August 19, 2009

House Democrats Investigating Health Insurer Pay and Profits

Aug. 19 (Bloomberg) -- U.S. House Democrats asked the nation’s biggest insurers to provide details on executive pay, spending on retreats and entertainment, and other financial records as part of an examination of industry practices.

House Energy and Commerce Committee Chairman Henry Waxman and Representative Bart Stupak, chairman of the panel’s oversight committee, sent a letter dated Aug. 17 to dozens of health-insurance companies, including Blue Shield of California.

The letter asks the companies to name all employees who were paid more than $500,000 in a single year between 2003 and 2008 and to itemize their pay, including bonuses, stock options, perquisites and deferred compensation.

The panel is investigating “executive compensation and other business practices in the health insurance industry,” Waxman and Stupak wrote in the letter. The lawmakers asked the insurers to provide most of the pay information by Sept. 4, and the other data by Sept. 14.

Waxman, of California, and Stupak, of Pennsylvania, are among a team of House Democrats trying to beat back criticism of legislation to redraw the nation’s medical-care system. House Speaker Nancy Pelosi, a California Democrat, has complained about the insurance industry’s “immoral” profits.

The letter asked the companies to explain how they determined what to pay executives and provide documentation used by their boards’ compensation committees. It also seeks information about corporate events held off company grounds since Jan. 1, 2007, including how much was spent on transportation, entertainment, gifts and food.

Medicare Advantage

The lawmakers asked the companies how much they earn through programs such as Medicare Advantage, which allows private insurers to deliver federally funded benefits. They called on the companies to provide data on profits from the individual insurance market and insurance provided through employers.

The Obama administration has proposed financing its overhaul of the nation’s health-care system in part by cutting federal subsidies to insurers participating in the Medicare Advantage program by $175 billion over the next 10 years.

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Posted by healthinsurance at 09:16 AM | Comments (0)

August 06, 2009

Dr. Obama’s secret cure

The explosive battle over national health-care reform is wildly emotional, the issues are madly complex, and the expectations are impossibly high.

As 7 million uninsured Californians face east to pray for basic medical coverage from the high priest of change, President Barack Obama and his populist administration face a nearly hopeless task: Get concessions from historically—and stubbornly—self-interested stakeholders.

Just ask Hillary Clinton, whose own reform efforts in the early ’90s met with a blunt death blow at the hands of conservatives equating “reform” with “complete government control.” Clinton herself did not help matters by sequestering herself with a handful of brilliant minds and delivering her secret proposal on the steps of Congress, arms folded: health-care reform as fait accompli.

But there may be hope. Not just the hope Obama brings with his stunning worldwide popularity, grassroots support and Democratic Congress. And not just the hope gained from Clinton’s lessons of reform meltdown.

No, Barack Obama has a secret weapon right here in California that may help him claim ultimate victory: our state’s own failed reform effort.

Although the state’s health-care effort flamed out just a year and a half ago—hammered at a Senate Health Committee by a 7-1 vote in bipartisan opposition—it remains one of the nation’s most successful stabs at reform.

The story of Gov. Arnold Schwarzenegger’s grand vision of universal care is packed with devastating illness, seething passion, fretful hand-wringing and vicious table pounding. It features every interest group imaginable, each with its own angle, agenda and ideology. Like a Hollywood thriller, the stories intertwine, good guys turn sour, and even the best intensions are suspect.

Most important, it serves as the best road map so far to guide Washington over the bumpy, dirty boulevard of health-care reform.

“A lot can be learned by those in Washington, D.C., on how the Schwarzenegger administration conducted the negotiations and discussions,” said Jot Condie, president and CEO of the California Restaurant Association. “Whatever happens in California from a major public-policy standpoint usually rolls eastward.”

“Some important momentum happened in California to get beyond the usual stakeholders,” agreed Daniel Zingale, a health-care policy veteran from the administrations of President Bill Clinton and Govs. Gray Davis and Schwarzenegger. On the national stage, “the stakeholders are not lining up as usual.”

“Our work in California laid the foundation for what the Obama administration is proposing,” said Assemblyman Dave Jones, head of California’s Assembly Health Committee.

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Posted by healthinsurance at 08:50 AM | Comments (0)

December 17, 2008

First 5 California Contribution Extends Health Coverage to More Than 65,000 Children

With the help of funding from First 5 California, the state's Healthy Families program today moved to safeguard more than 65,000 infants and children from waiting lists for health coverage due to the budget crisis.

First 5 California will provide $16.7 million to the Managed Risk Medical Insurance Board, the agency that administers Healthy Families. The funds will be used to pay health care premiums for children up to age 5 who are new applicants to Healthy Families through the end of the fiscal year in June.

"Today's action will allow the state to continue to enroll tens of thousands of infants and children in the Healthy Families program, ensuring them access to much-needed health care services," said Governor Arnold Schwarzenegger.

With their unanimous vote Monday, State Commissioners affirmed First 5 California's ongoing commitment to helping ensure all children have access to health coverage, particularly during this period of high unemployment and economic instability.

"First 5's action shows that anything is possible when all sides come together to tackle a problem -- even in the worst budget times," said Senate President Pro Tem Darrell Steinberg.
Assembly Speaker Karen Bass added, "I thank the First 5 commissioners, including my appointees to the panel, for hearing our appeals and stepping up to the plate with a responsible resolution for these children."

Since voters passed Proposition 10 in 1998, First 5 California has established itself as the largest and most stable funding source of health coverage for children up to age 5 in California. Last year, the agency spent more than $48 million on children's health insurance.

"First 5 California is proud to help take this first step forward in expanding children's health coverage as part of our larger mandate to serve the needs of our state's youngest children," said Kris Perry, First 5 California executive director.

Forty-seven county commissions are committed to presenting their commissioners with requests to help provide part of this funding in the coming weeks.

First 5 county commissions that have pledged support include: Alameda, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Kern, Lake, Lassen, Los Angeles, Madera, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Orange, Placer, Plumas, Riverside, Sacramento, San Benito, San Diego, San Francisco, San Joaquin, San Luis Obispo, Santa Clara, Santa Cruz, Shasta, Solano, Sonoma, Stanislaus, Tehama, Trinity, Tuolumne, Ventura, Yolo and Yuba.

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Posted by healthinsurance at 12:38 PM | Comments (0)

December 02, 2008

Anthem Blue Cross Gives the Gift of Health to California

This December, Anthem Blue Cross is giving the gift of health to California as the Anthem Blue Cross HealthFair Bus travels the state offering free health evaluations. Launching on Monday, December 1 from the Anthem offices in Woodland Hills, California, the bus will depart on a multi-city tour to include Los Angeles, Ventura, Oxnard, Ojai, Fresno, Sacramento and San Francisco.

"Onboard the Anthem Blue Cross HealthFair Bus visitors will receive, free-of-charge, a health evaluation consisting of a full lipid panel; weight, height and waist measurements; blood pressure test; and Body Mass Index analysis. Together, these tests provide a snapshot of one's personal health," explained Leslie A. Margolin, president of Anthem Blue Cross. "Anthem is committed to the community, offering this service regardless of employment, immigration or insurance status. By proactively empowering individuals with vital, personal, medical information, we are taking an important step toward keeping Californians healthy."

"We're particularly enthusiastic about this tour because we'll be reaching several populations that might not necessarily have access to basic primary healthcare," noted Margolin. "For example, in the greater Los Angeles area we are partnering with strong community organizations such as the Urban League, P.A.T.H. (People Assisting The Homeless) and the Kedren Community Mental Health Center -- offering the free health screenings to their constituents. Anthem is committed to improving the lives of the people we serve and the health of our communities."

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

November 26, 2008

Health Insurers See ''Universal'' Opportunity

Health insurance companies such as Humana and UnitedHealth always seem to pay a price for "gifts" from the federal government.

Over the past several years, they have pocketed billions of dollars in government subsidies selling private Medicare plans. They know that Democrats aim to cut those bonus payments, however, so they're searching for new ways to grow. They see universal health care, which could turn 46 million uninsured Americans into potential customers, as their next big opportunity.

President-elect Barack Obama has regularly listed universal health care among his top priorities. Even so, some experts believe, the new president must address his prime concern -- the economic crisis -- before he can think about launching an expensive health care program. As a result, they say, private insurers will likely endure the looming Medicare cuts with little opportunity to offset those losses.

"There isn't going to be a growth driver in the health insurance business for the next few years," predicts Robert Laszewski, an industry consultant who serves as president of Health Policy and Strategy Associates. "It's going to be very bad times relative to the very good times" health insurance companies have enjoyed.

Others still see a real chance for meaningful reform. They believe that the economic crisis has been caused in part by skyrocketing health care costs, which have been blamed for half of all personal bankruptcies and the decline of giant corporations such as General Motors and Ford . As a result, they feel that the country's leaders must address both issues at the same time.

Sheryl Skolnick, senior vice president of CRT Capital Group, belongs to that camp. The veteran health care analyst predicts that Democrats will pounce on the "irresistible opportunity" to pass a comprehensive health insurance bill now that they have the power to do so.

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Posted by healthinsurance at 10:38 AM | Comments (0)

November 24, 2008

California health insurance premiums rising more slowly

Thousands of Sonoma County workers are facing decisions about their California health insurance, with many employer-sponsored insurance plans entering their annual open enrollment period.

Premiums continue to march upward but by and large seem to be in line with a trend seen last year: rising, but at slower rates than in the first half of the decade, when they rocketed higher and buffeted the local health care market.

Health insurance brokers who negotiate health plan packages for local companies say they are seeing some premium increases below 10 percent this year -- although depending on the plan and company size, some increases are far higher.

"It's all over the board," said Bud Martin of ABD Wells Fargo Insurance Services in Santa Rosa.

"It depends a lot on the size of the group and what kind of benefit structures they have," he said. "Sometimes it's 10 or 11 percent, sometimes it's 17."

Nationally, the annual cost of family coverage under employer-sponsored plans reached an average of $12,680 in 2008, up from $5,791 in 1999, according to the Kaiser Family Foundation, a nonprofit health research group. Employees' share of that annual bill hit an average of $3,354 last year, up from $1,543 in 1999.

Experts caution that workers shouldn't choose a plan on premiums alone, but should take into account factors such as how much they expect to use health care services.

"Often employees will just choose the plan that sounds the best or the name that sounds the best," said Debra Squyres, director of human capital consulting at TriNet. For example, an employee might choose a "Platinum" plan over a "Value" plan "not knowing really how that plan works," she said.

The San Leandro-based firm provides human resource outsourcing services including benefits management to about 900 Northern California firms.

Some plans, said Squyres, are not raising their premiums as much, but are offsetting that by increasing their patient deductibles, co-payments and out-of-pocket maximums.

That's not necessarily bad, because people who use their health services less may find that option more sensible and cheaper. But it illustrates why plans need to be carefully examined, Squyres said.

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Posted by healthinsurance at 11:56 AM | Comments (0)

November 19, 2008

Children from California Could Lack of Low-Cost Health Insurance

State officials from California want to cap the list of people registered in the health insurance system based on children of the poor working people. The authorities stated that this decision can come because of too many new clients who take upon the insurance health system.

But advocates say that if the Healthy Families Program needs such a drastic change, this would be the hardest decision to be taken in a 10-year history time. Lesley Cummings, the executive director of the Managed Risk Medical Insurance Board, said that nearly 162,750 children would have to wait almost six months before being checked by a doctor.

The program now gives medical insurance for almost 900,000 children and an averaged 27,000 kids are subscribed every month. If no action is taken, the system will reach a $17.2 million loss. A decision is expected to be taken in December and the waiting list will also be settled on December 18.

Cummings stated that if the board doesn’t cut the enrollment now, worse actions will be necessary taken later. "Capping enrollment, rather than eliminating coverage that a child currently has, seems the preferable path," he added. The bad thing is that kids who come from families who earn up to %250 of the federal poverty level are eligible for this health program.

Incomes of $3,667 a month divided to a family of three are $4,417 a month divided to a family of four makes it possible for the parents to subscribe their children to the Healthy Families Program. Those who are below this line get healthcare through Medi-Cal program.

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Posted by healthinsurance at 12:23 PM | Comments (0)

October 30, 2008

California Health & Longevity Institute Offers Innovative Health and Wellness Strategies

For organizations seeking innovative health and wellness solutions to offer employees during Open Enrollment season, California Health & Longevity Institute provides evidence-based programs to instill a culture of health throughout a corporation. The implementation of long-lasting wellness initiatives achieves an overall healthier workforce, higher productivity levels, increased employee retention and reduced health insurance costs. According to noted corporate health expert Steven Aldana, Ph.D., more than 30 published articles cite evidence that $3.50 are saved from lower healthcare costs per every dollar spent on employee health and wellness programs.

Programs and services at California Health & Longevity Institute are based upon the foundation of health and wellness: nutrition, fitness, medical and strategies for change. Leading experts including physicians, registered dietitians, exercise physiologists and lifestyle consultants offer immersive, customized group programs as well as individual consultations. A state-of-the-art medical clinic offers executive physicals, complementary medicine therapies such as acupuncture and diagnostic testing.

Companies are investing in longer-term solutions aimed at improving overall quality of life for employees and health of their organizations as the cost of employer-sponsored benefits continue to eclipse the majority of expenditures. Studies also note that more than 75 percent of employers' health-care costs in California and productivity losses are related to employee lifestyle choices (Centers for Disease Control and Prevention). Approximately $260 billion in output is lost each year due to health-related problems. (The Common Wealth Fund).

Click here for your free California health insurance quote today!

