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DMHC, Timely Access

Consumer Advocate Reaction to $55M Fine on LA Care Health Plan

Today, the California Department of Managed Health Care (DMHC)  and the Department of Health Care Services (DHCS) fined the L.A. Care health plan $55 million dollars for tens of thousands of violations that resulted in delayed or denied care. Going back several years, L.A. Care systematically failed to handle grievances timely, by not giving consumers authorization for timely care, and by failing to ensure that LA County Department of Health Services provided timely access to care, especially specialty care.

Affordable Care Act, Covered California

California Health Committee Chairs Introduce Bills to Increase Affordability in CoveredCA

New state legislation introduced today would fill key affordability gaps in Covered California, potentially lowering cost-sharing and eliminating deductibles for over a million Californians getting coverage through the state marketplace.

AB 1878 by Assemblymember Dr. Jim Wood, and SB 944 by Senator Dr. Richard Pan, both sponsored by Health Access California, the statewide health care consumer advocacy coalition, would remove financial barriers to care for hundreds of thousands of patients, and encourage even more Californians to sign up for coverage.

Medi-Cal

JOINT STATEMENT: Consumer Advocates Respond to Kaiser Medi-Cal Contract Announcement

Two leading health and consumer advocate organizations have released the following statement in response to the recently announced Medi-Cal contract between the Department of Health Care Services (DHCS) and Kaiser Permanente.

 “Health and consumer advocates have been strong supporters of the state’s proposal to recontract with all the managed care plans in our Medi-Cal program. It’s been decades since this re-contracting process has been done, and we have urged the state to hold all plans to higher standards for quality and equity for the over 14 million Californians who depend on Medi-Cal for their care.  These standards should include Kaiser, which has avoided a statewide contract to date, and push them to do more in Medi-Cal.”

Affordability, Budget, Legislation, Medi-Cal, Prescription Drugs

Key Health Investments to be Heard in CA Budget Committees Starting This Week

Big health reforms, from major expansions of access and affordability to efforts to control costs and improve quality and equity, will be heard in the California Legislature starting tomorrow, as hearings begin on the Governor Gavin Newsom ‘s $286.4 billion state budget for 2022-23. The hearings will discuss historic steps to close coverage gaps and bring California to near-universal health coverage. These hearings will debate what is in the current budget proposal, but also areas where the state can improve, or take additional steps to strengthen our health care system. 

Affordability, Consumer Protection, Medi-Cal, Surprise Bills

HEALTH ACCESS: Updated Health Access Report Points to Success for New National Law Against Surprise Medical Bills Now in Effect

On the week that new federal rules go into effect to prevent patients from getting surprise medical bills, consumer advocacy group Health Access California releases an updated report on the California experience of a similar state law. The report shows the laws success in protecting patients from unexpected out-of-network bills as well as inflated premiums from provider overcharging with no indication of negative impacts on network size or patient access to care.

Consumer Protection, Cost Containment, Mergers

HEALTH ACCESS: CA DMHC Approves Centene-Magellan Merger With Conditions

For immediate release: Thursday, December 30, 2021 For more information, contact:Anthony Wright, executive director, Health Access California, 916-870-4782 (cell) MERGER WATCH: CALIFORNIA DMHC APPROVES CENTENE-MAGELLAN MERGER WITH CONDITIONS AND CONSUMER PROTECTIONS California’s Department of Managed Health Care today approved a “diagonal” merger between the health plan Centene and Magellan, with several conditions on protecting patients from premium hikes as a results of the merger, improving access to care, especially regarding […]

Scorecard

California Health Consumer Champions Revealed in Health Access’ 2021 Legislative Scorecard

Health Access 2021 Legislative Scorecard analyzes how California legislators voted on bills to improve our health care system for California health consumers, including efforts to expand coverage, lower the cost of care, and hold the health care industry accountable for quality and equity. More than half of all legislators (27 Senators & 42 Assemblymembers) voted with health care consumers 100% of the time for the 2021 legislative session, with 26 lawmakers (10 Senators & 16 Assemblymembers) earning the title of “Health Consumer Champion” for receiving 100% for 3 years running (2019-2021).

Affordability, Budget, Federal, Legislation, Medi-Cal

California Health Consumers to Benefit as U.S. House Passes Build Back Better Bill

This morning, the U.S. House of Representatives passed the Build Back Better Act, with 42 California congressmembers voting to advance the historic legislation that would help lower health care costs and otherwise make investments to improve our health care system. The bill now goes to the Senate for consideration, and would come back to the House for a concurrence vote before heading to President Biden for a signature.

Covered California, Economy, Expanding Coverage, Legislation

Today Begins 2021-22 Covered California Open Enrollment with Lowest Premiums Ever

Today marks the first day of the 2021-22 open enrollment period for Covered California, kicking off the most affordable coverage year ever for Californians purchasing care on their own. State efforts, coupled with historic federal investments passed this year, will mean premium help for almost all of the 1.6 million Californians enrolled in Covered California, and even more reason for the 1.1 million remaining eligible uninsured to get covered. 

