Archive for the ‘Health Reform in California’ Category

New coverage begins for those with pre-existing conditions…

Posted on October 27th, 2010 by HCAN California in Health Reform in California

Re-posted from Health Access California blog:

Earlier today, Governor Schwarzenegger announced the official start for California’s Pre-Existing Condition Insurance Program (PCIP), to provide access and affordability for coverage for Californians with pre-existing conditions. In particular, it provides more affordable, and more comprehensive coverage, than the state’s current “high-risk” pool, which currently has a wait list.

This is much-needed relief for people denied for pre-existing conditions by private insurers. It’s not just a better option, it is for many Californians the only option for getting coverage at any price.

Because of federal health reform, Californians who are abandoned by the current broken individual health insurance market will be able to get the coverage they need. This is also an important bridge to broader reforms in 2014 where insurer won’t be able to deny or charge more for pre-existing conditions at all.

The short-term challenge now is to make sure that people who have been denied for coverage know about this new option, so Californians and our state’s health system takes advantage of the $731 million federal dollars that are available. The state needs an aggressive outreach campaign so Californians know their rights and options.

The longer-term challenge is to transition to a market where insurers compete on cost and quality and wellness, rather than on which insurer is more deft at denying patients who actually need care.

Johanns Amendment Defeated!

Posted on September 16th, 2010 by HCAN California in Health Reform in California, News

The amendment from Senator Mike Johanns (R-NE) to the Small Business Jobs bill was defeated this week in a vote of 46-52!

Senator Mike Johanns (R-NE)

Senator Mike Johanns (R-NE)

If passed, the Johanns Amendment would have stolen important funding away from two of important provisions - free preventive care & shared responsibility - by repealing part of the health law that requires businesses to report certain transactions as a way of improving tax collection.

We generated several thousand calls to Senators Boxer and Feinstein this week, urging them to “VOTE NO” on the amendment. Once again, our Senators showed that they understand the importance of standing up to the insurance industry and their allies in Congress, and the need to defend the gains we’ve made thus far since the passing of the health law back in March.

THANK YOU to everyone who took the time to make the phone calls & stand up for our health care!

New Report - Health Law Will NOT Increase Spending

Posted on September 9th, 2010 by HCAN California in Health Reform in California, News

For months now, the right-wing noise machine and other opponents of health reform have been claiming (ad nauseum) that the new Federal health law will result in “massive spending,” likely plummeting the country further into debt.

However, according to a New York Times article today, a government study found that the new law will have, “negligible effects on total national health spending in the next 10 years.”

“In the aggregate,” said Andrea M. Sisko, the principal author of the report, “it appears that the new law will have a moderate effect on health spending growth rates and the health care share of the economy.”

In 2009, the report said, national health spending, public and private, totaled $2.5 trillion and accounted for 17.3 percent of the economy, as measured by the gross domestic product. The report predicts that health spending will rise to $4.6 trillion and account for 19.6 percent of the economy in 2019.

By contrast, in February, before passage of the comprehensive health care law, the same team of government experts, using the same economic and demographic assumptions, predicted that national health spending would reach $4.5 trillion, or 19.3 percent of the gross domestic product, in 2019.

Meanwhile, it’s important to focus on what the Federal health law actually DOES:

  • Expands coverage to approximately 32.5 million people;
  • Allows young adults to stay on their families’ coverage through age 26;
  • Prohibits insurance companies from denying coverage to children (2010) and adults (2014) due to so-called “pre-existing conditions;”
  • Requires insurance companies to provide free preventive care services;
  • Creates the Pre-Existing Condition Insurance Plan - for people previously unable to get coverage due to so-called “pre-existing conditions;”

Likewise, we’re continuing to work at the State level to promote legislation that would implement and improve upon the Federal health law, while also working to engage and educate the public about how the law will help them.

You can sign-up to receive the latest updates, action alerts and other info on health care by subscribing to HCAN-California above!

State Health Reform Bills Pass!

Posted on June 2nd, 2010 by HCAN California in Health Reform in California

Yesterday, California’s legislature passed four key state health reform implementation bills to help Californians get the most out of the newly passed national health care reform law, including setting up a new exchange to help individuals buy insurance, prevent overpriced premiums for children with pre-existing conditions and several other important provisions.

All four bills passed on Tuesday will help in the implementation of health care reform by setting the stage for California to move forward with the strongest provisions contained in the law.

But there are still two bills that need to be passed before Friday (June 4) which aim to introduce stronger rate regulation and oversight of the private insurance industry in California: AB2578 (Jones) and SB1163 (Leno).

Word has it that the private insurance industry is desperately trying to prevent the passing of these two bills that would improve protections for California consumers against attempts by the private insurance industry to raise our premiums and deny us coverage.

For more info on these bills, check out today’s post on the Health Acess weblog.

There’s still time to take action! So far, hundreds of Californians have already called their legislators in the State Assembly and State Senate, urging them to support these critical bills. With the deadline only a couple of days away, it’s critical that we get on the phone now and call on our leaders to VOTE YES on these two remaining bills!