Posted by healthinsurance at 10:50 AM | Comments (0)

October 08, 2008

Schwarzenegger vetoes health insurance bill

Gov. Arnold Schwarzenegger vetoed a bill Tuesday that would have cracked down on health insurance companies that cancel policies of people who make expensive claims.

Schwarzenegger, in a memo to lawmakers, called the so-called rescission practice “deplorable,” but noted he vetoed the bill because it lacked several consumer protections and was “written by the attorneys that stand to benefit from its provisions.”

The measure would have established an independent review process of each case and required that policies be rescinded only if insurers prove consumers willfully misrepresented their pre-existing conditions on a policy application.

Schwarzenegger said he wanted the bill to include six other protections, including a requirement that companies continue health insurance coverage for family members of someone whose policy has been dropped.

Assemblyman Hector De La Torre, D-South Gate, who sponsored the health care bill, said the governor's criticisms were ill-founded. He said the family protection provision was left off the bill because it was contained in a different measure that the governor approved, Assembly Bill 2569.

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Posted by healthinsurance at 03:29 PM | Comments (0)

October 05, 2008

Schwarzenegger Vetoes Health Insurance Bill

Gov. Arnold Schwarzenegger vetoed a bill Tuesday that would have cracked down on health insurance companies that cancel policies of people who make expensive claims.

Schwarzenegger, in a memo to lawmakers, called the so-called rescission practice “deplorable,” but noted he vetoed the bill because it lacked several consumer protections and was “written by the attorneys that stand to benefit from its provisions.”

The measure would have established an independent review process of each case and required that policies be rescinded only if insurers prove consumers willfully misrepresented their pre-existing conditions on a policy application.

Schwarzenegger said he wanted the bill to include six other protections, including a requirement that companies continue California health insurance coverage for family members of someone whose policy has been dropped.

Assemblyman Hector De La Torre, D-South Gate, who sponsored the bill, said the governor's criticisms were ill-founded. He said the family protection provision was left off the bill because it was contained in a different measure that the governor approved, Assembly Bill 2569.

“The governor is not fulfilling his obligation to the insured population of California,” De La Torre said. “For the foreseeable future they will be able to be dumped with impunity, as they have in the past.”

De La Torre also noted that the governor had stonewalled legislators in negotiations.

“It's good enough for him to get an applause line in the State of the State address, but it's not good enough for him to follow through and work with Legislature to make it happen,” he said.

Daniel Zingale, the governor's top health adviser, said Schwarzenegger's opposition to rescission is clear, noting that the state has taken several actions against California health insurance companies during his administration.

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Posted by healthinsurance at 03:29 PM | Comments (0)

September 16, 2008

Health Net To Reinstate Canceled Health Insurance Policies In California, Pay Fine, Reimburse Former Plan Members For Denied Claims

Health Net on Thursday agreed to reinstate coverage for 926 former members in California whose health insurance policies were canceled after they filed claims and to pay $3.6 million in fines, the Los Angeles Times reports. The company also will pay as much as about $14 million to reimburse expenses for medically necessary care that would have been covered had the policies not been cancelled.

In the last year, Health Net -- California's largest health insurer -- has been forced to pay a number of fines and penalties related to the company's policy rescission and cancellation practices, according to the Times. An investigation by the California Department of Insurance found that the company did not follow state laws whKen handling policyholders' claims and treated them unfairly. Health Net also will work with the department to make improvements to its cancellation and rescission practices and could face an additional penalty of as much as $3.6 million if a follow-up investigation finds that the company has not corrected all deficiencies, the Times reports.

The agreement allows Health Net to avoid any further penalties for potential legal violations uncovered by auditors. The California health insurance company did not admit any wrongdoing. Chief Executive Jay Gellert said his company did "not necessarily agree with the California Department of Insurance," but the settlement was a chance "to move forward and make sure these affected individuals can obtain coverage" (Girion/Lifsher, Los Angeles Times, 9/12).

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Posted by healthinsurance at 07:24 PM | Comments (0)

September 04, 2008

Thousands of California children in danger of losing health insurance

Thousands of Californian children are in danger of losing health insurance, indicating the failure of the state's promising strides toward extending medical coverage to all its children, the Los Angeles Times reported on Sunday.

Increased premiums for low-income families are expected to put the program out of reach for many and a new insurance policy in California is also expected to cut enrollees, the paper said.

"The trend is likely to further destabilize California's already shaky healthcare system," the paper noted.

Studies have found that children without health insurance are less likely to go to the doctor for routine visits that allow early diagnoses and treatment for diabetes, obesity and other increasingly common ailments, according to the paper.

Between 2001 and 2005, the number of Californians younger than 19 who were uninsured at any given time decreased 25 percent to about 763,000, according to the for Health Policy Research at the University of California in Los Angeles.

Uninsured children in California
tend to perform worse in school and miss more classes than those with coverage, several studies have found.

Most of the drop came through aggressive enrollment efforts in state and private healthcare programs and despite the erosion of employer-based insurance, which was leaving more adults without coverage, the paper said.

But legislative budget negotiators this year have decided to increase premiums for the state's California's Healthy Families program, which pays for medical care for more than 850,000 children of low-income workers who are above the federal poverty line.

The state estimates that the parents of 19,000 children will end up dropping out of the program by July because of the two-dollar or three-dollar monthly increases. A family with three or more children, earning between two and 2 1/2 times the federal poverty level of 24,800 dollars a year, would see the monthly premium rise to 51 dollars.

The state expects the rule to pare Medi-Cal rolls by about 196,000 children over the next two years.

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Posted by healthinsurance at 07:50 PM | Comments (0)

August 13, 2008

Thousands of Californians whose health policies were canceled to be offered new coverage

About 3,400 Californians whose health insurance was canceled by Kaiser, Health Net, and PacifiCare after they got sick will soon receive notification that they may be eligible for new coverage and for compensation for medical bills they paid while they were uninsured.

In a deal with state regulators, the insurers agreed to offer former members new coverage regardless of preexisting medical conditions and to reimburse them for medical expenses. In exchange, the California Department of Managed Health Care will close investigations into the companies' rescission practices. Regulators began mailing out notices to individuals Tuesday.

The state's largest insurers have all been widely accused of looking for ways to drop individual policyholders who incur high costs. The insurers contend that members who are dropped have misrepresented their medical histories on their applications.

The practice has been condemned by lawmakers, judges and regulators.

The agreements between the state and the insurers were unprecedented in their ambition to restore health insurance coverage. But they also have come under fire from consumer advocates.

The mailed notices triggered another flare-up.

Lawyers for policyholders expressed concern Friday at a hearing in a suit against Health Net over a plan for the insurer to notify former members about the state agreement.

State law stipulates that such notices go through lawyers for members of the presumed class, said Mike Bidart, one of the policyholder lawyers.

What's more, he said, California insurance policyholders would eventually receive court-approved notices about developments in the case, including any settlement.

"Our concern was that it creates tremendous confusion for people to get one notice and then another," he said.

Los Angeles County Superior Court Judge Victoria Chaney set a hearing for Sept. 2 to consider the issue. Then late Monday, Bidart said he learned that the state intended to send the notices out itself.

"I'm sure they are doing this because the courts don't currently have jurisdiction over the DMHC," Bidart said. "They are basically end-running what was about to be heard by the court."

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Posted by healthinsurance at 01:20 AM | Comments (0)

August 05, 2008

California insurance bill nears completion

The state of California is nearing a compromise on legislation that would tighten controls on individual medical insurance policies, sources said.

The bill aims to restrict profit on individual policies, mandate a minimum for benefits and regulate California insurance companies' ability to cancel plans retroactively, the Los Angeles Times reported Monday.

The plan falls short of Gov. Arnold Schwarzenegger's original plan of providing insurance for 5 million uninsured Californians, the Times reported.

State law makers rejected Schwarzenegger's $14.9 billion insurance plan in January, although insurance companies backed the bill, as it would have provided them with millions of new customers, the report said.

The new bill has little support from California health insurers because it crimps profits on some of their most lucrative policies, the Times reported.

A 2006 survey found that individual policies cost an average $259 per month, compared with $383 per month for policies purchased by small businesses for their employees.

Individual policy owners, however, paid three times the amount the group policy members paid for deductibles and co-payments, the Times reported.

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Posted by healthinsurance at 12:01 PM | Comments (0)

July 30, 2008

Federal Standards For Long-Term Care Insurance Policies Needed, Witnesses At House Hearing Say

Witnesses on Thursday at a House Energy and Commerce Oversight and Investigations Subcommittee hearing called on federal lawmakers to require minimum standards for private long-term care insurance policies, CQ HealthBeat reports. Bonnie Burns, a training and policy specialist at California Health Advocates, said that, because states regulate such policies, the standards offered differ based on where policyholders live. She said, "It should not depend on the state a person lives in whether they have a quality product," adding, "There's a disconnect between those services available in a community and the way they are described in a California insurance policy, and no two companies have the same definitions."

Some witnesses also raised concerns about large premium increases for long-term care insurance policies. Washington State Insurance Commissioner Mike Kreidler in written testimony said, "The majority of consumer complaints my office receives about long-term care insurance are about the double-digit rate increase they received on products they purchased in the late '80s and early to mid '90s."

In addition, witnesses discussed the inconsistencies in denials of claims submitted under long-term care insurance policies. Burns said that such denials often appear "completely unpredictable." However, according to Marc Cohen, president of the long-term care research and consulting firm Life Plans, a recent survey conducted by the company found that, among 1,500 policyholders who filed claims under long-term care insurance policies, 94% reported no unresolved disagreements with their California health insurers and that insurers denied only 4% of those claims.

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Posted by healthinsurance at 08:43 PM | Comments (0)

July 18, 2008

Rising Costs and Universal Health Care in California

As you know, since most of you are co-authors of this bill, SB 840 is California’s plan to establish a functional, modern, universal health care system for the 21st Century.

This bill covers every California resident with comprehensive, affordable health benefits, contains the growth in health care spending while improving quality.

And most importantly it guarantees every patient with total choice of their doctors and hospitals.

Each year health care costs grow 2-3 times faster than wages. The Journal of Health Affairs recently reported that health care spending will nearly double over the next decade. This means that, in 10 years, healthcare will cost 20 cents of every dollar our nation produces.

With that kind of cost inflation, discussions about covering the uninsured are pointless. Our failure to address this problem is close to gross negligence.

In the real world, 50% of bankruptcies are due to medical costs, employers are eliminating benefits if they can, and if not, like so many school districts and other public employers, they may face bankruptcy.

Our own budget crisis is greatly affected by the rising health care costs. The state budget buys a lot of healthcare in Calfifornia - directly through public programs and as employers.

If costs grow 2 to 3 times faster than wages, but the taxes that pay for the health care are a function of wages, then we are basically stuck in quicksand - each year sinking deeper and deeper.

In response to exploding health care costs, we are dismantling our system. Not one of us in this room has the level of health care benefits we had 10 years ago – and we’re paying a lot more for what we still have.

The US is now in a state of severe health care rationing. Doctors’ reimbursements are frozen. Coverage for the insured is very fragile and unreliable due to rescission, improper denials, gutted benefits, and growing deductibles. Patients experience shockingly long wait times, shorter hospital stays, fewer specialist visits, limited drug formularies, and rushed doctor visits. And yet…costs keep rising.

In 2005, the Lewin Group completed a financial analysis of the bill which found that the bill would be fully funded in 2006 with a combined payroll tax of about 12%. The report additionally found that the bill would produce savings of about $29 billion in the first year alone, most of which will be spent on insuring the uninsured and improving the health care benefits for all of us.

The Lewin study found that SB 840 would save California businesses 16% off their employee benefit costs, while families would save hundreds of dollars a year and state and local government would save nearly $1 billion in the first year alone.

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Posted by healthinsurance at 06:06 PM | Comments (0)

July 09, 2008

Kids health insurance program in California to close

he countdown has begun for families served by the Alameda Alliance for Health's Healthy Kids program.

Phone calls and letters continue to roll out to families this week after the Alliance's June 30 announcement that it expects close the Healthy Kids program on Sept. 30 because of a lack of funding and diminished hope for the creation of a state universal health care plan for children.

"We had thought it was going to be a two-to-three-year effort to make the policy (changes) happen," said Alliance Chief Executive Officer Ingrid Lamirault, referring to policy that would provide universal health care coverage for all California children, regardless of their immigration status.

But the story of Healthy Kids has reached its final page without the happy ending for which administrators were hoping.

Proposed state legislation, which would have provided more coverage for children, stalled in January in the face of California's budget crisis. With the stall, the final phase of Healthy Kids in Alameda County began.

Started in 2005, the program provides low-cost, comprehensive coverage for 1,050 children in low-income families not eligible for government-funded programs like Medi-Cal. There are Healthy Kids programs in 30 counties statewide serving more than 80,000 children.

The program's closure could leave those children without any insurance options and further strain county clinics and emergency rooms which likely will become the primary care centers for the uninsured.

About 95 percent of the children in the Alameda County program are undocumented immigrants.

The program, like in other counties, had been funded by public and private grants, but six months ago, "things started unraveling," said Lamirault.

Earlier this year, two separate health care reform bills sponsored by state Senate President Pro Tem Don Perata, D-Oakland, and former Assembly Speaker Fabian Nunez, D-Los Angeles, were held up in committee.

With hopes of universal health care legislation dashed at least for now, the program later learned it would lose more than half of its funding this year and the remainder over the next year and a half.

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Posted by healthinsurance at 10:38 PM | Comments (0)

July 06, 2008

Health Net of California Signs Agreement with Alvarado Hospital

Alvarado Hospital of San Diego and Health Net of California, Inc. have signed a new agreement that provides California Health Net members with access to health care at Alvarado Hospital.

