Archive for the ‘Next Steps’ Category

A Holiday Message: Fulfilling the Promise of Health Care Reform

Posted on December 22nd, 2010 by HCAN California in Next Steps

Just like you, we at Health Access and HCAN California are taking stock of 2010 and what it is that we are grateful for: our partners, activists and donors - who have stood with us in the fight to pass meaningful health care reform!

Earlier this year, we celebrated the passage of the Affordable Care Act. This historic federal law has made health care reform a reality for millions of Californians, and as the weeks and months pass we are seeing more and more benefits becoming the law of the land. It was a hard fought campaign, and we in California are proud that many key consumer protections and ideas that were pioneered in our state were included in the final legislation.

The new law provides tangible gains for California patients that include new consumer protections regulating insurance company abuses, providing funds to expand coverage and help make care affordable for low- and moderate-income families, and laying the foundation for reducing costs, improving quality, and encouraging prevention and wellness.

Health Access was thankful the major grassroots organizing and campaign work in California paid off, helping ensure that every Congressional Democrat-33 Representatives and our two Senators-supported health reform, despite California’s large contingent of “Blue Dogs,” the most (7) of any state. Of the 12 largest states, only California and Michigan showed such unity on such a crucial issue.

But we were mindful that with this victory our work didn’t end, rather it has exploded with a new array of challenges and opportunities. Its success or failure here in California depends on our continued activity and vigilance in the coming months and years. That’s why we need your support.

Because the challenges and opportunities are so great, I urge you to make a tax-deductible gift to Health Access Foundation and become a partner in our efforts to fulfill the promise of reform here in California. You can contribute online, just by going to the Health Access website at: http://www.health-access.org/donate.asp

Consumer and community advocates have the daunting task of guiding specific policy and regulatory implementation to ensure that health reform is consumer-friendly, and fulfills its promise at the state and federal levels, through legislation and regulation.

We started quickly, and California has taken the lead implementing and also improving upon the federal law.

Several new laws were enacted this year. Most significant was the creation of a state health insurance Exchange, a core element of health reform. Beginning in 2014, the new Exchange will be the one-stop shop for getting health coverage for individuals and small businesses, providing easy-to-compare choices, accessing federally-funded subsidies to make coverage affordable, and amassing the bulk purchasing power of millions of Californians to bargain for the best price and value.

We also passed laws to enact and improve upon key consumer protections in the federal law, such as to ensure access to coverage for children with pre-existing conditions. There’s more work to do on this issue and many more.

Also important is the new Medicaid Waiver agreement between the state and federal governments establishing a plan for the next five years for Medi-Cal, the state-federal program that covers over 7 million low-income California children, parents, seniors, and people with disabilities, and is a central funding source for our entire hospital and health care system. The new waiver includes important investments in the health care system, and at our urging allows for the early expansion of coverage as a transition to 2014. Of particular interest, the waiver allows counties to get federal matching funds to cover low-income Californians, helping those families, our health care system, and our economy, and providing a bridge to health reform.

As historic as our victory to pass the federal law, and as significant as our work to get California to act quickly and affirmatively is, there’s much more to do at regulatory agencies and in the legislature to put the pieces together to fulfill the promise of health reform.

At the same time we are moving forward to implement and improve federal health care reform, the state’s ongoing budget crisis threatens devastating cuts that jeopardize California’s existing health care safety-net on which millions already rely.

Now, more than ever, Health Access is in a crucial position to protect against further budget cuts and work to restore health care services in California, while undertaking to implement and protect the federal health reform law.

Your gift willhelp us educate the public about the benefits of health care reform, and fight back against the powerful opposition that is already working to “repeal and replace” this landmark law.

It will also help us guard against significant setbacks from budget cuts that threaten to cripple our health system, our families, and our economy. We will make sure that the real cost and impacts of proposed cuts are understood, offer alternatives to them, and work with grassroots groups to make sure the voices of their constituents are heard.

At this crucial time, we need to prevent the worst, both with budget cuts and efforts to repeal reform; but also to organize and advocate for the best, for both a better implementation and to go beyond the federal law.

