HCAN!California

Archive for April, 2010

Anthem Blue Cross withdraws rate hikes, for now..

Posted on April 30th, 2010 by HCAN California in Private Insurance Industry

By Anthony Wright | Health Access WeBlog

California consumers got some relief today. Insurance Commissioner Steve Poizner announced that Anthem Blue Cross of California has withdrawn their rate filings, after a review of an independent actuary has revealed various problems, including arithmetic errors and double-counting.

The rate hikes of up to 39% were controversial, the subject of a white-hot presidential spotlight during the health reform debate.

It’s great that California ratepayers got a reprieve from outrageous rate hikes by Anthem Blue Cross of California.

But more than rate relief, this withdrawal of the rate hike proposals show why we need regulators to have active oversight over the insurance industry. This review was done under existing law, which provided very limited authority, and it was still able to find basic problems in arithmetic and double-counting.

Oversight and regulation matter. This shows why more extensive oversight is needed, some of which is in the federal health reform that passed, and additional rate review proposals that are pending at both the state and federal levels.

Federal health reform (and pending state implementation) would create health insurance exchanges, where people buying coverage as individuals could join and benefit from group purchasing to negotiate for better prices and value. There are also pending proposals at both the state and federal levels to have rate review and approval authority, especially in the period before 2014 when the exchange come into full effect.
* At the federal level, California Senator Feinstein has a proposal to regulate rates at the federal level, especially for states that don’t have a rate review process.
* California is one of those states that does not have rate review, but there are pending bills. Assemblyman Dave Jones has a rate approval bill, AB2578. State Senator Mark Leno has a bill for insurers to disclose their rate methodology, SB1163.

We need these continued reforms, so when Anthem Blue Cross resubmits rate hike proposals, there’s a process to properly review them.

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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

HEALTH ACCESS ALERT
Tuesday, April 6, 2010

HEALTH REFORM DEBATE SHIFTS TO IMPLEMENTATION BILLS IN CA LEGISLATURE

* 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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