The contract covers Health Net members with employer-sponsored, Individual & Family Plans, Medicare, Medi-Cal and Healthy Families coverage. Members have access to Alvarado's wide range of medical services, including medical and nursing care, inpatient and outpatient surgeries, many specialty services such as bariatrics and skull base surgery, and complete orthopedics, emergency room care and diagnostic testing.

"Our agreement means San Diegans covered by Health Net health insurance may continue receiving the same quality care they have come to know and trust from Alvarado Hospital," said Martha Smith, Health Net's vice president of Health Plan Network Management.

"We have long-established relationships with Health Net members, and we have excellent physicians on our medical care staff who have provided care to Health Net members for years," said Harris Koenig, Alvarado Hospital chief executive officer. "We are excited to have the opportunity through this new agreement to continue caring for them."

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Posted by healthinsurance at 04:21 PM | Comments (0)

July 01, 2008

California Health Insurance Companies Spend $10.3 Billion On Administration And Profit

Private health insurance companies regulated by the Department of Managed Health Care (DMHC) spend $6 billion each year on administration, and divert an additional $4.3 billion to profit, according to a report released by the California Medical Association (CMA). Prepared using data obtained under the Knox Keene Act, the report breaks down how private health insurance companies spend their revenues.

"This report paints in stark terms why health care costs are skyrocketing for Californians," said Dr. Richard Frankenstein, M.D., President of CMA. "Health insurance companies in California spend billions of California's health care dollars each year on administration, and for-profit insurers divert billions of dollars more to profit. Californians' health care dollars should be spent on health care, not on bureaucracy."

Currently, private health insurance companies regulated under Knox Keene - representing some 60% of the health insurance market - are required to spend no more than 15% of their revenues on administrative costs. CMA and other health care advocates believe the statute includes profits as administrative costs; health insurance companies exclude profits from the 15%, allowing them to spend as little as they want on actual California health care. SB 1440, a bill authored by Senator Sheila Kuehl and sponsored by CMA, would require insurance companies to spend 85% of their revenues on health care, driving down health care costs for consumers and potentially making coverage more affordable.

"It's not acceptable for us to ignore such massive waste in the California health insurance industry when Californians are being bankrupted by rising health insurance premiums and gutted benefits," stated Senator Kuehl. "California consumers have a right to know that there is a basic formula in the law for how much of their money is actually being spent on medical care. This is the least we should be doing."

If SB 1440 had been in effect in the last reporting year, HMOs would have spent $1.1 billion less on administrative costs and profit - money that would have gone instead to provide health care to their policyholders. Blue Cross policyholders alone would have benefitted from $700 million more in health care that instead went to administrative costs and profit.

The Department of Insurance (DOI) collects the same data as the DMHC, but the DOI refuses to make the data public. CMA strongly supports the DOI and DMHC releasing this information to the public so that consumers can make informed decisions about whether a health plan is spending their premiums on health care.

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Posted by healthinsurance at 01:16 PM | Comments (0)

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.

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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.

About is a leading provider of Kaiser Permanente California Health Insurance Quotes, and has been a trusted name in the health insurance industry for years. The company is a licensed insurance agency that offers competitive prices for a variety of insurance plans. In addition to their informative, interactive website, all customers have access to live support on the phone with the company's experienced benefits specialists.

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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)

May 29, 2008

Health Insurance Company Paid its Workers Bonuses to Cancel Patient Policies

Health insurance company Health Net Inc. rewarded employees for finding ways to drop customer policies and not pay for their medical expenses, according to an investigation by the California Department of Managed Health Care (DMHC).

Since 2005, the DMHC has been investigating five of the seven insurance companies that provide health care plans to individuals in California. The department is attempting to crack down on the practice among insurers of dropping people's coverage based on often accidental errors in their enrollment applications. In many cases, people's policies have been dropped after they submitted medical claims.

The DMHC has fined Health Net $1 million for failure to disclose a program in which employees received bonuses for meeting or exceeding quotas for health insurance policies to be dropped. The department continues to investigate Health Net and has yet to determine if the dropping of policies or the bonus program are illegal.

The DMHC describes itself as the only stand-alone watchdog agency for managed health care in the country. Since 2005, it has fined Blue Cross $1 million for rescinding its members' health plans and $200,000 for rescinding one person's plan in particular. It has also fined Kaiser Permanente's Kaiser Foundation Health Plans $325,000 for illegally rescinding two policies.

"None of the plans that we are investigating thus far have had an adequately fair process" for dropping policies based on application errors, said DMHC Director Cindy Ehnes.

Health Net's employee bonus program was revealed in the course of a lawsuit by a breast cancer patient who had her health insurance policy dropped by the company after she became sick. The company dropped 1,600 policies between 2000 and 2006, avoiding paying $35.5 million in medical fees.

Ehnes and California Insurance Commissioner Steve Poizner have proposed new regulations that would require health care providers to find that customers deliberately misrepresented information on their applications before dropping their coverage.

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Posted by healthinsurance at 11:31 AM | Comments (0)

May 22, 2008

California Insurance Department Encouraging Residents to Use Online Personal Health Records

Not enough California residents are using online personal health records offered by insurers and managed care groups in the state, according to a report released on Tuesday by the state Department of Insurance, the Sacramento Bee reports. The report was based on a survey of California's major insurers. The report states that PHRs are secure and efficient and allow people to better manage their health care and handle their health insurance claims. Based on the report, the state is encouraging residents to use PHRs. The department also is expected to announce the creation of a working group that would aim to ensure patients can keep their PHRs when they switch insurance companies.

Some privacy advocates have expressed concern about PHRs. Sue Blevins, founder and president of the Institute for Health Freedom, said, "While providing information is essential when seeking services, one shouldn't be forced to give up privacy and the freedom to withhold consent." Blevins said, "In fact, as the nation moves toward interoperable electronic medical records, it's important for citizens to gain greater privacy and control over their health care information." However, state officials on Monday said that the PHRs available through insurers in the state are securely managed (Glover, Sacramento Bee, 5/20).

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

May 15, 2008

Kaiser patients to receive health coverage again

Kaiser Permanente today became the first California health plan to reinstate the individual insurance policies of consumers who were improperly dropped, often after running up expensive medical bills.

The California Department of Managed Health Care announced that Kaiser will offer coverage to 1,092 consumers whose policies were rescinded from 2004 until 2006, when Kaiser stopped the practice. The state has been investigating the five largest health plans for retroactively dropping consumers for making minor mistakes about their medical histories on their health insurance applications.

Kaiser will also pay a $300,000 fine.

One of those dropped consumers, Denise Fenton of Lake Forest said she bought an individual Kaiser policy because she’s self-employed. While insured, she was diagnosed with diabetes. Kaiser then dropped her, she says, calling her diabetes a preexisting condition.

“I was suddenly left with no insurance and now knowing I had diabetes I was going to have to disclose it, basically making it impossible for me to get health insurance from anyone else,” she said.

Fenton said she was able to form a corporation and then qualify for Kaiser insurance again, but at double the price.

Cindy Ehnes, director of the agency, said Health Net will be the next insurer to approve a similar plan to reinstate 85 consumers.

In addition to the offer to repurchase their insurance, Kaiser will reimburse those dropped for medical expenses accrued while they were insured, but that were not paid by Kaiser once their policies were canceled. Kaiser will also pay for medical bills incurred after consumers lost their health coverage.

Ehnes estimated that roughly 4,000 more Californians were rescinded by the other major health plans. The state is undertaking a review of patients from other health plans who were rescinded to determine if insurers should be ordered to reinstate them.

William Shernoff, a Claremont attorney representing several Orange County patients who are suing other insurers who dropped them, said though Kaiser wasn’t a big player, he hopes the other health plans will follow suit.

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Posted by healthinsurance at 01:59 PM | Comments (0)

May 13, 2008

California polls show health care a growing concern

A new poll shows concerns over rising health care costs have kept pace with other major economic worries - second only to skyrocketing gas prices and tied with getting a job or raise that pays enough to cover increased living expenses.

The survey by the Kaiser Family Foundation, being released today, found that 44 percent of the more than 2,000 adults interviewed April 3 to 13 ranked paying for gas as a serious problem, compared with 29 percent for jobs and 28 percent for health care.

Difficulties paying for rent or mortgage followed at 19 percent, with food and credit card or personal debt close behind at 18 percent.

Health experts said the Kaiser poll, along with other studies released this week, show that health care in California remains in the forefront of Americans' concerns despite the mortgage crisis and growing overall economic woes. A Field Poll released Monday showed nearly 75 percent of Californian voters would have approved a health reform package brokered by Gov. Arnold Schwarzenegger and Democratic leaders that failed in the Legislature earlier this year.

"It is surprising to see that problems paying for health care are right up there with the top pocketbook issues that average Americans are facing and are much higher than some of the other problems you'd expect to see at the top of the list," said Drew Altman, president of the Kaiser Family Foundation, a health philanthropy in Menlo Park.

The poll showed that health care also plays a significant role in lifestyle decisions. Twenty-three percent of those surveyed said they or a member of their household either switched or stuck with a job because of health benefits. Seven percent said that health care was a factor in their or a household member's decision to marry within the past year.

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Posted by healthinsurance at 11:54 AM | Comments (0)

May 08, 2008

Bush Administration Suggests Leeway on Kids' Health Coverage

The Bush administration on Wednesday sent letters to state health officials to clarify a policy directive issued last year that restricts states' ability to expand eligibility for their versions of the State Children's Health Insurance Program, CQ HealthBeat reports (Carey, CQ HealthBeat, 5/7).

According to guidelines issued in August 2007, before expanding SCHIP eligibility to children in families with incomes greater than 250% of the federal poverty level, states first must demonstrate they have enrolled at least 95% of eligible children with family incomes below 200% of the poverty level (California Healthline, 4/21).

According to the Wall Street Journal, most states do not meet the requirements, which has meant that several states, including New York and Ohio, have had to abandon their SCHIP expansion plans.

The letter sent Wednesday will qualify "many" of the states that did not meet the 95% requirement by using data from the Current Population Survey, according to Herb Kuhn, deputy administrator and acting director for the Center for Medicaid and State Operations at CMS (Zhang, Wall Street Journal, 5/8).

The recent letter says that states can use data on Medicaid, SCHIP or private insurance to demonstrate they had reached the 95% requirement.

"This is an achievable, goal and based on conversations with states, we are convinced that a number of states have already reached this goal," Kuhn wrote in the letter.

The letter also clarifies that the guidelines do not apply to children already enrolled in SCHIP. It also says that state health officials can recommend other ways to prevent families from substituting SCHIP coverage for private insurance, CQ HealthBeat reports (CQ HealthBeat, 5/7).

The guidelines currently say that states seeking to expand SCHIP eligibility must establish a minimum of a one-year period of uninsurance for individuals in families with incomes greater than 250% of the poverty level (California Healthline, 4/21).

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Posted by healthinsurance at 01:59 PM | Comments (0)

May 01, 2008

California Can Learn Health Care Lessons From Down Under

The health care reform is still on the table in California, which should consider carefully the achievements and failings of foreign systems. Canada is the usual candidate but Australia’s health care strategies deserve a closer look.

The negative effects of Australia’s government-run health system are predictable and apparent: limited distribution of technology, restrictions on the number of medical students and Medicare providers, and waiting lists. Recognizing this, the country recently reformed private health insurance – which is not mandatory – in order to attract more Australians to sign up.

Australian taxpayers finance almost 70 percent of total health care expenses, including a subsidy for private health insurance, under which almost half of the Australian population is now covered. Taxes fund a 30-percent rebate on private insurance premiums for Australians under the age of 65. Rebates go up to 40 percent for older patients.

Australia phased in a Private Health Insurance Incentives Scheme (PHIIS) to improve citizens’ access to care, which caused the number of privately insured Australians to rise from 31 to 46 percent. The plan incorporated several reforms. Most importantly, it allowed age-rating in private health insurance, which was previously forbidden.

With age-rating, insurers started charging lower premiums for younger people, attracting them to purchase policies. To manage the transition, those above 30 who signed up before a cut-off date in 2000 were also given a discounted premium. Those who did not sign up in time would pay higher premiums equal to the base discounted premium plus 2 percent for every year after age 30.

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Posted by healthinsurance at 02:29 PM | Comments (0)

April 29, 2008

California Above U.S. Average for Health Insurance Cost Increases

The cost of health insurance premiums for coverage through private-sector jobs increased more than 10 times faster than employees' incomes from 2001 to 2005, according to a report released Tuesday by the Robert Wood Johnson Foundation, the Washington Post reports (Washington Post, 4/29).

In California, health insurance costs for the average family increased by about 34%, from $7,898 in 2001 to $10,551 in 2005, according to the study. During that period, salaries increased by about 9% on average for California workers.

California's jump in health insurance costs gives it the 12th-largest increase in the nation. The national average increase in health care costs was 30%, according to the study (Colliver, San Francisco Chronicle, 4/29).

Study Methodology

Researchers from the State Health Access Data Assistance Center at the University of Minnesota analyzed data from the U.S. Census Bureau and the Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality to compile the report (Forster, St. Paul Pioneer Press, 4/28).

The information was released in conjunction with National Cover the Uninsured Week (Anstett, Detroit Free Press, 4/29).

National Findings

According to the report, monthly premiums for family coverage increased 34.6% from $1,921 in 2001 to $2,585 in 2005, while median family income rose 3.1% from $40,818 to $42,068 during the same period (Washington Post, 4/29).

The report also found that employees nationwide are paying a larger percentage of their insurance premiums -- 24.1% in 2005 compared with 23.2% in 2001 (Park, Arkansas Democrat-Gazette, 4/29).