With your support, Health Access Foundation will continue to empower Californians to engage in the debate, and to win policy victories on behalf of health care consumers.

We would greatly appreciate your contribution to help make it a happy and healthy New Year. Thank you for your consideration.

As always, my best wishes to you and your health - and thanks for all you have done to make our work possible!

Bills to implement and improve reform…

Posted on April 8th, 2010 by HCAN California in Health Reform in California, Next Steps

By Anthony Wright at the Health-Access Blog

Tuesday, April 6, 2010


* California Effort Begins to Implement & Improve Federal Health Reform
* Health Committees in Assembly and Senate to Consider Bills in Next Few Weeks
* Today’s Assembly Health Committee to Vote on Bill to Help Kids Stay on Coverage
* Groundwork is Laid for a New Exchange; New Insurer Accountability on Rates; Etc.
* ALERT: Organizational Support Letters Needed to Support Key Reform Bills!

* Read Our Health Access Blog! Join Us on Facebook! Follow Us on Twitter!

HEALTH REFORM HAS JUST BEGUN: Two weeks ago, President Barack Obama signed into law a historic health reform package, one that would reform the worst abuses of the insurance industry, secure coverage for those that have it, and provide new and affordable options for those that don’t. One week ago, President Obama approved a “reconciliation” package of improvements to the health reform, the first of many that will be considered in the months and years ahead.

The work to implement and improve health reform at the state level starts today, with state legislation being considered today and over the next few weeks in health policy committees. A series of bills critical to easing California into a smooth transition to health reform is moving through the process.

This afternoon, the Assembly Health Committee, chaired by Assemblyman Bill Monning, will consider several bills, including AB2477 (Jones). The bill will allow for continuous eligibility for children in Medi-Cal, without threatened mid-year status reports that would prevent kids from staying on coverage. This would start to align our eligibility requirements with those of federal health reform.

Most of the other bills are basic consumer protections that would increase accountability for the insurance industry. In some cases, the federal law requires states to act, within certain parameters; other proposals would implement some aspects of health reform early, and in other cases would build on federal health reform but go further. Some bills are up as early as next week in committee, which means organizational letters of support would be due in the next day or two.

One such bill for next week is AB 2042 (Feuer), which would prevent health insurance companies from raising rates more than once per year. This unfair practice is not unheard of. It’s bad enough that Anthem Blue Cross refuses to budge on its outrageous up-to-39% annual increase scheduled for May 1, but they also announced that they may increase their rates over the course of the year. The bill would provide ratepayers some security in being able to predict their health care costs over the course of a year.

There are many other bills coming up in the next week, and insurance companies are already sending in their letters of opposition, on everything from rate regulation to limits on charging children with pre-existing conditions.

ALERT: SEND ORGANIZATIONAL LETTERS OF SUPPORT: These bills need organizational letters of support ASAP. Please send letters to the bill’s author, the chairs of the relevant Health Committees, Senator Elaine Alquist and/or Assemblyman Bill Monning, and members of the relevant policy committee that will review the legislation.

Insurers have already started to get in their opposition letters, and so we need consumer, community, and constituency organizations to submit their letters in support of these specific bills. Contact Health Access for sample letters on some of these bills; a full list of health reform related bills is listed below.

PENDING BILLS TO IMPLEMENT AND IMPROVE HEALTH REFORM Below is a list of health consumer bills currently in the California State Legislature that are intended to implement and improve certain provisions in the federal health reform law and prepare the state for other provisions contained in the law. This list is regularly updated and can be found at www.health-access.org.Creating a Consumer-Friendly & Transparent Individual Insurance Market & Exchange

* AB 1602 (Bass) CALIFORNIA PATIENT PROTECTION & AFFORDABLE HEALTH CHOICES: Would create the California Cooperative Health Insurance Purchasing Exchange (Cal-CHIPE) and expand dependent coverage in private insurance to age 26.

