Timely Access

Covered California Open Enrollment Started Sunday!

Yesterday marked the official start of Covered CA open enrollment, which will run through January 31, 2016. For coverage effective January 1, people must enroll by December 31, 2015. As always, Medi-Cal enrollment is open year-round and individuals experiencing any life transitions (losing a job or moving, among many qualifying events for Special Enrollment) may […] Read More

Key Health Care Consumer Protections to Prevent Unfair Out-of-Pocket Costs Advance to Final Floor Votes

SB137 (Ed Hernandez), to require updated, standardized & accurate health plan provider network directories, passed out of Assembly Appropriations Committee. AB533 (Bonta), to stop “surprise” billing from out-of-network doctors; AB339 (Gordon) to prevent unfair cost-sharing for specialty drugs, and AB1305 (Bonta) to limit out-of-pocket costs for individuals in family plans, passed out of Senate Appropriations Committee. SB248 (Roger Hernández), a bill to prevent […] 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 […] 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 […] 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 […] Read More

Kaiser Family Foundation Survey Findings Affirm Results of State Reform Efforts to Date and Consumer Advocates’ Legislative Focus Two Years into Affordable Care Act

Findings from a recent Kaiser Family Foundation survey of low and moderate income California residents, released yesterday, suggest the state is generally on the right track in ACA implementation, specifically in its choice to build a robust “active purchaser” exchange and to target communities with the largest coverage gaps. Those and other priorities of Covered […] Read More

Another troubling stat…

As many as 20% of patients at California’s emergency departments leave without being seen, according to a new study published in the Annals of Emergency Medicine, HealthDay reports. For the study, researchers analyzed information from a database run by the Office of Statewide Health Planning and Development. The database contained information on 9.2 million ED […] Read More

A timely salute to a public servant…

As part of the transition to the new Brown Administration, Cindy Ehnes is stepping down as the head of the Department of Managed Health Care (DMHC). I was pleased to speak last night at Cindy’s farewell party, alongside the head of the HMO Association. Cindy had previously served as a consumer representative in Colorado, and […] Read More