According to the report, the number of people with private coverage dropped by about 6% nationally, while the number of private-sector employers who offered health insurance declined by 0.8% nationally (St. Paul Pioneer Press, 4/28). Premium increases contributed to 2.4 million fewer U.S. residents with private health coverage in 2005 than in 2001, according to the report (Krouse, Cox/Raleigh News & Observer, 4/29).

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Posted by healthinsurance at 04:16 PM | Comments (0)

April 24, 2008

Insurance reinstatement orders put health plans on edge

Last week’s move by state regulators, opening the door to restoring health insurance to thousands of customers who had their coverage cancelled by health plans, has the health care world waiting to see what will happen next.

The plans say they are still waiting for word from the Department of Managed Health Care about which 26 customers have been ordered to have their health care coverage restored. Thousands of other cases will be reviewed by an arbiter, selected by the department.Representatives from various health plans said they expect the broader review of these cancellations to be challenged in court. Though none would speak for attribution, they said they are waiting to see the details of the process established by the department before commenting on any potential legal action.

The department ordered the reinstatement of 26 patients who had their health coverage cancelled by Blue Cross, Blue Shield and Kaiser. More reinstatements may be ordered as the department winds up its investigation of HealthNet and PacifiCare.

Blue Shield and Kaiser said the department made the public announcement before revealing to the plans which patients were being reinstated. It was unclear whether the plans would fight those specific reinstatements.

“We are in the process of contacting them,” said DMHC spokeswoman Lynne Randolph. She said the DMHC had contacted the health insurance plans for information on cases, and would issue the formal reinstatement orders shortly. “We should have it wrapped up by the end of the week,’” she said.

DMHC Director Cindy Ehnes said her office would review cancellations between 2004 and 2008. “Every single rescission will be reviewed by this department,” Ehnes said, adding that patients would be compensated for their costs in the event the rescission was flawed. “For the first time, we are giving people a second chance to get that health coverage,” she said.

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Posted by healthinsurance at 02:38 PM | Comments (0)

April 22, 2008

California Health Insurers Must Reinstate Policies

Chalk one up for sickly patients. California regulators have ordered insurers there to reinstate the health insurance policies of 26 people who lost their coverage after the insurers claimed they had lied on their applications, according to news reports. The 26 cases represent the most egregious examples of insurers wrongly "rescinding" policies, typically for inadvertent errors. The person gets sick and starts making expensive claims, and the insurer cries "fraud!" The patient says "forgot!" or sometimes "say what?" For example, one woman I spoke with on this topic had answered "no" when asked if she'd been treated for cancer in the past 10 years. Later her policy was yanked because the insurer claimed that regular blood work she had to ensure her earlier cancer hadn't returned constituted cancer treatment.

Now California begins a case-by-case review of thousands of rescissions in the past four years, and it may be that these 26 are the tip of a fairly hefty iceberg. And consumer advocates say there's no reason to believe this issue is confined to California. They expect similar cases to begin emerging elsewhere.

These problems arise in the individual health insurance market, where people buy policies on their own. That market is much more loosely regulated than the group market—and often more problematic for patients—as I discussed a few months ago.

Right now, only about 5 percent of people buy insurance this way. But if Sen. John McCain has his way, many more would very likely start buying insurance on their own. The presumptive Republican nominee has proposed eliminating the tax break that employees currently get on their health insurance benefits and instead giving people a tax credit of $2,500 for individuals and $5,000 for families to put toward buying coverage. I also wrote today about the presidential candidates' healthcare reform proposals.

Many policy analysts see merits to the restructuring that McCain proposes, but they argue that without better regulation of the individual market, people who are older or sick won't be able to get affordable health coverage, or any coverage at all. They point to what's going on in California as an example of the kind of problems that can occur. "Look at the rescission mess in California," said health policy analyst Robert Laszewski, when I interviewed him for the election health reform piece. "The Democratic nominee will stand up and say, 'John McCain will throw you to the market wolves.' " McCain is expected to elaborate on his healthcare reform proposal at the end of April. Maybe at that time he'll offer details about how he plans to protect consumers from predatory insurance practices.

As for this rescission mess, I'd like to hear from people who've experienced problems similar to what's occurring in California. Is this just a left coast phenomenon, or is it happening elsewhere, too?

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Posted by healthinsurance at 02:38 PM | Comments (0)

April 17, 2008

Los Angeles Files Lawsuit Alleging Anthem Blue Cross Illegally Canceled Health Insurance Policies

Los Angeles City Attorney Rocky Delgadillo on Wednesday filed a lawsuit against Anthem Blue Cross alleging the insurer violated more than 25 state and federal laws and "sold people false promises of coverage and concealed a scheme to renege on policies for those diagnosed with serious and often expensive medical conditions," the Los Angeles Times reports. Delgadillo claims the insurer issued false promises of coverage and concealed a plan to rescind the health insurance policies for patients diagnosed with serious and costly medical conditions. The suit seeks restitution for patients left with medical bills and more than $1 billion in penalties.

The lawsuit claims that the company's coverage "is largely illusory." Delgadillo said Anthem "engaged in an egregious scheme not only to delay or deny the payment of thousands of legitimate medical claims but also to jeopardize the health of more than 6,000 customers by retroactively canceling their health insurance when they needed it most." He added, "Countless Californians who believe they have good health insurance actually have policies that aren't worth the paper they're printed on."

The charges cited by the suit include some allegedly illegal activities reported by a Times article highlighting the rescission of policies held by individuals with costly medical conditions. Jerry Flanagan, a patient advocate with Consumer Watchdog, said, "The complaint makes it very clear that a key part of the resolution will be to make sure everyone has coverage."

Cindy Ehnes, director of the state Department of Managed Care, on Thursday is expected to announce that rescinded policies of several individuals would be reinstated by health care plans and to describe a process by which other patients could have rescissions reviewed and reconsidered. State Insurance Commissioner Steve Poizner said he would examine the allegations and decide whether action is needed.

A spokesperson for Anthem's parent company, WellPoint, said the company "strongly disagrees with the allegations" and plans to defend itself. "Anthem has offered on several occasions to meet directly with the city attorney to provide further information on Anthem's rescission procedures," said Shannon Troughton of Wellpoint. "To date, the city attorney rejected each of these offers, and we are disappointed by his actions today because of our attempts to meet with him," she added.

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Posted by healthinsurance at 11:53 AM | Comments (0)

April 11, 2008

Two health-care rescission bills make way through Assembly

The battle over how and when health plans can cancel a patient's insurance policy returned to the Capitol this week as two key pieces of legislation cleared the Assembly Health Committee.

At issue are the rules health insurance companies must abide by before they cancel a patient's health care coverage.

"In the five years that we have records, there have been about 700 rescission per year," says Hector De La Torre, D-South Gate, author of one of the bills passed out of Health Committee this week. "This bill would make it so those rescissions would have to be reviewed by a third party before they can happen."

Under current practice, health plans have the authority to unilaterally rescind a policyholder's insurance if they find there has been a "willful misrepresentation" of the patient's medical history on their initial health care application. De La Torre's bill would force health plans to seek approval from a third-party arbiter before an enrollee's health insurance policy can be revoked.

A number of high-profile cases in recent years have found that health insurance plans have improperly revoked policies from insurance holders for accidental omissions on their health insurance applications.

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Posted by healthinsurance at 05:43 PM | Comments (0)

April 08, 2008

Report links deaths in California to lack of insurance

A report by a national health advocacy group says at least eight Californians die every day because they lack health insurance or have insufficient coverage.

The study, conducted by Families USA, says an estimated 3,100 adults died in California in 2006 because they lacked health insurance, could not afford care or received substandard or late care because of a lack of insurance.

The report follows a three-year study by the National Institute of Medicine that linked roughly 18,000 deaths annually to a lack of insurance in the U.S.

Families USA, based in Washington, D.C., says its report is the first to link deaths to a lack of health insurance on the state level.

The group says the uninsured are less likely to have regular physician visits and more likely to put off the medical care they need. They also receive less health care once they are in hospitals and often cannot afford prescription medication to control chronic illnesses.

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Posted by healthinsurance at 04:32 PM | Comments (0)

April 03, 2008

Many Asian Americans in Sacramento County lack health insurance

Even while her stomach was killing her, Melelea Tausinga remained the heart and soul of Sacramento's Tongan community.

She counseled troubled teens, was the water mom for Tongan rugby teams and danced everything from Tongan classics to her favorite, "The Electric Slide."

But Tausinga never went to a doctor because she didn't know where to go and felt she couldn't afford it anyway, her husband said.

Tausinga, who died Oct. 25 of stomach cancer at age 51, was among tens of thousands of Pacific Islanders, Korean Americans and Southeast Asians without health insurance.

These ethnic groups "are doing much worse than other subgroups in terms of health insurance and access to health care," according to a study of Asian Americans released Tuesday by the Kaiser Family Foundation and the Asian & Pacific Islander American Health Forum.

Korean Americans, Native Hawaiians and Pacific Islanders are less likely to be insured than other Asian American groups such as Japanese or Asian Indians and twice as likely to be uninsured as whites, according to an analysis of national health data from 2004-2006.

The disparity is particularly acute in California, home to a third of the nation's Asian Americans and Pacific Islanders, said Cara James, the foundation's senior policy analyst for race and ethnicity.

"People who do not have health insurance delay much needed medical care, are more likely to forgo care because of costs, and when they do finally show up for care the conditions they have are often far more severe," James said. "They are more likely to show up with late stage cancer."

That's what happened to Tausinga, said her husband, Tevita Tausinga, who won't shave his beard or change his black clothes until his wife has been gone a year.

"She was almost everywhere, and she always followed the kids, who came by the hundreds to see her before she died," he said.

Melelea Tausinga, mother of four and grandmother of seven, not only gave herself to her community, she worked for more than 10 years as motel maid, then as teaching assistant at Susan B. Anthony Elementary, where her granddaughters attend. Neither job provided health insurance.

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Posted by healthinsurance at 01:32 PM | Comments (0)

March 29, 2008

Health insurers to meet with state agency on rescission probe

California's largest health insurers, facing possible fines and other penalties for the way they sometimes cancel policies after patients pile up medical bills, meet today with regulators to discuss ongoing state enforcement efforts.

The meeting was called by the Department of Managed Health Care, which oversees health maintenance organizations and other types of health plans, because it was nearing completion of investigations into the cancellation practices of Health Net Inc., Kaiser Permanente and Blue Shield of California, said spokeswoman Lynne Randolph.

The department plans to discuss the standards to which it is holding the insurers' practices, she said, as well as remedies for problems identified in the probes of policy cancellations, known as rescissions.

"This is our opportunity to move forward and conclude this phase of our investigation into rescissions," Randolph said. "Our goal is to bring a quick resolution to this problem to protect consumers today from illegal rescissions."

Randolph said the results of the remaining three investigations would be announced soon but that the process -- including today's meeting with the health plans -- was confidential until then to protect the insurers' due-process rights.

The closed meeting has alarmed consumer advocates because it comes as the insurance industry is pushing a plan that critics believe could make it easier for sick patients to lose coverage through no fault of their own. But the department said the industry's proposal was not on the agenda.

California health insurers -- battered by newly aggressive regulators, a $9-million court judgment and stinging criticism from lawmakers, judges and consumer advocates -- are fighting on several fronts this spring in Sacramento and elsewhere.

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Posted by healthinsurance at 07:45 PM | Comments (0)

March 25, 2008

PacifiCare Capitulates to Latest California Patient Revolt

In the face of a national campaign on behalf of Nick Colombo, insurance giant PacifiCare has reversed its decisions and agreed to critically needed cancer treatments for the 17-year-old from Placentia, Calif. The decision came after the company was overwhelmed by calls organized by Nick's friends and family, along with RNs from the California Nurses Association/National Nurses Organizing Committee, and netroots activists.

Over 100 of Nick's classmates, friends of the family with their young children, and nurses protested in front of the health insurance company headquarters this morning to demand that the approval be put in writing, which a PacifiCare representative, surrounded by T.V. cameras, and promised to do.

"I am extremely happy about PacifiCare's reversal," said Ricky Colombo, Nick's 19-year old brother. "The goal was to get treatment for Nick, and CNA/NNOC and other allies helped us with that. We decided to go through with the rally in order to get their decision on the record and make sure they back up their words -- and also because there are thousands of others in similar situations who can't get the care they need. We feel blessed to have this community supporting our family."

This is the latest example of a "patient revolt," where friends, family, and healthcare activists demand treatments denied by for-profit insurance corporations. In this case, Nick's physicians pleaded with PacifiCare to approve a cancer treatment, only to be overruled by an insurance company medical reviewer. PacifiCare is owned by United Health, the nation's largest health insurer, and just last year was fined $3.5 million by the state of California for wrongly denying 133,000 cases in a two-year period.

Inspired by the pleas of Nick's 19-year-old brother Ricky -- A national web of friends and family of Nick -- CNA/NNOC registered nurses, doctors, healthcare advocates, and netroot supporters pitched in on a national day of action Monday on Nick's behalf. Hundreds of phone callers clogged the lines of PacifiCare and United Healthcare offices around the country yesterday, at times shutting down the phone system, and leading a spokesman to complain about being "overwhelmed" by healthcare activists.

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Posted by healthinsurance at 01:50 PM | Comments (0)

March 23, 2008

Fighting Health Insurance Cancellations

Imagine spending thousands of dollars a year for health insurance, only to have it canceled after filing claims for treatment of a serious illness. Some retroactive policy "rescissions" appear unfair and arbitrary, raising doubts about the value of insurance and embarrassing the industry.

