Insurers

Consumer Advocates Raise Concerns About Aetna-Humana Mega-Merger at CDI Hearing

On April 27, the California Department of Insurance held a hearing on the proposed merger of Aetna and Humana. This hearing takes place after a public meeting held by the Department of Managed Health Care (DMHC) in January. This hearing comes on the heels of a Senate Health Committee hearing this month on SB 932 (Hernandez), a bill that ensures that mergers and consolidations in California’s health care marketplace do not have a negative impact on cost, quality, and access to care for California consumers. Currently, two of four major health insurance mergers have been finalized by the state of California; Blue Shield of California acquired Care1st last year and Centene’s proposal to acquire Health Net was approved with conditions […] Read More

Legislative Priorities Clear Deadlines

As the April 22 policy deadline approached, all of Health Access’ priority bills made it over the finish line. Last week, the legislative committees voted on two important bills that will increase transparency in our health care system. Transparency for Prescription Drug Costs Prescription drugs are the health service most commonly used by consumers and contribute to soaring out-of-pocket costs. AB 2436 (Hernandez), heard in the Assembly Health Committee on Tuesday, seeks to increase transparency in drug prices by giving consumers more information about the cost of their prescription drugs and how much they will have to pay. In committee, the bill was amended to remove a provision that would also require the drug company to disclose the cost of the […] Read More

Patient-Protection Bills Moving Forward in Legislature

With the legislative session in full-swing, Health Access California’s bills are moving full steam ahead! Last week, SB 908 and SB 1135 both passed the Senate Health Committee. SB 1135 (Monning) helps consumers know there are time limits on how long they have to wait to get health care appointments and who to complain to if they have problems with their health plan. Among other provisions, the legislation would put the state regulator’s complaint number on the insurance card. SB 908 (Hernandez) gives consumers and purchasers the information they need to decide if they want to stay with a health plan that has an unreasonable rate increase. Both of these measures now move to the Senate Appropriations Committee. This week, the Senate […] Read More

Covered California Board Addresses 1332 Waiver, Quality Requirements, Special Enrollment Verification and other Hot Topics

This blog was written by Kate Burch On April 7, 2016, the Covered California Board addressed several hot topics at their April meeting. You can find a recording of the board meeting, links to the presentations, and links to all of the proposed regulations, attachments, etc. here. 1332 Waiver Report Stakeholders and experts have been very involved in working with Covered California over the last three months to develop the ideas and possibilities for a 1332 waiver, which allows states to make certain changes to their implementation of the ACA as long as they meet key goals on coverage, affordability and more. The Covered California staff considered the many proposals that were put forward and presented an analysis of some of […] Read More

Wonkery for Your Week

We wanted to spotlight two of the recent Health Wonk Reviews, a biweekly compendium of the best from the health policy blogosphere. Last week, Charles Gaba at ACAsignups.net (the best place to track Obamacare enrollment nationally) had a very California-heavy edition, with posts about Covered California’s quality initiatives, our death-with-dignity law, and our post about anti-tobacco activity. Also directly relevant to the current debate in the California legislature is a post from Louise Norris at Colorado Health Insurance Insider about the recent Florida legislation against surprise medical bills. The previous edition, David Williams at Health Business Blog featured our post on health plan mergers. Expect a new edition later this week by Jaan Sidorov at The Population Health Blog.

First Patient Protection Bills Up in Committee Next Week

UPDATE: The hearing for these bills has been pushed backed to a later date. Stay tuned for more information. (3/25/2016) When the Legislature comes back from Spring Break next week, the Senate Health Committee will be hearing two consumer protection bills, SB 908 and SB 1135 on Wednesday, March 30. Both of these bills are sponsored by Health Access California. Unreasonable Rates: Notice/Opportunity to Shop: SB 908 (Hernandez) requires individuals and small business owners be notified if the premium for a plan they choose is “unreasonable” and “unjustified” and be given a new open enrollment opportunity to potentially find a new plan. Notification of Consumer Rights: SB 1135 (Monning) requires health plans and insurers to notify consumers and health care providers […] Read More

New Timely Access to Care Standards Adopted by CA Department of Insurance

On March 9, consumer advocates cheered the new standards announced by the California Department of Insurance for health insurers to create and maintain accurate provider directories. The new standards also require insurers to have adequate numbers and types of providers in their networks so consumers can get the care they need when they need it. These new standards make sure all California consumers can find a provider in their network and access to the care they need in a timely manner. All insured Californians should have basic access to timely care and not have to deal with an inaccurate provider directory when looking for an in-network doctor. While many of these consumer protections have been in place for health plans […] Read More

Anthem Blue Cross-Cigna’s Troubling Track Records Spotlighted at DMHC Public Meeting

On March, 4, 2016, the Department of Managed Health Care (DMHC) held a public meeting on the proposed takeover of Cigna by Anthem Blue Cross. The public meeting was requested by consumer groups including Health Access, Consumers Union, and others to raise questions about the structure of the deal, its potential impact on California’s patients and health care systems, and ensure proper oversight as insurance companies merge and become larger. The proposed Anthem Blue Cross-Cigna merger is one of three pending insurer mergers being reviewed by DMHC. Late last year, DMHC approved a merger between Blue Shield and Care1st, following Health Access’ and other consumer groups’ requests for strong conditions to address potential negative impacts. Health Access is also monitoring the proposed Centene-Health […] Read More

Covered CA Board Takes Big Steps on Standardized Benefit Design and Quality/Equity Measures; Considers New Barriers to Special Enrollment

Thursday’s Covered California Board meeting, the first since the last day of open enrollment 2013, offered a deep dive on the standardized benefit designs and the quality/equity framework that will guide contracting with insurers for the next 3-year cycle (2017-2019), and a heated discussion about the new documentation requirements that insurers are calling for to qualify as a SEP enrollment. Executive Director Report Covered CA Peter Lee shared observations about OE3 and the second renewal period: With 440,000 new enrollees and a decent number choosing new plans in renewal, competition and shopping tools seem to be working. Take up by diverse and subsidy-eligible populations affirms Covered CA’s more targeted approach to marketing and outreach. Even better for the risk mix and therefore […] Read More

Legislature Holds Informational Hearings on MCO Tax

Today, the Legislature’s special session Committees on Public Health and Developmental Services each held informational hearings on the Administration’s proposed Managed Care Organization (MCO) tax. The hearings were held to help legislators and the public understand the proposal and no votes were taken today. The Administration’s MCO tax proposal is reflected in AB 2x-20 (Bonta) and SB 2x-15 (Hernandez), which have identical language. Jennifer Kent, Director of the Department of Health Care Services (DHCS), presented the Administration’s proposal at both hearings. California must overhaul the current MCO tax or lose $1.1B in funding for the Medi-Cal program. The proposed MCO tax proposal has broad support from health plans, consumers groups like Health Access and Western Center on Law and Poverty, […] Read More