Anthem Blue Cross and more about health reform…

Monday, March 1, 2010

* Rate Hikes Draw Scrutiny; CA’s AB 2578 Rate Regulation Bill Gains Momentum
* Deep Details from D.C. Hearing with Anthem Blue Cross/Wellpoint CEO
* DMHC Holds Hearing on So-Called “Discount Health Card Plans”
* Health Access to Help Represent Consumers at Natl Assn of Insurance Commissioners

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NEW MOMENTUM FOR HEALTH REFORM: A real life and timely example of what needs fixing–in the form of the actions of Anthem Blue Cross of California–can spur momentum for needed reforms of the broken health care insurance market. In Washington, DC, the rate hikes by California’s biggest insurer have become Exhibit A in the fight for comprehensive health reform. President Obama even adopted, as part of his proposed unveiled a week ago Monday, a proposal by California Senator Dianne Feinstein for additional federal rate authority to review and reject increases, where appropriate.

These rates were also brought up in the much-commented on White House bipartisan health reform summit this past Thursday. Legislative leaders, including Speaker Nancy Pelosi of California, continue to press to pass a major reform with the goal of completing work before Easter. This would involve the Senate bill–which had already passed the Senate by a 60-vote supermajority–and some changes and improvements done through “reconciliation,” which is the purpose of that majority-vote procedure.

RATE REVIEW TO GET A REVIEW: Back in California at the Assembly Health Committee’s informational hearing on the rate increases planned by Anthem Blue Cross, Chair Dave Jones (D) cited Anthem’s upcoming premium hike of 39% as reason to move aggressively forward with his AB 2578. The bill would allow the Department of Insurance as well as the Department of Managed Health Care to regulate rate increases. Assemblyman Mark Leno (D) is principal co-author. According to Assembly procedural rules, the first date it can be heard in committee is Tuesday, March 23rd.

CONGRESS RELEASES SOME OF THE ANTHEM DOCUMENTS: The Congressional subcommittee of the House Energy and Commerce Committee (chaired by California Rep. Henry Waxman) holding a hearing last week on Anthem’s rate increases released a lot of in-depth financial information about WellPoint, Anthem Blue Cross’ parent corporation. We’ve got links and details on the Health Access blog for the wonkish and curious.

SPEAKING UP FOR CONSUMERS AT THE NAIC: This past week, sixteen consumer representatives were named to regularly attend the National Association of Insurance Commissioners–including Health Access and other state-based consumer organizations throughout the country. Health Access’ Elizabeth Abbott, was selected by NAIC as one of the official consumer representatives appointed to advise state insurance commissioners and their national organization on health policy and market regulation. The designation of consumer representatives is designed to ensure consumer protections and good public policy are adopted in regulations and policies drafted by the NAIC which often serve as a template for state regulators. Health Access sees this appointment as particularly well-timed to influence state-based and national health care reform efforts with this influential association, which has some specific tasks under the pending health reforms.

In addition to the four years Ms. Abbott has worked for Health Access, she has considerable experience as a long-time federal employee with the Social Security Administration and most recently as the Centers for Medicare and Medicaid Services (CMS) Regional Administrator for the western states and the Pacific Territories.

CRACKDOWN ON “DISCOUNT” PLANS: Health Access and several of our coalition partners (including the California Pan Ethnic Health Network [CPEHN], Health Rights Hotline, and the Health Consumer Alliance) testified before the Department of Managed Health Care (DMHC) in Oakland on February 22 regarding new regulations concerning so-called Discount Health Plans.

Many consumer advocates generally favor the new DMHC regulations because of the strict new requirements laid out governing the actions of these so-called discount health plans operating in California. DMHC has received over 1,000 consumer complaints regarding the deceptive practices engaged in by more than 150 plans selling what they portray as “comprehensive health insurance.” However, many of these companies do not offer a valid discount off the price from a known network of providers. After consumers buy this “discount card” for $25 to even $100 a month, they find that the doctors do not accept the card, do not provide a discount, or would have granted the same or an even greater discount for free based on other affiliations such as churches, unions, automobile clubs, or fraternal organizations.

DMHC has ordered 8 of these companies to “cease and desist” operations in the state, and are establishing requirements and consumer protections for those companies who want to do business in the state. The discount companies were at the public hearing in force claiming these proposed regulations are an unfair restriction on their ability to do business in California and an infringement of their free speech rights. DMHC will take all comments under advisement and release new regulatory language within the next several months. We urge organizations who have members under this predicament to contact us,

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

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