Insurance companies
say they need the right to void policies because some applicants lie about their health. But stung by widespread outrage over some recent cancellations, the industry is proposing a way to resolve rescission disputes between policyholders and companies.

America's Health Insurance Plans, an industry group in Washington, is advocating an appeals process involving independent review by a panel of outside experts. Decisions would be binding on health insurers. Earlier this month, the group presented the plan to representatives of state regulators, insurance commissioners and consumer advocacy groups.

"It's a positive step in the right direction and provides an opportunity for prompt dispute resolution while minimizing the need for litigation," says Ron Pollack, executive director of Families USA, a Washington nonprofit consumer organization.

Direct Buyers Only

This issue affects people who purchase their own policies -- not those who are covered under an employer-sponsored plan. Health insurers in most states can deny coverage based on an applicant's health history. Disclosure of some pre-existing conditions, such as cancer or heart disease, may result in a policy denial. But failure to do so could trigger a retroactive policy cancellation in the midst of treatment.

One challenge for health insurance applicants is that sometimes the medical-history forms they must complete are confusing and difficult to understand. Minor health issues that may not seem worth mentioning, and that were never treated by a physician, may later turn out to have been early warning signs of disease. Brokers or agents eager to complete a sale may urge a naive applicant to fudge an answer.

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Posted by healthinsurance at 08:29 PM | Comments (0)

March 18, 2008

Health care a prime target for states' cutbacks

Financially strapped states are looking to take away government health insurance and benefits from millions of Americans already struggling with a souring economy.

An Associated Press review of the budgets in all 50 states reveals that coverage would be eliminated for hundreds of thousands of poor children, disabled and the elderly. More than 10 million people would lose dental care, access to specialists, name-brand prescription drugs or other benefits. About 20 million could see their care jeopardized by further cuts to doctors' reimbursements.

Health care in California is a choice target as governors and legislators confront the worst deficits they have faced in a decade or more, but that is not their only target: They also are considering cuts in aid to schools and universities, shrinking state work forces and even releasing prisoners before their sentences are completed.

Safety-net programs for the elderly, disabled and out-of-work also could be cut, even as the demand for those services is on the rise.

Despite the dire conditions, only a few states are seriously considering general tax increases or even modest increases on the wealthy to close the gaps. Lawmakers say they fear such actions would only further stress the economy.

Instead of health insurance, states are looking to increase lottery ticket sales, promote Indian gambling or further raise taxes on cigarettes and alcohol. Those taxes disproportionately hit the pocketbooks of the same poor and working-class that would be hurt by the spending cuts, studies show.

Nearly two dozen states are grappling with deep cuts and tax proposals to close shortfalls totaling more than $34 billion. That includes California, where lawmakers have made emergency cuts and authorized billions in bond sales to halve a deficit once projected at $16 billion through June 2009. Another dozen states are bracing for falling revenue.

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Posted by healthinsurance at 01:06 PM | Comments (0)

March 14, 2008

Insurance Drops for Municipal Debt, Undermines MBIA

Demand for municipal bond insurance is shrinking at the fastest pace in the industry's 36-year history.

The backing of an insurer has become a liability for tax- exempt borrowers, sometimes doubling interest rates instead of lowering them. State and local governments bought protection on 26 percent of the $40.8 billion in bonds they sold in January and February, down from 53 percent a year earlier, according to data compiled by Bloomberg. At that rate, 2008 will mark the steepest-ever annual decrease, wiping out almost two decades of growth, Thomson Financial data show.

An extended decline would undermine the two biggest bond insurers, MBIA Inc. and Ambac Financial Group Inc., because they're counting on municipal sales to shore up credit ratings threatened by losses on mortgage-backed debt. Treasurers from California, Pennsylvania and Mississippi told lawmakers yesterday many borrowers would never have relied on insurers' ratings if their own were assessed like corporate debtors.

``This is a watershed moment in the municipal bond industry,'' said Richard Larkin, research director at brokerage Herbert J. Sims & Co. in Iselin, New Jersey, and the former chief municipal rating officer at Standard & Poor's. ``The bond insurers have lost a tremendous amount of credibility.''

Municipalities from California to New York are rejecting insurance as fallout from the collapse of the subprime mortgage market strips some of the biggest guarantors of their top AAA ratings. Even the safest debt that they back is tainted.

AAA Ratings

California, which spent $102 million to insure $9.1 billion of bonds between 2003 and 2007, decided insurance wasn't worth it on its most recent $5.95 billion of debt sales, said Treasurer Bill Lockyer.

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Posted by healthinsurance at 04:17 PM | Comments (0)

March 13, 2008

Legislation Would Set Standards for Individual Health Insurance Market in California

The fight on health reform in the last year put a spotlight on many of the real issues in the health insurance market, and in response, legislators this year have introduced a slew of stand-alone bills designed to set cost and benefit standards for health insurance and otherwise increase oversight of the private insurance industry.

A list of many of these bills is available at the Health Access California website.

SB 1522 (Steinberg), sponsored by Health Access California, would set standards for cost and coverage in the individual insurance market. It would provide immediate help to consumers who have to buy insurenace coverage in the individual market, such as the self-employed and those between jobs, while providing a framework for further health reform.


SB1522 (Steinberg) organizes the individual insurance market and makes it understandable for consumers. It would allow consumers to see and understand their choices in the individual market, and be better informed about a plan's premium, benefits and cost-sharing. By setting a standard for coverage, it would also effectively weed out a lot of "junk" insurance.

Consumers in the individual market would have a better sense of their health coverage choices, since all health plans sold in the individual market would be classified into five "tiers." In this way, consumers would be able to know if a certain plan is a top-tier comprehensive plan, or a bottom-tier catastrophic plan, or something in between, and if one plan from one insurer is roughly comparable with another plan by another insurer. This provides some standardization and simplification of the marketplace, while preserving a wide range of choices for consumers.

To allow real price comparison, Insurers would be required to offer five "benchmark" plans, one in each tier. The bill would enable consumers to do cross-insurer price shopping, to make apples-to-apples comparisons, with the confidence of knowing that benchmark plans in a given tier have similar cost-sharing, benefits, and other plan features. The benchmark plan would help define the tier, by being the lowest-price plan in a given tier.

The bill would eliminate some "junk" insurance, products that are coverage in name only, that provide such limited benefits or leave consumers so financially exposed, that the product is not of value. Such plans, deceptively offer "coverage" but leave consumers facing major gaps in coverage and significant out-of-pocket costs. California health insurers would not be able to sell new plans that do not meet the minimum benefit standards.

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Posted by healthinsurance at 11:18 AM | Comments (0)

March 11, 2008

Scrutiny of California Health Insurers Draws National Attention to the Problem

Dow Jones on Friday examined how a "series of troubling developments" related to rescissions of individual health insurance policies in California "is bringing national attention to the problem of patients having their coverage taken away when they need it most." According to Dow Jones, health insurers maintain that they "have a responsibility to ensure applicants are truthful about any pre-existing conditions they may have so companies can accurately price insurance policies and hold down costs for all their members," but consumer advocacy groups "warn that tactics such as tying financial incentives to the number of rescissions an employee makes or involving doctors in investigations after policies have been issued aren't working and may be illegal in some states."

California Department of Managed Health Care spokesperson Lynne Randolph said, "We don't think it is only happening in California ... but California's farther ahead in terms of enforcement," adding, "We had a statute in place that companies must do underwriting up front and a consumer must willfully misrepresent their health condition on an application in order for a company to rescind. We feel that means it can't just be an inadvertent omission."

America's Health Insurance Plans, which has begun to draft a proposal that would allow individual health insurance policyholders to appeal rescissions, said that the practice affected only 0.15% of individual health insurance policyholders in 2006. AHIP President Karen Ignagni said, "We recognize the process needs to be very transparent and people need to have peace of mind that they will have an independent review," adding, "As states adopt this proposal, they'll have a place where they can have these cases vetted external to the health plan." Meanwhile, some health insurers, such as Health Net, have begun to establish their own independent review programs.

Sandy Praeger, president of the National Association of Insurance Commissioners, said that health insurers are "making a lot of money collecting premiums" on individual coverage policies and "need to honor those contracts." She said, "I don't dispute (their) ability to drop someone who's intentionally lied," adding, "But to have policy language and application forms that are hard to understand and rely on a third party to explain them to you, it opens the door to people making unintentional mistakes. They shouldn't be held accountable for those." NAIC has begun to develop a standardized application for individual health insurance policies that could help prevent unintentional errors (Gerencher, Dow Jones, 3/7).

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March 06, 2008

California Senate Kills $15 Billion Health Insurance Plan

A California Senate committee has rejected Gov. Arnold Schwarzenegger's plan to provide government-controlled health insurance to millions more of California's citizens.

The January vote of the Senate Health Committee against the $14.9 billion plan came after nearly a year of tense negotiations between Schwarzenegger (R) and Assembly Speaker Fabian Nuñez (D). Last December the two announced a bipartisan compromise on a plan to add 3.6 million of California's five million citizens without health insurance to the rolls of the insured by 2010.

Called "an incredible plan" by Nuñez, the proposal--which would have appeared on the California ballot in November if lawmakers had approved it--included a mandate requiring nearly all Californians to buy private health insurance or enroll in a government program that would have been expanded to meet the additional demand.

Analysts called the plan unworkable, saying the revenue sources were too unsure and the mandate too difficult to enforce.

The committee voted 7-1 against the plan. Much of the opposition was based on the projected impact on the cash-strapped state's economy.

The estimated price tag had climbed from $14 billion at the time the plan was announced to $14.9 billion by the time of the committee vote. State budget officials are projecting a $14.5 billion overall budget deficit.

Tax Increases

The Health Care Security and Cost Reduction Act, Assembly Bill X1 1, was to receive funding from four sources: a $2.3 billion increase in the state hospital tax, a new payroll tax on businesses of 1 to 6.5 percent, an additional $1.50 to $2 per pack tax on cigarettes, and another $2.3 billion in funding from the federal government.

The measure also would have prohibited insurers from denying coverage to people because of existing medical ailments and would have required them to spend at least 85 percent of insurance premiums exclusively on medical care.

The plan was scheduled to move through California's state legislature in two parts.

The first, which laid out the changes and expansions being made to the state health care system, passed the General Assembly by a party-line vote at the end of 2007.

The second piece of legislation, dealing with program funding, was expected to take more time to pass than the first part because California requires a two-thirds majority vote to approve tax increases. Tax hikes therefore need bipartisan support.

Job Loss Fears

"The biggest problem for the state was the proposal to force employers to spend between 1 percent and 6.5 percent of payroll on health coverage," said Devon Herrick, a senior fellow at the National Center for Policy Analysis. "This tax on labor would have stalled job growth and increased costs on employers whose workers aren't willing to forgo sufficient cash wages to cover health benefits."

Stephen J. Entin, president of the Institute for Research on the Economics of Taxation, called the health plan "a tax on the poor, who smoke disproportionately, as well as on young workers and small businesses. Low-income workers would have been forced to use a large part of their limited compensation for insurance and taxes."

California Senate Health Committee Chair Sheila Kuehl (D-Santa Monica) said, "It doesn't matter how many good things are in the bill if there isn't money to pay for them."

State Sen. Leland Yee (D-San Francisco) concurred, saying, "Nothing that came out of [the committee] hearing gives me the comfort level that working people of California won't be left holding the bag."

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Posted by healthinsurance at 11:14 PM | Comments (0)

March 02, 2008

Insurance company: Doctors' Social Security numbers went on Web

A health insurance company in California has notified more than 100,000 doctors in Michigan and 10 other states that their personal information was posted on the Internet.

Health Net Federal Services spokeswoman Molly Tuttle says the doctors' Social Security numbers were accidentally posted on a Web site for about two months, beginning in November.

Tuttle says the company has no indication that anyone's doctor's personal information has been misused.

HNFS is a government contractor providing health insurance for nearly 3 million military families and veterans in 23 states.

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Posted by healthinsurance at 12:50 PM | Comments (0)

February 28, 2008

Bills aim at insurers after health care reform in California collapses

With health care reform dead in California - at least on the grand scale that Gov. Arnold Schwarzenegger envisioned - lawmakers are stepping in with a series of measures they say would help consumers and ban some egregious practices by insurance companies.

The bills fall far short of the governor's vision of sweeping reform, which collapsed last month under the weight of a nearly $15 billion price tag. And they would do little, if anything, to reduce the ranks of the roughly 6.5 million uninsured.

But short of that, supporters say the state can use its regulatory heft to aid consumers and possibly rein in rising health care costs. The measures, they say, would lay the groundwork for the next major reform push, possibly in 2010.

Lawmakers are "looking for an easy path to do something positive that won't cost money that the state doesn't have," said E. Richard Brown, director of the University of California-Los Angeles Center for Health Policy Research. The state has a projected budget shortfall of roughly $8 billion.

One bill is meant to help guide anyone trying to make sense of the dizzying combinations of deductibles, co-pays and premiums in choosing a health plan. The measure, SB 1522, sponsored by Sen. Darrell Steinberg, D-Sacramento, would simplify the process. Insurers would have to offer five "benchmark" plans, with easy-to-follow benefits and costs, so a person could make "apples-to-apples" comparisons from one insurance company to the next.

In a similar vein, Assemblyman Felipe Fuentes, D-Arleta, has a bill to help people measure what they're getting in return for hefty hospital and doctor bills. The bill, AB 2967, would create a "transparency" committee that would collect medical data to gauge the performance of hospitals and doctors treating certain illnesses, relative to what they charge.

At least three bills target a practice that's received widespread attention in recent months - insurance companies that retroactively cancel a patient's insurance coverage, often only after the person gets sick. Some insurers have defended so-called "rescissions" by claiming that patients lied about their health condition in their applications.