* SB 900 (Alquist) CREATING A CALIFORNIA HEALTH INSURANCE EXCHANGE: Would establish the California Health Insurance Exchange within the California Health and Human Services Agency to make health coverage available and create the California Health Insurance Exchange Fund to be governed by a board appointed by the Legislature.

* SB 890 (Alquist) IMPLEMENTING FEDERAL HEALTH REFORM: Creates rules in the individual market similar to those for Medi-Gap so that insurers cannot cherry-pick individuals based on health risk status. Sets standard of basic health care services for DOI products as well as DMHC products.

Providing Access for Those with Pre-Existing Conditions

* AB 2244 (Feuer) ASSURING KIDS COVERAGE: Requires guaranteed issue, eliminates all pre-existing condition exclusions and phases in modified community rating for children under age 19 in the individual market.

* AB 2470 (De La Torre) REGULATING RESCISSIONS AND MEDICAL UNDERWRITING: Would require regulations to be created that establish standard information and health history questions used by health insurers on application forms, and required insurers to complete medical underwriting and review for accuracy before issuing an individual a health plan contract or policy.

* SB 227 (Alquist) SECURING FUNDING FOR MRMIP, CA’S “HIGH-RISK” POOL: Creates fee on insurers to support California’s high risk pool for those denied for pre-existing conditions.

Continuing and Expanding Coverage

* SB 1088 (Price) ALLOWING YOUNG ADULTS TO STAY ON THEIR PARENTS’ COVERAGE: Would require group health plans to allow young adults to continue on coverage as a dependent up to age 27, however employers are not required to contribute to the cost of coverage for those dependents 23 or older.

* AB 2477 (Jones) KEEPING CHILDREN ON MEDI-CAL COVERAGE/CONTINUOUS ELIGIBILITY: Would adopt rules to expand continuous eligibility in Medi-Cal to children 19 years of age and younger.

Regulating Insurance Company Rates

* AB 2578 (Jones) REQUIRING APPROVAL FOR RATE HIKES: Would require approval by the Department of Managed Health Care or the Department of Insurance of an increase in the amount of premium, co-payment, coinsurance, deductible or other charges under a health plan.

* SB 1163 (Leno) PROVIDING SUNSHINE ON PRICE GOUGING: Would require health plans to provide, in writing, specific reasons for denial of coverage or for charging higher than the standard rates for coverage.

* SB 316 (Alquist) ENSURING PREMIUM DOLLARS GO TO PATIENT CARE/MEDICAL LOSS RATIO: Would require health plans to provide written disclosure of the medical loss ratio (the ratio of premium costs to health services paid) whenpresenting a plan contract or policy for sale to an individual purchaser or to groups of 50 or fewer individuals.

* AB 2042 (Feuer) PROHIBITING MID-YEAR RATE HIKES: Insurers and HMOs cannot change or increase premiums, cost sharing or benefits more often than once a year.

Setting Minimum Standards

* AB 786 (Jones) SETTING BASIC INSURANCE MARKET STANDARDS: Would sort health insurance policies into a number of categories, based on benefit comprehensiveness and cost-sharing. Would set a minimum standard that requires coverage of doctor and hospital care and an overall limit on out-of-pocket costs, thus eliminating deceptive “junk” insurance.

* AB 1825 (De La Torre) ENSURING MATERNITY CARE: Would require most health plans to cover maternity services.

* AB 1600 (Beall) REQUIRING MENTAL HEALTH PARITY: Would require most health plans to provide coverage for the diagnoses and treatment of a mental illness.

Additional Consumer Protections

* SB 56 (Alquist) FACILITATING A PUBLIC HEALTH INSURANCE OPTION: Would authorize county-organized health plans and other health benefits programs to form joint ventures in order to create integrated networks of public health plans that pool risk and share networks, subject to the requirements of the Knox-Keene Act.

* AB 2110 (De La Torre) PROVIDING PREMIUM GRACE PERIODS: Would extend the grace period for premium payments from 10 or 31 days up to 50 days for most plans regulated by the Department of Insurance.

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