would Mandate Maternity Coverage
The Senate Health Committee approved AB 1825 by Assembly member Hector De La Torre (D-South Gate) on Wednesday, which would force health insurance groups and plans to cover maternity services for women in California.
“It is similar to AB 98, which was vetoed by the governor last year,” Senate member Gloria Negrete McLeod (D-Chino) said. “It is four years till the (national health care) health exchange will open. Already we’ve seen a drop in coverage since 2007 from 22% to 19% coverage … and four more years will push many more women out of coverage.”
Maternity coverage particularly needs to be covered, Negrete McLeod said, because in many cases women don’t plan to become pregnant, and then find themselves scrambling to change their coverage to accommodate their now-preexisting condition.
Insurer Response Remains Key Story To Watch
The health industry’s focus is on HHS this week, as the department sprints to launch insurance portals and pools by key implementation deadlines. However, tensions between policymakers and private payers remain the long-term narrative to watch.
How Much Risk Will $761 Million Pay For?
The state legislature passed two bills yesterday that establish a temporary high-risk insurance pool. California currently has a high-risk pool system that handles 7,100 patients across the state. The new legislation would corral $761 million in federal funds over the next four years to create a significantly larger program.
High-risk pools are designed to insure those who can’t get health insurance. But that “uninsurable” bar is pretty low, according to legislative advocate Elizabeth Lansberg of the Western Center on Law & Poverty.
“Being uninsurable is not hard to achieve,” Lansberg said. “There are many people who just have high blood pressure or high cholesterol. But if you’re over 45 and have a pre-existing condition, it can be nearly impossible to get coverage.”
San Diego Biotech Gets Boost From Reform Tax Credit
San Diego, a national hub for biotechnology, has seen a flurry of activity as companies prepare to apply for a new tax credit included the health care reform package that will provide $1 billion to small biotech and life sciences companies.
Despite Best Intentions, New Ratios Creating Problems
Requiring insurers to spend a certain amount on patient care was a widely acclaimed element of the health care overhaul. However, early efforts to set standards for medical-loss ratios are delayed, and resistance is growing. While some say industrywide MLR standards remain achievable, others are warning that it’s a “fool’s errand.”
High-Risk Success Riding on Twin Bills
Last week the Assembly passed AB 1887 by Mike Villines (R-Clovis) and the Senate passed SB 227 by Elaine Alquist (D-Santa Clara). The two-bill package would establish a temporary high-risk insurance pool to meet federal guidelines for national health care reform.
The legislation is now being considered in the appropriations committees in each house. The bills are procedurally joined, which means one can’t become law without the other. At stake is $761 million in federal funding, which is one reason the proposed laws have urgency status.
But urgency status has one big drawback — that means both bills need a two-thirds vote to become law.
Enrollment Work Group Gets Down to Business
Last week, the Health IT Policy Committee’s recently created Enrollment Work Group held its inaugural meeting. Meeting participants seemed excited and eager to get down to business, but they were realistic about the challenges that lie ahead, especially with such tight deadlines.
Insurance Czar May Gain New Clout in California
With the state’s pending implementation of national health care reform, the role of state insurance commissioner is in position to assume new political power in California.