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Posted by healthinsurance at 02:41 PM | Comments (0)

February 26, 2008

California Health Plans Pay $65 Million to Improve Performance in Patient Care

Physician Groups Rewarded for Achieving Pay for Performance Measurements with Payments That Exceed Prior Year by More Than $10 Million.

Pay for performance (P4P) bonus payouts from health plans to California physician groups to reward quality of patient care totaled $65 million in 2007, according to the Integrated Healthcare Association (IHA). The payments were distributed during the third and fourth quarters of 2007 based upon the 2006 performance of physician groups serving HMO members. Aetna, Blue Cross of California, Blue Shield of California, CIGNA HealthCare, Health Net, PacifiCare, and Western Health Advantage participated in the performance payments with each health plan determining its own budget and methodology for calculating bonus payments to the physician groups.

These health plans have distributed over $210 million in payments to physician groups as a result of meeting P4P quality measures in the first four years of the program. The total financial payout equates to about 2 percent of the overall reimbursement to physician groups annually. Payments to individual groups vary from no payments to payments equaling up to 5 percent of overall reimbursement based upon performance.

Payments are typically paid on how well a physician group performs versus its peers, but emphasis is also placed on groups that show significant improvement over prior years. Participating health plans have been encouraged to allocate 20 percent of 2008 bonus payments for physician groups that make the most significant improvements.

Another incentive to promote improved physician group performance involves public reporting of results. Annually the results for each performance measure are reported by physician group on a website managed by the California Office of the Patient Advocate (OPA).

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Posted by healthinsurance at 09:50 PM | Comments (0)

February 24, 2008

Blue Cross of California Responds to Recent Media Coverage of Rescission

-- Blue Cross of California is committed to being the industry leader when it comes to protecting those seeking health insurance. That's why in September of 2006, Blue Cross was the first health care insurer in California to implement a series of steps to strengthen and make more transparent our process for rescinding policies in order to further minimize the possibility of errors.

These initiatives included:
-- Creating a new simplified application for individual benefits policies
-- Revising policies to clarify the initial underwriting process
-- Forming a new committee structure for the rescission review process
-- Adding dedicated liaisons for members undergoing retrospective review
or who have had their policies rescinded
-- Revising documentation to improve the accuracy and consistency of
review processes
-- Enhancing training programs for the underwriting and the retrospective
review process

In addition to these steps, for the past several weeks Blue Cross of California has been in the process of developing an outside third-party review process for all rescission cases. This means an independent, outside agent will help us validate whether rescission of a member's benefits is warranted. Blue Cross will be bound by the decision of the third-party reviewer. As the market leader in California, this practice is intended to further our efforts to protect all health care consumers.

Rescission, a tool designed to protect the system from abuse, affects a very small percentage of new enrollments -- roughly one-half of one-percent out of 300,000 new applicants a year. Blue Cross takes the issue of rescission very seriously, and we are leading the industry in working with legislators, regulators, providers and our members to help improve the access to health care for all Californians.

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Posted by healthinsurance at 07:00 PM | Comments (0)

February 23, 2008

California act to protect individual health insurance coverage

Lawmakers in several states are limiting insurers' ability to cancel health policies for consumers who buy their own coverage.

The state actions come as more people buy individual insurance policies because they are self-employed, unemployed or don't get coverage at work. More than 18 million people have individual coverage.

Unlike group health insurance policies offered by employers, individual plans require applicants to submit many years' worth of detailed medical information. The insurers use that information in deciding whether to offer coverage and how much to charge.

Most states allow insurers to revoke an individual policy — generally within two years of granting it — if they find an applicant lied or inadvertently omitted information on an application.

Cancellation of a policy is retroactive. Patients must pay for all their past medical care, even if the insurer previously approved and paid for the care. There is little nationwide data on the extent of cancellations. Blue Cross of California has said it cancels fewer than one-half of 1% of all new policies, an average of 1,000 a year.

Prompted by numerous consumer complaints and lawsuits against insurers, state lawmakers are taking action. Among their efforts:

•New Mexico. The Legislature this month passed bills requiring insurers to show that applicants deliberately gave incorrect information on an application. Current law allows cancellation if the error or omission was inadvertent. The governor has not said whether he will sign the bills, says spokeswoman Caitlin Kelleher. Without the law, "the consumer has no ability to defend" against a cancellation, says Melinda Silver, attorney with the state's Managed Health Care Bureau.

•Connecticut. In October, a new law took effect requiring approval from the state insurance commissioner before an insurer can cancel an existing policy.

•California. Legislation introduced last week would require insurers who want to cancel a policy to first win approval from the state's Department of Managed Health Care. Last year, legislators adopted a law requiring insurers to pay for any medical treatment they approve, even if they later cancel the policy.

California state regulators have announced cancellation-related fines against some insurers, including Blue Cross, Kaiser Permanente and Blue Shield of California.

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Posted by healthinsurance at 06:37 PM | Comments (0)

February 21, 2008

Los Angeles Launches Action Against California Health Insurer

The Los Angeles city attorney launched a wide-ranging legal action on Thursday against one of California’s biggest health insurance providers, accusing it of illegally selling policies to customers and then denying them coverage when they fell ill.

The action is being launched as health insurers face closer scrutiny from US regulators and legislators. Health insurance has become one of the dominant themes of the presidential election, with Democratic challengers Hillary Clinton and Barack Obama promising to reform what they contend is a broken system.

Rocky Delgadillo, the Los Angeles city attorney, accused Health Net of defrauding customers by setting illegal policy cancellation targets for its sales agents, who rarely possessed any medical training.

Mr Delgadillo said 1,600 Health Net customers had policies cancelled illegally. Damages of $2,500 (€1,700, £1,275) per customer are being sought. But the final damages tally could be much higher as Health Net is also held responsible for illegally advertising its products to thousands more customers.

The company is accused of “unlawful, unfair and fraudulent business acts and practices and deceptive advertising”. In addition, Mr Delgadillo said the company created a “secret unit” responsible for cancelling policies.

More than $35m of claims for medical treatment had been denied, he said, adding that customers were often in a vulnerable position when they discovered they were not covered with health insurance. “Just imagine . . . you’re in a hospital bed awaiting treatment and you find that Health Net will not provide the coverage you have paid for,” he said.

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Posted by healthinsurance at 02:37 PM | Comments (0)

February 19, 2008

Candidates' health plans duck some key questions

Democratic presidential candidates Hillary Clinton and Barack Obama are sparring over which of them is more electable, whether change is better than experience, and how the party's "super delegates" should vote.

What they are not doing as much of is debating issues. That's because on most policy matters, beyond the backward-looking debate over invading Iraq, there's little daylight between them.

The notable exception is health care. Both candidates say they favor universal coverage, a worthy goal in a country where 44 million people are uninsured. Their big difference is whether uncovered individuals should be required to buy health insurance. Clinton says yes, that anything less is unsatisfactory. Obama would require only that all children be covered. Adults will buy health insurance, he says, if given incentives, a questionable assertion.

Clinton's broader mandate (with government subsidies for the poor) would get the nation closer to the goal of universal health care coverage and would spread the cost over a larger pool of individuals, both good objectives. Further, it would do more to reduce the hidden tax on insured people, estimated at more than $1,000 a family, to pay for the health care of those who don't have insurance and show up at hospital emergency rooms.

But for voters, this narrow policy difference provides little basis for a judgment. That is because both plans are sketchy and incomplete, making the mandate on individual coverage kind of like a loose piece on a giant puzzle. Without seeing how it would fit with all the other pieces, it is difficult to make an informed decision.

Both Democrats' health care plans are more ambitious than that of presumptive Republican presidential nominee John McCain, who proposes much more modest adjustments to the health care system, centered on tax changes to encourage consumers to take a more active role in choosing, and paying for, their health coverage. Even so, Clinton and Obama are heavy on promises about making insurance affordable and available, and light on the more painful details. Neither says, for example, how he or she would enforce the individual mandates (Clinton's for everyone, Obama's just for those 18 and under). Would they garnish people's wages? Deny them access to health care? Shrug and look the other way?

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Posted by healthinsurance at 11:20 AM | Comments (0)

February 17, 2008

Bill Targets California Health Insurance Cancellations

Spurred by complaints that Blue Cross of California and other health insurers cancel patients' policies after they get sick, a Southland lawmaker has introduced legislation that would require state regulators to sign off before carriers drop policyholders for allegedly failing to disclose preexisting medical conditions.

Assemblyman Hector De La Torre (D-South Gate) said his bill was prompted by recent letters from Blue Cross to physicians asking them about new patients' health issues that could be used as a reason for canceling insurance coverage.

De La Torre said his bill was needed because insurance companies "were not intending to abide by the spirit" of a law he wrote last year prohibiting carriers from refusing to pay medical bills for previously authorized services.

"We all agree that if someone is lying and doing willful misrepresentation, then they should not be insured," the assemblyman said. "But the insurance companies should not be taking premium dollars from someone and dumping them."

Health insurance companies contend that weeding out people who may not have been forthright when they applied for coverage is an essential part of keeping treatment costs under control.

"We need to make sure that the process for application, rescission and cancellation is fair," said Christopher Ohman, chief executive of the California Assn. of Health Plans. "But we also want to make sure that the millions of people who do the right thing aren't left paying for the relatively few who don't."

Ohman's association represents 40 health maintenance organizations and preferred provider organizations covering 21 million enrollees in California.

Ohman said his group's members were "analyzing the implications" of De La Torre's bill.

The assemblyman's bill is the latest in a series of legislative, regulatory and legal actions in California in response to aggressive efforts by insurers and health maintenance organizations to drop patients who hold individual policies after they've filed claims.

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Posted by healthinsurance at 06:41 PM | Comments (0)

February 14, 2008

Study shows Latinos willing to pay for cross-border California health insurance

Research out of UC Berkeley points to cross-border health insurance as a way to expand health coverage to Mexican immigrants living in the United States, and a county health staffer plans to learn more about it.

The study, by Arturo Vargas Bustamante, a doctoral candidate at UC Berkeley, found:

• 62 percent of Mexican immigrants surveyed said they would support a cross-border insurance plan.

• 57 percent said they'd pay $75-$125 per month if services in Mexico were provided in public hospitals.

• Mexican immigrants in the U.S. sent $20 billion to their relatives back home in 2005, primarily to help cover family health care expenses.

• Those who sent money for family health care expenses strongly supported cross-border insurance.

The study was released as the Pew Research Center unveiled projections that Latino population in America would more than double from 14 percent in 2005 to 29 percent by 2050.

"The Mexican-born population in the U.S. has the lowest share of health insurance coverage than any other foreign-born group," said Gil Ojeda, director of UC Berkeley's California Program on Access to Care and Health Initiative of the Americas, which co-funded the study.

California is the only state to offer cross-border health insurance.

About 50,000 Mexican immigrants living between Los Angeles and San Diego are enrolled, a small percentage of the estimated 11 million Mexican immigrants who live or work in the U.S.

Carmen Robles, a senior health analyst for Santa Cruz County, said she plans to attend a conference Feb. 28-29 in Berkeley where the cross-border approach will be discussed.

Dr. Jose Chibras of Salud Para la Gente, which treats many Latino families in Watsonville, said he was not familiar with the existing cross-border health insurance program. He had a lot of questions.

"Who's going to pay for it?" he asked. "What would the reimbursements be for the physicians? What does it cover? What could a person actually get for that amount of money? Are the patients able to afford $150 a month? That is a lot of money to put out, $1,500-$1,600 a year. And who would be eligible?"

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Posted by healthinsurance at 08:23 PM | Comments (0)

February 13, 2008

California Health-care solution

Since many conservative politicians oppose universal health care because they feel it takes away patients’ right to choose where to get their health insurance, wouldn’t it make sense for the government to adopt a system that promotes public-private competition?

In his book The Conscience of a Liberal, Paul Krugman, opinion columnist for The New York Times and economic teacher at Princeton University, advocates for a health-care system that gives people the choice to either buy into a Medicare-type government insurance plan or stick with their private insurance companies.

Wouldn’t this be a logical compromise that could be made between conservatives and liberals?

It would provide health care to all Americans without taking away a person’s right to choose where to get their health insurance.

Health care reform plans similar to the one envisioned by Krugman have been proposed at the national level by Sen. Barack Obama and at the state level by California Gov. Arnold Schwarzenegger.

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Posted by healthinsurance at 07:19 PM | Comments (0)

February 12, 2008

New Study on Individual California Health Insurance Mandates

Behind the escalating debate on the health care between Senators Hillary Clinton and Barack Obama on individual mandate – she’s for it, he’s against it – is a critical policy battle that not only cuts across healthcare reform but also the neo-liberal privatization dreams, the home mortgage crisis, and the recession that is no longer looming, it’s here.

Sound farfetched? Take a closer look, starting with the millions of Americans staring at the loss of their homes due to the subprime loan debacle. It’s not a loan or a mortgage crisis for those families; it’s a debt crisis being forced upon them by the banks, hedge funds, and some California insurers who are desperate to shift their own mammoth debt onto someone else.

Banking, other financial institutions, insurance and real estate which make up the finance sector, now account for about half of U.S. corporate profits. And, they are in trouble with more than $2.5 trillion in outstanding consumer credit, $800 billion of that in credit card debt, and another $10.1 trillion in domestic mortgage debt.

Being thrifty won’t solve that problem. The financial planners have identified two lucrative pots of money. Trading carbon credits for industries and employers that want to brand themselves as green while continuing to pollute. And, making a killing in healthcare premiums, currently 16 percent of our national economic pie and rapidly growing.