Starting today, November 1, Californians will have a full 3 months to enroll in or change their coverage plan. Many will see savings in their current plans, but Californians could save more by shopping and switching. 

Affordability, Affordable Care Act, Economy, Equity, Expanding Coverage, Federal, Legislation, Medi-Cal, Medicare

Federal Build Back Better Framework Includes Major Health Investments, Falls Short on Prescription Drug & Medicare Reform

Today President Biden announced a federal framework for the Build Back Better proposal that includes historic investments to help Californians afford their health care, but does not include key proposals around prescription drug price reform and expanding Medicare dental and vision benefits. 

Affordability, Affordable Care Act, Budget, Care4AllCA, Covered California, Economy, Equity, Expanding Coverage, Health Reform, Legislation, Medi-Cal

New Data Released on Benefits of Build Back Better for Sacramento County’s’ Health

Health Access California today released new data on the regional impacts of the proposed federal Build Back Better bill on Sacramento’s health care as Congress continues to negotiate a final deal. The new data includes how many in Sacramento County would benefit from improved Medicare benefits and extended ACA affordability assistance, and how much local residents might save from these and other reforms, including efforts to negotiate and lower prescription drug prices.

Affordability, Care4AllCA, Economy, Gov. Newsom, Medi-Cal

Leg Recap: CA Takes Key Steps to Universal & Improved Health Care System This Year

The Governor’s final signatures over the weekend capped off a notable year of progress for Californians health care. Through both the legislative session and budget actions, this year saw major expansions to health care coverage, more affordable health care options, and efforts to improve quality and equity in our care. These steps will make improvements to our health care this year, in order to address the urgent needs of Californians during the pandemic and beyond, and bring our state closer than ever to universal coverage.

Affordability, Federal, Legislation

New Data Released on Benefits of Build Back Better for Californians’ Health

Health Access California today released new data on the statewide impacts of the proposed federal Build Back Better bill on California’s health care as Congress continues to negotiate a final deal. The new data includes how many Californians would benefit from improved Medicare benefits and extended ACA affordability assistance, and how much Californians might save from these and other reforms, including efforts to negotiate and lower prescription drug prices. You can find the statewide fact sheet here: Build Back Better: What’s at Stake for California’s Health.

Affordable Care Act, Covered California

Statement Peter Lee Leaving Covered California

During today’s Covered California board meeting, Peter Lee, the first Executive Director of Covered California, announced he will be departing the role in February of next year. Covered California, established in 2010, was the first state-based exchange to be created after the enactment of the Affordable Care Act. Lee took the helm in 2011 and working alongside advocates, health plans, and enrollers, built an exchange that now enrolls over 1.5 million Californians and serves as a model for the nation. 

Affordability, COVID-19, Federal, Under-insured

Another Low Rate Increase for 2022 Covered California Health Premiums New Federal & State Aid Means Even Lower Premiums for Most Covered California Consumers

Following a year that has seen the greatest investment in the Affordable Care Act since the law took effect, Covered California, the state’s health care insurance marketplace, today announced its third straight year of minimal premium rate increases.

In fact, earlier this year, virtually all in Covered California saw reductions in their premiums through federal subsidies, which will continue in 2022. Through the American Rescue Plan (ARP), the Biden Administration took action to increase subsides for those who purchase health care on their own via the marketplace, capping premiums to 8.5% of income across the board – and much lower for middle and lower income consumers. These actions, along with state affordability assistance, have significantly reduced costs for the nearly 1.6 million enrollees in Covered California, leading to higher enrollment and a more stable market.

Affordability, Affordable Care Act, Budget, Economy, Equity, Expanding Coverage, Gov. Newsom, Health4All, Legislation, Medi-Cal

Governor Newsom Signs 2021-22 Health Budget Bill

Today Governor Gavin Newsom signed one of the key pieces of the 2021-22 state budget, the health budget trailer bill (AB 133) which includes historic funding in Californian’s health system, making it more universal, equitable, and affordable in the wake of the COVID-19 pandemic and beyond. Today’s signing ensures a first-in-the-nation end to the exclusion of income-eligible undocumented adults age 50 and over in Medi-Cal. Other major initiatives improve and expand Medi-Cal, and make Covered California more affordable.

Affordability, Affordable Care Act, Budget, Care4AllCA, Cost Containment, Covered California, Economy, Equity, Gov. Newsom, Health4All, Legislation, Medi-Cal

2021-22 CA Budget Takes Major Steps to a More Universal & Equitable Health Care System

Today the State Legislature passed the final 2021-2022 health budget bill (AB 133) that includes historic investments in expanding and improving health coverage for millions of Californians. It now goes to Governor Newsom for his final signature in the coming days. Many of the proposals included in this budget bill were key priorities of the Care4All California coalition of over 70 consumer, community, labor, progressive, and health care organizations working to advance the goal of quality affordable health care for all Californians as soon as possible. 

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