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June 26, 2008

Opposition to Proposed Health Care Cuts Rises in California

Gov. Arnold Schwarzenegger's (R) proposed budget changes to health care programs would increase the number of uninsured residents in California by about one million over the next three years, according to a study released Wednesday by Health Access California, a consumer advocacy group, the Los Angeles Times reports.

The report said the governor's proposed 10% cut to Medi-Cal payments to health care providers and changes to Medi-Cal eligibility rules would create much larger increases in uninsured residents than previous studies have estimated. Medi-Cal is California's Medicaid program (Rau, Los Angeles Times, 6/26).

The report projects that:

* 471,500 children would lose Medi-Cal coverage over the next three years because of Schwarzenegger's proposal to require eligibility verifications quarterly rather than yearly (Rojas, Sacramento Bee, 6/26); an

* 429,000 adults would lose Medi-Cal coverage if the maximum income eligibility level for the program is dropped to 61% of the federal poverty level.

In addition, the California Budget Project estimates that 60,000 children would lose coverage through Healthy Families, California's version of the State Children's Health Insurance Program, if premiums are increased. The governor has proposed increasing monthly premiums by:

* 77% for children from households with incomes between 151% and 200% of the poverty level; and
* 27% for children from households with incomes between 201% and 250% of the poverty level.

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Posted by healthinsurance at 03:32 PM | Comments (0)

June 22, 2008

Huge demonstration for better health coverage in California

Government officials joined thousands of patients, union members and activists from throughout Northern California in front of San Francisco's Moscone Center Thursday afternoon to advocate universal health care and protest insurance-company practices.

Protesters — including an unknown number from the Palo Alto/Stanford area — lined Fourth Street and wrapped around Howard Street, swarming the building where California insurance companies and stakeholders were gathering for an annual convention.

America's Health Insurance Plan, an association representing some 1,300 companies that provide health insurance, hosted Thursday's conference, called Institute 2008.

Outside the conference, advocates held signs with slogans such as "Patients Not Profits" and chanted expressions such as "Californians should beware, insurance companies just don't care."

Speakers included state Sen. Sheila Kuehl, D-Los Angeles, San Francisco Supervisor Tom Ammiano and Los Angeles City Attorney Rocky Delgadillo.

"All of us know the California health care system should be a model for the country," Delgadillo said.

He said the nation's health care system is "broken" and some insurance companies maximize profits at the expense of patients and illegally rescind coverage when a person needs it the most.

Protesters focused on advocating two pieces of legislation. Kuehl's SB 840 would create a single-payer system for California and HR 676, introduced by U.S. Rep. John Conyers, D-Mich., strives to create a national single-payer health insurance program that would be publicly financed and privately delivered.

Donna Cook, a 60-year-old retired teacher, came in from Chico to attend today's event in support of single-payer health insurance.

She said that she has health insurance but that her daughter and 5-year-old grandson do not.

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Posted by healthinsurance at 04:22 PM | Comments (0)

June 16, 2008

United Health Group and PacifiCare announce $6.2 million grants

United Health Group Inc. and Pacificare announced Monday some $6.2 million in grants to a dozen California nonprofits that deliver California health care.

The grants are part of a state-required program to distribute a total $50 million in contributions and make some $200 million in investments over five years to benefit California health care.

United Health Group (NYSE: UNH) agreed to the payments as part of a deal negotiated by former Insurance Commissioner John Garamendi to ensure California consumers wouldn't be saddled with costs of the $9 billion takeover of PacifiCare by United Health Group.

The Northern California recipients of the grants include:

- $250,000 to San Francisco-based North East Medical Services to implement a chronic disease management system.

- $396,057 to Santa Clara-based Community Health Partnership to implement a clinical information management system.

- $276,859 to Stockton-based Child Abuse Prevention Council of San Joaquin County for start up costs for its Therapeutic Services for Children and Families Program.

- $394,470 to Sacramento-based La Cooperativa Campesina de California, to expand patient and physician use of a personal health record system designed for low-income populations with sporadic access to care.

- $841,140 to Fresno-based Kings View Behavioral Health System to implement a telemedical delivery system for mental health services.

- $2.5 million to the Sacramento-based Health Professions Education Foundation to expand its clinician support program that helps place clinical professionals in under-served communities.

- $100,000 for Salinas-based Center for Community Advocacy to help launch its Gang Violence Prevention Initiative.