The banks are already into healthcare in a big way, serving as a repository for health savings accounts and other tax credit schemes so beloved by the Bush administration and the Republican presidential candidates. But the financiers would like more.

Enter the neo-liberal think tanks and policy wonks and plans they hawk to expand the reach of the market, especially the financial market, in health care. Central to that approach is shotgun insurance, forcing everyone not currently covered to buy health insurance policies.

Compelling people to buy insurance, however, is not the easiest sell. Big insurers and HMOs have a well deserved bad reputation for heartless denials of care – that’s how they make money. And, it’s pricey. Premiums the past decade have gone up 87 percent, not to mention the ever climbing bills for insurance deductibles, co-pays, and a host of other transaction fees.

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Posted by healthinsurance at 02:08 PM | Comments (0)

February 11, 2008

Challenges Loom for Childrens' Health Insurance in California

Since President Bush did not renew the State Children's Health Insurance Program, or S-CHIP, California is grappling with the future of its version of the program that covers more than 900,000 kids. But many people don't realize the other looming challenge of getting health insurance for low-income children. From Sacramento Kelley Weiss explains.

This time California health officials are bracing for a federal law that will take effect in August. The law will cut back how much money a family can make to qualify. Bonnie Ferreira is with Cover the Kids. Her program, based in Sacramento, picks up children who don't qualify for Medicaid or Health Families, the state version of SCHIP. Right now there are 10,000 enrolled in Cover the Kids. Ferreira says she's worried that the new law will further strain the health care system.

Ferreira: Our local communities cannot afford to have all these kids uninsured. Where do they show up? They show up in high cost care, they show up in emergency rooms.

Dr. Patricia Samuelson works at the Norwood Clinic in Sacramento. In her practice, she sees a lot of kids without health insurance. She says the national veto and upcoming law could affect more than emergency rooms.

Samuelson: When your children don't have any medical insurance there are parents who don't let them play, don't let them ride their bikes for fear of injury.

But, some health officials say it could be worse.

Spingarn: I don't think anyone really believes at this point that there's going to be no federal funds and no state funds for this program in the future.

That's Ronald Spingarn with California's Managed Risk Medical Insurance Board that oversees Healthy Families. The good news, he says, is even with the national uncertainties California plans to add more than 65,000 kids to the program.

He also says the feds will give California money until September. But, from September to March 2009, when SCHIP is slated to end, he says there are no funding guarantees. So, while there are different predictions on just how SCHIP changes will impact California, officials agree it's a 'wait and see' scenario.

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Posted by healthinsurance at 12:51 PM | Comments (0)

February 09, 2008

Growing Pains of Universal Coverage for Californians

It has not been a good few weeks for state efforts to provide universal health insurance. A pioneering program in Massachusetts to cover hundreds of thousands of uninsured has cost a lot more in its opening phases than originally projected, raising fears about its sustainability. An even more ambitious proposal to cover millions of uninsured in California collapsed in the State Senate over fears that it would prove unaffordable.

Neither setback means that states should stop trying to cover the uninsured — especially since the federal government is AWOL. The problems do suggest that officials need to make the most realistic possible cost estimates and be prepared to provide resources to subsidize coverage for those who can’t afford it.

The Massachusetts plan was the result of compromises between a former Republican governor — Mitt Romney, who lost his enthusiasm just in time for the presidential primaries — and a Democratic Legislature. It required all residents to buy health insurance or suffer financial penalties, subsidized those unable to afford it, imposed a small fee on businesses that failed to provide employee coverage and set up a marketplace where people can buy portable insurance with pretax dollars.

The financial problems are mostly because of underestimating the number of uninsured and the rate at which they would sign up for subsidized coverage. As a result, the state, which had originally expected to spend $472 million on subsidized insurance this fiscal year, now expects to spend about $150 million more than that. It anticipates spending almost $870 million next year.

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Posted by healthinsurance at 07:20 PM | Comments (0)

February 07, 2008

Schwarzenegger vows to pursue health insurance

California Gov. Arnold Schwarzenegger on Tuesday vowed to press on with legislation to provide health insurance to his state's uninsured, a day after a universal health care bill he backed died in a Senate committee.

"I'm as determined as ever," Schwarzenegger said.

Lawmakers who voted against the bill missed a golden opportunity for California to demonstrate to the rest of the United States how to establish a universal health care system, Schwarzenegger said in a speech to the press club of the state capital of Sacramento.

"The issue is not going to go away," he said.

The Republican governor and Assembly Speaker Fabian Nunez had brokered a bill that would have provided Californians without medical insurance some level of coverage by requiring they obtain it individually or through employers or a state program.

The Democrat-led Assembly had endorsed the legislation but on Monday the health committee of the Democrat-led Senate voted it down 7-1.

Top Democrats in the Senate had joined with the chamber's minority Republicans in opposition to the legislation's complexity and projected cost, expected to be more than $14 billion to help establish a fund to subsidize medical insurance for more than 5 million uninsured Californians.

The fund would have relied on tobacco taxes and fees on employers and hospitals. Opposition to the bill grew after a report last week by the state's budget watchdog warned the insurance scheme could cost the already cash-strapped state much more than supporters claimed.

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Posted by healthinsurance at 08:27 PM | Comments (0)

February 06, 2008

Clinton's health-care insurance plan might garnish paychecks

Democratic presidential candidate Hillary Clinton said workers' wages might be garnished to pay for health insurance under her health-care plan.

"We will have an enforcement mechanism," Clinton said today on ABC's "This Week" program. The New York senator said possibilities include paying for the program through the tax system and automatic enrollments, as well as "going after people's wages." Clinton said her plan would "enable everyone to afford" coverage.

Clinton has attacked Barack Obama for promoting a health plan that doesn't require universal coverage and portrayed herself as the Democrat with the best chance to win the presidency, as part of her closing arguments before primary and caucus voting in 22 states on Feb. 5.

"It would be a big mistake for Democrats to nominate someone who's already conceded on the issue of universal health care," she told reporters on her campaign plane while traveling to Arizona from California yesterday. "My strong advocacy for universal health care puts me in a much better position to take on John McCain."

Illinois Senator Obama has focused on lowering the cost of health care and opposes forcing Americans to pay for health insurance, saying that some people still wouldn't be able to afford it and mandates in states such as California and Massachusetts show that it doesn't work.

Clinton, 60, is seeking to sharpen distinctions with Obama before the "Super Tuesday" Democratic nominating contests this week. She said voters should look beyond the choice of the first woman or black to be elected president.

"Whichever one of us emerges, we will make history," Clinton told a few thousand voters yesterday during a rally at California State University in Los Angeles. "It's not just about making history in a symbolic way, it is about changing lives for the better."

Clinton and Obama, the two leading candidates for the Democratic nomination, are crisscrossing the nation ahead of Super Tuesday, when voters in states including New York, Massachusetts and Georgia will choose about half the delegates needed for the nomination.

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Posted by healthinsurance at 05:20 PM | Comments (0)

February 04, 2008

California's reform fails; can a federal solution work?

The demise of California's attempt at comprehensive health-care reform last week means that advocates of overhauling the health-care system will turn their focus back to Washington, several experts said, as an increasingly tough budget climate raises new questions about whether states can go it alone.

When the plan championed by Gov. Arnold Schwarzenegger, a Republican, and state Assembly Speaker Fabian Núñez, a Democrat, went down to defeat in a legislative committee, so did hopes that successful reform in such a populous, influential state would bolster efforts elsewhere to cover more of the nation's 47 million uninsured.

While California is unique in some respects -- it has a diverse electorate, a high number of uninsured and a history of occasional budget crises -- experts said some of the same economic forces at work there threaten to slow or swamp similar proposals in other states. The slumping economy diminishes states' tax revenue at the same time that spending demands increase as more people seek help from programs such as Medicaid, which serves the poor. And, unlike the federal government, state governments have to balance their budgets.

"The failure of California's plan pushes the focus about expanding coverage even more strongly towards Washington," said Paul B. Ginsburg of the Center for Studying Health System Change, a nonpartisan policy-research group. "I've never believed that states would be able to go very far on their own because of their fiscal limitations. A state in an average year could be able to afford something, but once they get into a recession, they get into fiscal trouble."

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Posted by healthinsurance at 07:14 PM | Comments (0)

February 03, 2008

California health care dream gets a lethal shot of budget reality

A year ago, Gov. Arnold Schwarzenegger set out to show the nation that California could do what the federal government and many states could not: transform a health care system that leaves millions uninsured and countless others paying ever more for skimpier benefits.

That dream died Monday in a Senate committee, falling victim to a faltering economy and leaving reformers to wonder whether a historic opening was squandered. With the governor and lawmakers now focused on the state's budget woes, the next chance may be at least a year away, after the next president is inaugurated.

"California had a major opportunity," said Peter Harbage, an independent health care consultant affiliated with the New America Foundation think tank. "This would have been one of the biggest reform efforts in the nation in a very long time, really since the Clinton effort" in the mid-1990s.

The Republican governor's proposal, crafted after months of contentious negotiations with Assembly Speaker Fabian Núñez, D-Los Angeles, sought to put the state on a path to universal coverage and fundamentally change how health care is provided. Businesses would have faced a new requirement to cover workers, and individuals would have had to carry insurance.

The plan would have expanded government health programs to cover more poor and working-class residents, and taxed hospitals and cigarettes to help pay for it. Insurance companies, notorious for weeding out sick customers, would have had to halt that practice.

Altogether, about 3.6 million of the 5.1 million permanently uninsured residents would have received coverage.

But the $14.7 billion proposal ultimately may have been undone by a state budget deficit of roughly the same size. A warning last week of potentially huge shortfalls made it difficult for even liberal Democrats to get behind the landmark plan.

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Posted by healthinsurance at 09:41 AM | Comments (0)

February 01, 2008

The California Health Plan Collapse: Another Big Lesson in What Not to Do in Health Policy

The collapse of Governor Arnold Schwarzenegger’s California health plan was anti-climactic. For months, it was clear that the complex $14 billion proposal reached by Governor Arnold Schwarzenegger and liberals in the California state legislature was a political non-starter. In the process of hammering out the details with the help of liberal health policy analysts, the Governor managed to alienate entire classes of groups and institutions which should have been his natural allies: the business community, doctors and hospitals, Republicans in the state legislature and the conservative voters in the state, and voters of every partisan persuasion who did not think it was a good idea for taxpayers to subsidize health insurance for illegal aliens. Alienating that many constituencies over one issue is a unique achievement. So, it was a good lesson in the politics of health care reform, and what exactly not to do.

The obvious and more important- and broadly overlooked- fact about the now dead California Plan is that it was not even a reform, if that word has any meaning at all. It was largely an expansion of the status quo. What Schwarzenegger and his legislative allies proposed was, with minor exceptions, simply to accept the current structure and financing of the existing health care system- the mix of public and private, employer-based health insurance arrangements that exist today- expand it, and then slap mandates on both employers and individuals to force them to participate in today’s flawed system. New taxes on doctors and hospitals, plus cigarette taxes- a thoroughly unreliable stream of funding- would be imposed to finance the thing. Not surprisingly, many liberal policy analysts are now saying that the failure of California is proof that health care cannot be reformed at the state level, and that only Washington can be entrusted with getting it right. Drew Altman, president of the Henry J. Kaiser Family Foundation, recently told The Washington Post, “California’s failure, after coming so close, underscores the lesson that too many states don’t have the political will or the resources to reform health care on their own, and thus the need for a national solution of some kind.”

No, not quite. Aside from reforming the inequitable and inefficient federal tax treatment of health insurance, Washington can do little to improve the health care system. States can reform health care, but real reform means real reform. It means changing the structure of the health insurance markets, so that individuals and families, not government officials or employers or managed care executives, control the dollars and make the key decisions in the system. It means reviewing and repealing old and outdated insurance rules and regulations, while developing innovative and imaginative solutions to adverse selection and risk adjustment or designing pooling arrangement. It also means changing the structure of health care financing, in particular, redirecting the billions of dollars of existing government subsidies from health care institutions to individuals and families so that they can get private health insurance that they want and that they like. No, this is not easy. It’s heavy lifting. But it can be done. And every state in the union is inherently capable of doing it.

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Posted by healthinsurance at 01:48 PM | Comments (0)

January 31, 2008

Labor Unions Against California Health Insurance Mandates

The "most vociferous opponents" of the California health care reform legislation, which the state Senate rejected on Monday, "were not fiscal conservatives but labor unions that launched a last-minute revolt against its most crucial feature: an individual mandate that would have forced everyone to buy coverage," Shikha Dalmia, a senior analyst at the Reason Foundation, writes in a Wall Street Journal opinion piece. Dalmia writes that "many California unions argued that a mandate would force uninsured, middle-income working families to divert money from more pressing needs toward coverage whose price and quality they cannot control."

She adds that the failure of the California legislation has "national political implications." According to Dalmia, although Democratic presidential candidate Sen. Hillary Rodham Clinton (N.Y.) has "denounced" rival Sen. Barack Obama (Ill.) for "refusing to include an individual mandate in his health care plan," he "seems to understand the perverse side effects of an individual mandate." Obama is "surely correct that part of the reason 45 million Americans are uninsured is not that no one is forcing them to buy it but that they can't afford it," Dalmia writes.

In addition, the recently implemented Massachusetts health insurance law, which served as the "inspiration" for both the California legislation and the Clinton proposal, "has inflated demand, which, combined with onerous regulations on insurance suppliers, has triggered premium increases of 12%" for 2008, according to Dalmia. She writes that Massachusetts "won't be able to fully shield those it subsidizes from the premium increases" and that "uninsured folks who don't qualify for government help really get pounded."

