Individual Market

Exchange bills pass the CA Senate…

HEALTH ACCESS UPDATETuesday, August 24, 2010 CALIFORNIA LEGISLATURE PASSES FIRST-IN-NATION BILLTO IMPLEMENT HEALTH REFORM BY CREATING NEW INSURANCE EXCHANGE * Key Bills, AB1602(Perez) and SB900(Alquist/Steinberg), Pass Tough Senate Vote * In 2014, New Exchange Will Be One-Stop Shop for Consumers to Compare Plans, Get Affordability Subsidies & Get Quality Coverage with No Pre-Existing Conditions Denials* Exchange Would Pool Bargaining Power of Millions of Californians to Negotiate with Insurers for Best Price & Value* Anthem Blue Cross Opposed Bills, Including the Exchange’s Bargaining Power, and its Conflict-of-Interest Provisions * AB1503(Lieu) Also Passes Senate, to Prevent Uninsured from Overcharging from Emergency Room Doctors* Key Other Bills Up Later This Week, including Rate Transparency, Rate Regulation & Approval, Benefit Standards, and Affordable Access […] Read More

Three down, many more to go…

HEALTH ACCESS UPDATETuesday, August 24, 2010 KEY HEALTH CONSUMER PROTECTIONS HEAD TO FINAL FLOOR VOTES THIS WEEK * Bills Pass Monday to Prevent Rate Hikes More Than Once a Year; Allow Young Adults up to Age 26 Onto Parental Health Plans; and Facilitate Local Public Health Insurance Options * Multiple Pending Bills Would Implement & Improve Federal Health Reform in California* Key Bills Would Set Up New Exchange to Negotiate with Insurers for Best Price & Value* One Bill Would Establish Minimum Benefit Standards, Allow Better Comparison Shopping* Bills for Rate Review & Transparency and Rate Regulation & Approval Hotly Contested* Also At Stake: Affordable Access for Children with Pre-Existing Conditions* Votes This Week, While Anthem Blue Cross and Other […] Read More

The key bills in this week’s legislative battle…

This week, California legislators will decide whether to institute new patient protections, to provide consumers with greater access and affordability for coverage, and to implement and improve the new federal health law. Victoria Colliver at the San Francisco Chronicle reports on some of the bills heading to a final deadline. Here are key bills that are crucial for health care consumers, yet are opposed by Anthem Blue Cross and other insurers. * CREATING A NEW CONSUMER-FRIENDLY EXCHANGE WITH BARGAINING POWER: AB 1602 (Perez) and SB 900 (Alquist/Steinberg) are companion bills, up in the Senate today or tomorrow, that will establish a new health insurance Exchange as required by the federal health reform law. In 2014, the new Exchange will be […] Read More

The core bills start to move…

A bill that sets up the governance of a new health insurance exchange, SB900(Alquist/Steinberg), passed the Assembly earlier today, 49-25. This, along with the companion bill AB1602(Perez), which creates the exchange, is a central element of health reform, as it will how California families and small businesses will be able to get coverage easily and affordably. Starting in 2014, individuals will be able to get coverage regardless of pre-existing conditions. The exchange will offer one-stop shopping, providing easy-to-compare options. It also will be the vehicle for consumers to get which to get subsidies to afford coverage. In the exchange, basic coverage won’t cost more than a certain percentage of premium, based on a sliding scale. And for those under 400% […] Read More

A Report from “The Battle in Seattle”

Well, I’m back from the National Association of Insurance Commissioners (NAIC) meeting in Seattle! I went to the NAIC meeting because I am one of the dozen or so consumer representatives who were chosen in March to represent consumers’ interests as that organization works out many of the details of how health care reform will play out. The NAIC increased the numbers of consumer representatives this year because of the central role the NAIC has in writing policies and model regulations for the states and their official advisory role to the federal government in health care reform implementation. They already are lobbied by hundreds of industry representatives, and the commissioners needed the consumer perspective of how the implementation of health […] Read More

Real choices…

Last week’s passage of key state health reform implementation legislation mostly focused on the bills–SB900 and AB1602–setting up the California exchange, the new purchasing pool where many Californians–especially those not getting coverage through large employers–will be getting their coverage. California may well be the first in the country to pass a law, post-reform, to create an exchange, in accordance with the new federal law. But health reform’s transformation of how individuals buy coverage should not solely be within the exchange. Many of the consumer protections–from prohibiting denials for pre-existing conditions to setting standard benefits–need to be in the overall market for individuals and small businesses who purchase coverage. In this vein, SB890(Alquist/Steinberg) address the structural flaws in the overall individual […] Read More

Once a year is enough!

If you can believe it, the health insurance industry’s argument Tuesday against restricting rate hikes to once a year was that an incremental sprinkling of increases every few months would help consumers deal with sticker shock. Of AB 2042, a bill to limit insurance companies to just one premium increase annually, a lobbyist for health plans said: “This only ensures that consumers will receive a bigger rate increase once a year.” In his view, multiple “adjustments” in a year’s time — that is, in addition to “the one-time annual global increase in our premiums” — would serve to soften the blow. Members of the Assembly Health Committee, chaired by Assemblyman Bill Monning, weren’t buying the upside-down logic. AB 2042 by […] Read More

Sebelius writes Anthem Blue Cross of CA…

Maybe this is how we get some rate review after all. U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today sent a letter to Anthem Blue Cross of California urging it to publicly justify its premium hikes for its California individual market customers–hikes that are as much as 39 percent. Here’s the letter:  February 8, 2010Leslie MargolinPresident, Anthem Blue Cross Dear Ms. Margolin,One of the biggest pressures facing families, businesses and governments at every level are skyrocketing health insurance costs. With so many families already affected by rising costs, I was very disturbed to learn through media accounts that Anthem Blue Cross plans to raise premiums for its California customers by as much as 39 percent. These […] Read More

Those with the least pay the most…

Without bulk purchasing power, individuals are the most disadvantaged in the current health care system. The most recent example Anthem Blue Cross is raising its rates in the individual market, as reported by Duke Helfand in the Los Angeles Times today. It’s a Commonwealth Fund study further explores the difficulties with the current individual market. I make a similar point in the post highlighted in this week’s Health Wonk Review hosted by Joe Paduda at Managed Care Matters. When individuals are self-pay patients, they get charged more than insurers for the same level of care. That’s why the crux of health reform is to make sure individuals (and small businesses) have the benefits and bargaining power of large purchasers. Today’s […] Read More

The suspense is over

This report, prepared as the last week for fiscal committees to take action is winding down, is by Health Access advocate Beth Capell: Today, the Senate Appropriations Committee took action on numerous important health measures; some of the news is good, some of it is bad. In a very difficult state budget year in the midst of the worst economic downturn since the 1930s, it is not surprising that Appropriations members would be cautious about letting out measures that increase cost. Still the bad news is never pleasant. Good news: bills that passed…. AB786 (Jones-D), the Health Access-sponsored bill to provide consumer protections in the individual market. AB2 (DeLaTorre-D) on independent review of rescinded policies. AB98 (DeLaTorre-) on maternity coverage […] Read More