- $326,357 to Quincy-based Plumas District Hospital to upgrade its telemedical capabilities.

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Posted by healthinsurance at 09:33 PM | Comments (0)

June 13, 2008

States Can't Stop Health Insurance Abuses

People who buy individual health coverage in most states are vulnerable to insurance company tactics that can deny them care, a health care advocacy group warns.

A survey of insurance commissioners across the country shows that all but five states allow insurance companies (including California) to deny coverage to sick or older patients. All but 15 states have no limits on how much companies can raise premiums if individual policy holders get sick, according to the consumer group Families USA.

About 14.5 million Americans bought their own insurance on the individual market in 2006, according to the Henry J. Kaiser Family Foundation. Those numbers would likely grow under the health reform plan being touted by Sen. John McCain, R-Ariz., the presumptive Republican presidential nominee.

McCain's plan would replace existing tax breaks for employer-sponsored coverage with tax credits individuals could use to buy coverage on the individual market. The change would likely shift millions of workers onto individual coverage, where they would be vulnerable to insurance companies' cost-saving tactics, says Ron Pollack, Families USA's executive director.

"To deregulate the market would make a bad situation even worse," Pollack tells WebMD.

The group's report found wide variation in the number of consumer insurance protections in states.

Some states -- such as Maryland, Illinois, and Idaho -- let patients appeal when their individual insurance coverage is revoked; other states -- such as Ohio, Kansas, and Arizona -- don't allow appeals. Most states guarantee that customers can review when companies deny individual claims. But in only a handful of states are those reviews free and conducted by an independent third party, the report says.

Overall, New York, Connecticut, New Hampshire, and California had among the most protections. States including Alaska, Arkansas, and Wisconsin had relatively few, according to the report.

Click here for your free California health insurance quote now!

Posted by healthinsurance at 07:11 PM | Comments (0)

June 11, 2008

HMO Regulator''s Promise To Reinstate Health Coverage For Wrongfully Canceled Patients

HMO regulator's promise to reinstate California health coverage for wrongfully canceled patients; cautions that all health costs during gap must be covered.

Consumer Watchdog said such a step was largely unnecessary because the department's own surveys found a systemic failure at Blue Cross and other companies to review a patient's medical records and/or ask questions about past health conditions a process called "medical underwriting" - before issuing individual policy coverage.

Consumer Watchdog praised a California state regulator's efforts to begin reinstating the insurance coverage of patients left uninsured, uninsurable and often hundreds of thousands of dollars in medical debt when their health insurance policies were illegally canceled after they got sick. The nonprofit consumer group also cautioned that reinstatements must be complete and retroactive, with no gap in coverage from when the policy was issued to the time it was restored.

Last Monday, Consumer Watchdog petitioned the state Department of Managed Health Care to announce its plans regarding reinstatement of thousands of patients affected by the illegal practice.

"This a landmark step on the road to justice for the thousands of innocent patients those health insurance was retroactively canceled. This announcement applies to only 26 people, but the same law used here will provide reinstatement for thousands more. We look forward to working with the department," said Jerry Flanagan, Health Care Policy Director for Consumer Watchdog. "However, we caution that reinstatement must be retroactive to the time of the policy cancellation, and health insurers in California must be liable for all health expenses from the date of issuing the contract through the date of reinstatement. We're also very concerned about the state's plan to subject the remaining thousands of cases to unnecessary and lengthy 'third-party reviews' before restoring their coverage."

A recent survey of Blue Cross of California by the Department of Managed Health Care found that in 90 out of 90 retroactive policy cancellations - - known as "rescissions" - that it examined, Blue Cross failed to show that a patient "willfully misrepresented" a known health condition when applying for coverage. Such "willful misrepresentation" is the only legal grounds for rescission.

In a number of cases made public, policies were canceled for issues not related to the illness at hand, for instance the patient's stated weight on the application, or for omissions or errors that may have been induced by deliberately over-complicated application forms, or for medical issues in the applicant's medical record that the applicant was not aware of or did not understand.

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Posted by healthinsurance at 09:07 PM | Comments (0)

June 05, 2008

Kaiser Permanente Extends California Group Enrollment Deadline

Kaiser Permanente Extends California Group Enrollment Deadline
Deadline extended to Friday, June 6 for new groups to lock in current rates for one year.

