Insurers

Governor Brown Signs Key Patient Protections Bills Against Unfair Out-of-Pocket Costs

California Governor Jerry Brown yesterday signed four patient protection bills that will address unfair out-of-pocket costs, including out-of-network bills due to inaccurate provider directories, huge cost-sharing for specialty drugs, double deductibles in family plans, as well as extend protections against “junk insurance” to benefits offered by large employers. These Health Access-sponsored bills address some of the most common complaints we continue to hear from consumers. Under these new laws, patients will have better information, less out-of-pocket costs, and more financial security. These bills include: SB 137 (Hernandez) will require updated, standardized, and accurate provider directories.  Co-sponsored by California Pan-Ethnic Health Network, Consumers Union, and Health Access California (see separate SB137 fact sheet), SB 137 will address the common insurance industry practice of posting inaccurate, out-of-date, […] Read More

Key Patient Protections Pass Legislature, Now On Governor’s Desk

With the California Legislature adjourning after midnight last Saturday, most of the action on priority bills for health consumers moves to the Governor’s desk. Most of the Heath Access-sponsored bills protecting consumers from unfair out-of-pocket costs are now one Governor’s signature away from enactment. There were disappointments in the final days of this year’s legislative activity, including the lack of action on a range of revenue and tobacco control measures in the special session. Health Access’ consumer protection proposal AB 533 (Bonta), to halt surprise bills, failed on a vote of 38-10—just 3 votes short of passage. Overall, though, many important patient protections passed in a productive session advancing health reform. Even if a bill makes it to the Governor’s desk and even […] Read More

Final Week of Legislative Session: Where We Stand on Key Bills Protecting Consumers

Key patient protection bills hang in the balance this week, as Friday is the deadline for bills to pass from final floor votes in the California legislature to the Governor’s desk. In this last week of California’s legislative session, amendments have been taken on the key bills impacting health care consumers, but the substance of Health Access’ sponsored bills remains intact: to protect consumers from unfair out-of-pocket costs. SB 4 #Health4All has been scaled back to include mostly technical enrollment policy and process fixes related to covering all kids in Medi-Cal. Unfortunately, feedback from the Governor’s office has prompted bill author Senator Ricardo Lara to take out a key provision instructing the state to seek a section 1332 waiver to allow undocumented […] Read More

Covered California Board Meeting: Highlights from August 20, 2015

This Covered California board meeting featured a discussion of a vision benefit proposal and agents’ payments and responsibilities, both for action next month; the release of rates for 2016, an update on the redesigned navigator program; and a hearty welcome to new Board member and former Senator and Democratic Party Chair Art Torres (see his bio). Executive Director’s Report New rates for 2016 calendar year: Preliminary rate filings show an average rate increase of around 4%, which is lower than historical norms. Where there is greater market competition, as in Los Angeles, we find a smaller increase in rates (1.8%).  Covered CA Executive Director Peter Lee urged consumers to shop for better rates and network access in 2016–folks switching to […] Read More

Special Session on Healthcare – Informational Hearings

This week, the Legislature held two informational hearings as part of the 2015-16 Second Extraordinary Session on healthcare. These hearings were convened to help lawmakers, and the public, understand approaches to structuring a Managed Care Organization (MCO) tax and the state of Medi-Cal funding more broadly. The current MCO tax only applies to health plans that participate in Medi-Cal and these plans largely get their money back, with federal matching funds, through their capitated payments. New federal rules require the MCO tax to be broad-based, meaning it needs to apply to all health plans and not just those that participate in Medi-Cal. Senate Hearing on the MCO Tax Yesterday, the Senate Committee on Public Health and Developmental Services Committee held […] Read More

Close Up on A Key Consumer Protection Bill: AB 339 Prescription Drug Cost Sharing

Today many more Californians have access to health care coverage under the Affordable Care Act, however many premium-paying patients who are covered still struggle with out-of-pocket costs. Some practices by providers and health insurers unfairly burden patients with unmanageable cost-sharing, interfering with access to care people need. AB339 (Gordon), a Health Access sponsored bill moving through the California Legislature, would prevent discrimination against consumers with chronic health conditions and set standards for cost sharing for prescription drugs. The emergence of very high cost specialty drugs led health plans and insurers to impose high copays and coinsurance on these drugs. Such drugs are often placed on the highest cost tier of a drug formulary (commonly known as the “fourth tier” or […] Read More

Assembly Health Committee Gives Green Light to Key Consumer Health Bills

Earlier today the Assembly Health Committee voted on several priority bills impacting health care consumers and the remaining uninsured, including SB 4 (Lara) For those who keep score, here’s how key consumer protection bills came out in today’s vote: SB 4 (Lara) Health Care Coverage, Immigration Status: 10-6 SB 137 (Hernandez) Accurate Provider Directories 16-2 SB 43 (Hernandez) Essential Health Benefits 16-1 SB 4 (Lara): Allowing Broader Access to Covered California  As amended, SB 4 (Lara) seeks to allow all Californians, regardless of immigration status, to purchase coverage through Covered California, using their own money. While the Affordable Care Act limits participation in health insurance exchanges to citizens and legal permanent residents, SB 4 directs the administration to seek a […] Read More

To Celebrate the SCOTUS Decision: LGBT Health Roundtable with HHS Secretary Sylvia Burwell

In tribute to today’s Supreme Court ruling in favor of full marriage equality for LGBT Americans, Health Access presents this report from Kate Burch, Network Director for the California LGBT HHS Network. Health Access joins with many others in celebrating today’s historic ruling, even as we are mindful of the work still needed to ensure better and more equitable health and health care for all LGBT Americans. Last Friday, June 19, Health and Human Services Secretary Sylvia Burwell met with about 25 LGBT health advocates in Washington, DC to hear about the health care needs of LGBT communities around the country. After brief mention of the Affordable Care Act and the importance of addressing transgender health inequalities, Secretary Burwell opened up the […] Read More

Closing a Loophole on Subminimum Coverage

California Healthline this week is hosting a discussion on our bill, SB248 (Hernandez) to prohibit subminimum coverage. We sponsored this bill to close a loophole in the ACA that allows such coverage–prohibited in the individual and small group markets–to be offered by large employers, and if taken up could prohibit workers from getting subsidies for comprehensive coverage in Covered California. This bill is up in Senate Health Committee today. We appreciate the contributions from Julie Silas of Consumers Union and Gerald Kominski of UCLA Center for Health Policy Research. Here’s the full un-excerpted contribution from our policy advocate Beth Capell:   Some of the success that California has had implementing the Affordable Care Act could be undone if the state […] Read More

DMHC Hearing on Blue Shield Acquisition of Care1st Gets at Larger Questions on Nonprofit Obligations

Yesterday’s hearing (covered today in the LA Times) on nonprofit Blue Shield of California and its bid to acquire for-profit Medicaid managed care plan Care1st provided better clarity on the issues at stake in the $1.25 billion transaction, and little reason to doubt whether the assets Blue Shield proposes to use should be subject to charitable trust obligations. The comment period is open through this Friday, June 12 (details below), for the public to raise their issues and concerns. Health Access submitted comments with Consumers Union and other consumer groups on the charitable trust issues, and also published a recent issue brief/discussion draft on the obligations of a non-profit insurer in a post-ACA world. Requested by Consumers Union, Western Center on Law and poverty, CALPIRG, and Health Access, […] Read More