Blue Shield and Blue Cross settle on rescissions…

Big day on rescissions. I was in Los Angeles, testifying before the LA County Commission on Insurance in support of SB840, health reform, and specific pending legislation on recissions–after all there are no less than four bills, sponsored by Assemblymembers De La Torra, Deleon, Hayashi, and Lieu, that include a number of reforms.

I thought I was providing the most up-to-date information, but a lot happened.

The Capitol Weekly and The Los Angeles Times reports on two major settlements, with Blue Shield to restore coverage to 450 rescinded patients and pay a $3 million fine, and Blue Cross to restore coverage to 1770 patients and pay a $10 million fine. Earlier settlements were already reached with Kaiser, HealthNet, and Pacificare, albeit with smaller fines and numbers of people impacted, given their market share.

We’ll need to watch over the Department and the insurers to ensure their goals are reached for these consumers:”guaranteed issue coverage, a process for full monetary losses and no back premiums owed,” as Department of Managed Health Care Director Cindy Ehnes had identified in the LA Times.

It’s good that there has been a focus on getting these folks coverage as soon as possible, even as other court and other proceedings continue. The question is what laws can help moving forward so we radically reduce or eliminate these practices once and for all. The ideas pending include:
* providing a independent review of all rescission cases;
* standardizing the underwriting proccedings;
* shortening the time frame where a patient can be rescinded;
* eliminating bonuses paid to employees who rescind more patients;
* protecting family members’ coverage when a family member is rescinded; and
* setting standards for brokers due diligence.

Finally, at the federal level, Congressman Henry Waxman and the House Committee on Oversight and Government Reform held a hearing on the subject, featuring testimony from several rescinded patients, a representative of the insurers, and from California, Secretary Dale Bonner, which oversees the DMHC. It put a federal spotlight on the issues, hopefully helped in getting some attention on these issues in a new light, maybe helped serve as an impetus for these settlements, and sets what being “a regular” may mean.

Health Access California promotes quality, affordable health care for all Californians.

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