Click here to get started and take action NOW!

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Health Reform News - Apr. 22

Posted on April 22nd, 2010 by HCAN California in Health Reform in California, News

HCAN-California’s lead state partner, Health Access, reported Wednesday that the California Senate Health Committee approved a pair of bills authored by Senate Health Committee Chair Elaine Alquist and Senate President Pro Tem Darrell Steinberg setting up a new insurance exchange to help expand health care coverage for Californians.

  • SB 900 (Alquist/Steinberg) sets up a new insurance exchange that actively uses its negotiating power to seek out the best deals for individual and small group policyholders.
  • SB 890 (Alquist/Steinberg) standardizes and simplifies the health insurance market so that consumers better understand their choices and can make apples-to-apples comparisons.

In introducing her bill, Senator Alquist said, “This establishes the exchange as an active purchaser that will try to get the best possible deal for consumers shopping for individual policies.” She said the exchange would be administered by a board of legislative and gubernatorial appointees that would meet in public every two months. The board will be held accountable for its decisions, Alquist said.

Health Access advocate Beth Capell said it is estimated that between three and nine million Californians would get coverage through the exchange. The exchange will ensure that people are charged for health insurance on a sliding scale, so those who make less will be charged less, and those with higher incomes will pay prices according to a sliding scale as well. It is envisioned that this fundamental building block of health reform in California would be consumer-friendly enough to attract small businesses into the exchange.

Read more at the Health Access blog…

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Panel Approves Bill To Establish Health Insurance Exchanges

Posted on April 21st, 2010 by HCAN California in Health Reform in California, News

From the California Healthline

On Tuesday, the Assembly Health Committee approved a bill (AB 1602) by Assembly Speaker John Pérez (D-Los Angeles) that would create the California Health Benefit Exchange to allow individuals and small businesses to purchase private health insurance coverage, the San Francisco Chronicle reports (Colliver/Lagos, San Francisco Chronicle, 4/21).

The new national health reform law requires requires such exchanges to be established by Jan. 1, 2014. The law also aims to facilitate participation in the exchanges by providing tax credits to small businesses and federal subsidies to individuals without employer-sponsored coverage (Ferriss, Sacramento Bee, 4/21).

Pérez said state lawmakers will need to pass AB 1602 this year for it to take effect by the deadline. He added that swift passage of the legislation will provide California officials with sufficient time to set up the exchange (San Francisco Chronicle, 4/21).

Exchange Details

Pérez’s bill would direct the Legislature and the governor to appoint an executive board for the exchange (Sacramento Bee, 4/21). The board would administer federal planning money and oversee California’s efforts to establish the health plan marketplace.

In addition, the measure would charge California’s exchange with identifying individuals who qualify for public health insurance and enrolling them in Medi-Cal, Healthy Families or other services. Medi-Cal is California’s Medicaid program and Healthy Families is the state’s Children’s Health Insurance Program.

The exchange also would need to enforce the federal health insurance mandate. State officials would send reports to the U.S. Department of Treasury listing residents who could be exempt from the mandate because of a lack of affordable health care options.

Changes to State Law

In addition to establishing the exchange, Pérez’s bill would modify state law to conform to provisions in the national health reform law that will take effect by the end of 2010, such as:

  • Extending coverage for dependents until age 26;
  • Eliminating lifetime limits on policy benefits; and
  • Prohibiting insurers from denying coverage to children because of pre-existing conditions.

Bill on High-Risk Pools

In related news, the Assembly Health Committee has approved a bill (AB 1887) by Assembly member Mike Villines (R-Clovis) that would establish a high-risk insurance pool for individuals who are unable to obtain private coverage because of a pre-existing condition.

California already has a high-risk insurance pool that covers about 7,000 residents, but it does not meet requirements to qualify for federal subsidies under the new health reform law.

The high-risk pool proposed under AB 1887 would operate along with the state’s current pool until 2014, when insurance companies will be prohibited from denying coverage based on pre-existing conditions (Herdt, Ventura County Star, 4/20).

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Crowd shows appreciation for Rep. Matsui

Posted on April 12th, 2010 by HCAN California in Action, Health Reform in California

More than 150 supporters came down to Trinity Cathedral in Sacramento on Thursday (April 1) to show their appreciation for Representative Doris Matsui. The enthusiastic crowd thanked the Congresswoman for her long-term support and her vital role in making health reform a reality last month!

Among those groups who participated in the event included HCAN-CA lead state partner, Health Access, as well as AARP, California Primary Care Association, Sacramento Labor Council, Alliance of Californians for Community Empowerment and many others!

Check out the pictures below:

HCAN-CA Campaign Director, Patrick Romano, talks with Rep. Matsui

HCAN-CA Campaign Director, Patrick Romano, talks with Rep. Matsui

Crowd thanks Rep. Matsui for standing strong for health care reform.

Crowd thanks Rep. Matsui for standing strong for health care reform.

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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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