Kaiser Permanente California has extended the small group enrollment deadline to this Friday, June 6. Small businesses that apply by Friday can lock in the current rates for one year. After June 6, rates will be increasing on average between 8% and 12%. Some Kaiser medical insurance plans will experience an increase in health insurance premiums as much as 17%.

The plan being hit the hardest by rate increases is the $0/$1500 Deductible Plan with HSA. Kaiser Permanente priced this plan very competitively in 2007 in order to gain market share on the new health savings account plans. Utilization on this plan was higher than expected and forced Kaiser Permanente to implement rate increases around 17% for new groups who begin coverage on July 1, 2008.

For these reasons, many groups are scurrying to get California group health insurance quotes and lock in coverage before the rates go up. Kaiser Permanente underwriters and staff, facing this influx of business and wanting to give groups enough time to submit enrollment forms, made the decision this week to extend the small group enrollment deadline five days beyond the normal June 1st deadline.

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Posted by healthinsurance at 09:12 AM | Comments (0)

June 03, 2008

California legislators revive plans to expand healthcare insurance

The California Legislature is moving to curb some of the health insurance industry's most profitable and contested practices as lawmakers resurrect portions of Gov. Arnold Schwarzenegger's unsuccessful proposal to expand medical coverage.

More than a dozen health bills are advancing through the Legislature, many over the objection of insurers. Some of the proposals were transplanted from the plan that passed the Assembly last year, only to be rejected in the state Senate in January. Other measures are newly devised by the Democrats who control the Legislature.

The bills would require insurers to spend at least 85% of their earnings on patient care; block insurers from canceling policies of patients who need extensive care; and force them to cover more procedures, such as maternity services.

Over the objections of the major doctor and hospital lobbies, the Assembly approved a measure backed by Schwarzenegger that would require medical providers to publicly reveal their costs and medical performance.

In a sign that a desire for piecemeal health care changes is strong this election year, some of the Democrats' bills even have picked up votes among Republicans who did not support Schwarzenegger's package.

"In the aggregate, it could be pretty significant," said Sheila Kuehl (D-Santa Monica), chairwoman of the Senate Health Committee, of the legislation. "I think it's just getting to the point where the opposition has just overreached so badly and the insurance companies' actions have been so egregious that both sides of the aisle are getting fed up with them."

The governor's health care proposal was rejected in large part because of its $14.9-billion price tag, which senators considered untenable with the state deep in the red. But the bills that are winning initial approval now put most of their costs on the healthcare industry.

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Posted by healthinsurance at 09:30 PM | Comments (0)

June 01, 2008

States target companies for rescinding health policies

An insurance-industry practice of retroactively dismissing individual health policies and leaving some people with costly medical bills has come under fire from California to Connecticut.

The practice is generating many complaints to government regulators and some lawsuits claiming insurers have improperly dropped coverage. Some states are passing tough measures or pursuing regulatory actions and assessing fines to restrict these retroactive health policy voids.

Insurance companies say such cancellations, which they call "rescissions," are a rare but necessary tool to stop consumer fraud and lower costs for all individual policyholders.

Yet, consumers and lawyers who have challenged such insurance cancellations say there are many examples of insurers targeting patients who have been diagnosed with chronic or life-threatening diseases that require costly medical care.

In Arizona, two women say in separate lawsuits that Health Net of Arizona dropped their policies after they were diagnosed with cancer and that the insurer demanded that their doctors, labs and other medical care providers refund payments. A Phoenix man sued Golden Rule Insurance Co. after his policy was dropped and the insurer refused to cover the costs to remove a brain tumor and other medical procedures.

"The goal is to try to put a stop to this practice because it is hurting a lot of people," said William Shernoff, a Claremont, Calif., attorney who has filed dozens of lawsuits challenging such policy cancellations by insurers. "It is not only a financial burden on the people. When their coverage is pulled, they can't get treatment."

New Mexico Gov. Bill Richardson recently signed a bill that limits insurance companies' ability to rescind a policy. Insurers must show a consumer has been "willfully fraudulent" before rescinding a policy. Before the change, insurers could merely point to a mistake or omission on a health insurance application before dropping a policy.

The insurance industry recognizes how such cancellations are seen as controversial, and has recommended changes that it says will be fair for consumers and insurers alike.

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Posted by healthinsurance at 07:18 PM | Comments (0)