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Posted by healthinsurance at 04:09 PM | Comments (0)

Health Care Marketplace | California Regulators Issue $3.5M Fine

California health insurance regulators on Tuesday issued a $3.5 million fine against PacifiCare, a subsidiary of UnitedHealth Group.

The state Department of Managed Health Care issued the fine after a joint investigation with the state Department of Insurance found PacifiCare from July 1, 2005, through May 31, 2007, had more than 130,000 alleged claims processing violations. State regulators said that PacifiCare improperly denied 30% of claims reviewed during the investigation. In addition, they said that PacifiCare often delayed reimbursements to physicians and hospitals for more than 30 days.

Complaints against PacifiCare increased significantly in early 2006, when UnitedHealth acquired the company. The $9.2 billion acquisition increased UnitedHealth membership by about three million to 27 million. David Hansen, regional chief executive for UnitedHealth, on Monday in a meeting with the Los Angeles Times said that the company should have made fewer changes to PacifiCare at the time of the acquisition.

PacifiCare spokesperson Tyler Mason said that the company has taken "aggressive steps" to address the problems cited by state regulators. He added that PacifiCare has added 50 full-time employees to address claims processing issues. PacifiCare officials have not decided whether the company will pay the $3.5 million fine or pursue an appeal, Mason said.

State Might Issue $1.3B in Additional Fines
California Insurance Commissioner Steve Poizner on Tuesday said that the California insurance department might issue additional fines against PacifiCare for the alleged claims processing violations. Poizner said that fines for each alleged violation would range from $5,000 to $10,000.

According to the Wall Street Journal, additional fines could "theoretically add up to between $650 million and $1.3 billion," but "several analysts said additional fines would likely be far lower given the amounts traditionally levied in California." The state will issue the maximum fine only in the event that "authorities prove all the violations and show they were committed as part of a deliberate scheme."

More Audits
Poizner on Tuesday also said that the California insurance department will begin audits of the eight largest health insurers in the state to address alleged claims processing violations similar to those found at PacifiCare, the Union-Tribune reports. The eight health insurers include Aetna, Blue Shield of California, Cigna, HealthNet and WellPoint, among others. Representatives from WellPoint, which operates Blue Cross of California, and Blue Shield declined to comment on the audits.

Poizner said, "The actions today get at the very core of how our health care system operates. When a consumer gets sick, they expect their health insurance company to be there for them to pay legitimate claims to doctors and hospitals." He added, "I want to send a clear message to every health insurance company in California that I won't tolerate any company deploying a shoddy claims filing system"

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Posted by healthinsurance at 08:19 AM | Comments (0)

January 30, 2008

California Health Care Reform Bill Rejected

A California Senate panel voted 10-1 late Monday, January 28, to reject comprehensive health care reform crafted by Republican Gov. Arnold Schwarzenegger and Democratic Assembly Speaker Fabian Núñez. The panel action came just over a month after the Assembly approved a compromise bill hammered out by Schwarzenegger and Núñez.

Monday’s vote’s also canceled a companion ballot initiative that would have provided the funding for the reforms, including employer health care coverage spending requirements and an increase in the cigarette tax and fees paid by hospitals to support increases in provider reimbursement from the state’s Medicaid program.

Provisions in the compromise bill—aimed at bringing health insurance coverage to most of the state’s nearly 7 million uninsured—would require most state residents to obtain health insurance, while the state would subsidize premiums for lower-income state residents.

Employers would have to spend a specific percentage of payroll on health care for employees or pay into a pool that would be created to provide coverage for the uninsured.

The cost of the reforms was projected at more than $14 billion, roughly the size of the deficit the state faces this year. Before Monday’s vote on the bill, Núñez challenged the committee to come up with a better reform measure.

“I would challenge the members of the Senate to come up with a plan that’s doable, and that can withstand the same type of scrutiny [the proposal] was put through in this committee, the same kind of analysis by the Legislative Analyst, that is going to respond to the needs of those poor families who have absolutely no health care today,” Núñez said in testimony at the panel hearing Monday.

Meanwhile, Gov. Schwarzenegger is evaluating his next move, according to a spokeswoman.

“The fact that the Senate missed a golden opportunity to pass health care reform doesn’t change the governor’s commitment to fixing California’s health care system,” the spokeswoman said. “Keep in mind that in Massachusetts, it took Gov. Romney three years to push the concept of individual responsibility across the finish line.”

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Posted by healthinsurance at 11:54 AM | Comments (0)

January 23, 2008

California health care in critical condition

Sen. Sheila Kuehl (D-Santa Monica) stopped by the Los Angeles Times this week to discuss health care reform. Kuehl will hold a hearing today on the Nunez-Perata health care bill, which is supported by Gov. Schwarzenegger. The Assembly has already passed the bill. If Senate also approves it, an initiative providing funding for the new system will be put on an upcoming ballot for voter approval. Kuehl spoke about her skepticism of the bill and support for a single-payer system.

Sheila Kuehl: The bill has an individual mandate; every Californian would be required to buy health insurance. The minimum creditable coverage would be established by the Medical Risk Management Insurance Board, fondly known as MRMIB... MRMIB exists today. They essentially are tasked currently with finding insurance for un-insurable people. They have a waiting list that would go around this building, because they can't find sufficient insurance. But that's their job.

Eryn Brown: When I was reading over this a few months ago it seemed as if they didn't have jurisdiction over all the plans, that it was only some. So if they're determining minimum coverage would that be for all people in California or just for people in certain pools?

Sheila Kuehl: That's a good question. They are not allowed to say that employers have to buy certain plans. However, you would not satisfy the mandate unless you bought a plan that was the minimum creditable coverage. I think what they're trying to do — I mean, this give Rube Goldberg a new name for simplicity. It's much more complicated than any Rube Goldbergian machine that used to appear in this paper many many years ago. So they might offer plans that don't meet the minimum creditable coverage, but if you bought them you wouldn't have satisfied your mandate. So it's quite confusing.

Eryn Brown: "They" would be the insurance industry?

Sheila Kuehl: Correct. The thought being that young men who won't get pregnant and think they're going to live forever don't want to buy all these things because policies are mandated to cover pregnancy; they're mandated to cover diabetes, etc. Minimum creditable coverage would include all of those mandates in the state. Theoretically no policy can be offered in the state now that doesn't include all those items. So you would be required to buy an insurance policy. Employers would be required to spend a certain percentage of their payroll on insurance. And there are a certain number of things they can deduct from their percentage if they contribute to the employees' health, things like gym memberships. That is a real loophole, in my opinion... What we found when we studied workers comp in California is that some employers categorized some employees as independent contractors. Independent contractors don't count toward your payroll. It potentially is a way that employers could reduce their burden, by increasing the number of employees they categorize as independent contractors. Some of that happened with workers comp, but this is a big bite for employers. They might say, "I can't do this. You're an independent contractor now."

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Posted by healthinsurance at 10:01 PM | Comments (0)

January 22, 2008

State's health care overhaul could cost taxpayers billions

The proposed overhaul of California's health care system could cost taxpayers billions of dollars in unanticipated expenses within five years of being launched, according to a review released tonight by the Legislature's nonpartisan analyst.

Legislative Analyst Elizabeth Hill, warning that Gov. Arnold Schwarzenegger and other proponents of the legislation may have under-estimated the cost of providing care to millions of uninsured Californians, said that hundreds of millions of dollars in federal support is also uncertain as is the number of people who may need state support.

The report comes on the eve of a critical hearing about the bill before the state Senate's health committee, set for Wednesday.

The overhaul legislation, AB 1X was approved by the state Assembly in December, but senators have been skeptical of its cost and workability. The warnings from Hill may provoke even more concerns.

"If it doesn't pass my committee, if we don't approve it - the governor will be out there saying that the state Senate killed health care reform," said Sen. Sheila Kuehl, D-Santa Monica, chair of the health committee and a critic of the proposal.

"But the headline should be that the senate refused to put out a bad health care bill," she said.

The $14 billion overhaul proposal would mandate virtually all Californians to have insurance. Employers would be required to cover their workers or pay into a state pool for purchasing insurance at a cost between 1 percent and 6.5 percent of company payroll.

There would be a fee on hospitals and a $1.75 tax on a pack of cigarettes to help pay for coverage of an estimated 6.8 million Californians who lack insurance.

The fees and taxes would go before voters in November, if approved in the Legislature.

Steve Maviglio, spokesman for Assembly Speaker Fabian Núñez, D-Los Angeles and author of the health care bill, called the analysis "thorough" but said the speaker and legislative analyst disagree on some aspects.

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Posted by healthinsurance at 10:19 PM | Comments (0)

January 20, 2008

Governor's health care bill faces long hearing, close vote

SACRAMENTO—Gov. Arnold Schwarzenegger's $14 billion health care expansion bill moves to the Senate, where it will face an extended hearing this week and the likelihood of a close vote in the Health Committee.

"This is not a slam dunk," said Sen. Leland Yee, a San Francisco Democrat who could end up being the swing vote on the measure.

The bill passed the Assembly in December, but the Senate put off consideration to give the Legislature's budget analyst, Elizabeth Hill, time to report on the bill's costs.

The Health Committee will take it up Wednesday with a hearing that the chairwoman, Sen. Sheila Kuehl predicts will stretch from midmorning into the evening.

The panel will hear from Hill, take a look at health care experiments in other states, examine the bill piece by piece and take testimony from supporters, opponents and those on the fence looking for amendments.

"There are going to be a lot of witnesses," said Kuehl, D-Santa Monica.

The legislation would require employers to spend a certain percentage of their payrolls on health coverage for their workers, either by buying policies themselves or paying into a state health insurance pool.

Most Californians who couldn't obtain coverage through jobs or a government program would be required to buy insurance on their own.

The plan would be funded through employer contributions, fees on hospitals and an increase in cigarette taxes, in addition to premiums paid by consumers. Administration officials also are counting on getting additional federal funding to expand health care programs for the poor.

Supporters say the proposal would provide coverage for most of the 5.1 million Californians who lack health insurance and force insurers to take all customers instead of denying coverage because of pre-existing conditions.

"This is fundamental reform...," said Assembly Speaker Fabian Nunez, D-Los Angeles, who negotiated the legislation with Schwarzenegger and is carrying the bill.

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Posted by healthinsurance at 08:25 PM | Comments (0)

January 19, 2008

Insider Tips for Californians to Lower Health Insurance Premiums

Pick PPO

If you are covered by an HMO policy, immediately change your coverage to a PPO plan.

In California, HMO plans are substantially more expensive than PPO plans. With an HMO plan you may or may not have a deductible, but you will still make co-payments for office visits and other preventive services. With a PPO plan you, not the HMO, can select your doctor. I recommend changing to a PPO plan to save an average of 40 to 80 percent.

Increase Your Deductible

The cost of medical services in California has made your deductible nothing more than a down payment on your real financial exposure - your annual maximum out of pocket cost or expense. As an example, if you or a family member were to go to the hospital as an outpatient for a series of medical tests, the cost would range from $15,000 to $25,000, even though you were classified as an outpatient. In this example, no matter the size of your deductible, you would pay the annual out of pocket cost maximum, making the size of the deductible financially meaningless. I recommend that you increase your low deductible policy to one with a deductible at or near your annual maximum out of pocket cost, and save from 60 to 80 percent.

Separate Family Policies into Individual Policies

By separating policies into individual plans you will be able to customize your overall insurance coverage to reflect your specific needs. As an example, men between the ages of 18 to 35 usually do not go to the doctor as often as women in the same years; therefore, an annual physical would probably be sufficient. In addition, young children visit the doctor more frequently than their parents and may need a plan with more complete well baby office and other benefits. By separating family policies into individual policies, you may be able save 20-50 percent.

Select a High Deductible Health Savings Account (HSA) Qualified Plan

The requirements in 2008 for an HSA qualified health insurance policy are that the minimum deductible is $1,100 for an individual, and $2,200 for a family. The annual maximum out-of-pocket cost is $5,600 individual, and $11,200 for a family. With this type of insurance coverage you pay for all of your medical expenses, with the exception of your annual physical and annual OB/GYN exam, up to the amount of your deductible. The real benefit to you is that once you achieve your annual deductible/maximum out of pocket costs, all future medical expenses will be paid by the insurance company. Doing this can save you up to 35 or even 50 percent.

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Posted by healthinsurance at 08:35 PM | Comments (0)

January 17, 2008

Kids’ health plan in California saves big bucks

A new study found that providing health insurance to children through the local Children’s Health Initiatives saves California taxpayers in nine counties $7 million a year by preventing more than 1,000 unnecessary hospitalizations.

The study comes at an advantageous time for supporters of universal children’s health insurance, who fear momentum for guaranteeing coverage to all children may be waning in light of a $14 billion state budget shortfall and fading enthusiasm for comprehensive statewide health reform.

“It’s exactly the thing we need,” said Kena Burke, director of the San Luis Obispo County Children’s Health Initiative. “It demonstrates that when you put your dollars in the beginning, the kids stay healthier.”

Children’s Health Initiatives in 25 counties, including San Luis Obispo, boost enrollment in public programs, Healthy Families and Medi-Cal, in addition to offering their own insurance, Healthy Kids.

Healthy Kids is for children in families who don’t qualify for state and federal programs because their families earn too much or because of their immigration status.

The study released Monday by the Center for Community Health Studies at USC’s Keck School of Medicine compared preventable childhood hospitalizations in nine counties before and after the implementation of the Children’s Health Initiatives.

The study was funded by The California Endowment and First 5 Association of California.

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Posted by healthinsurance at 06:40 PM | Comments (0)

January 16, 2008

California court rules against insurer over policy cancellations

A California appeals court ruling may bode well for physicians and patients in their fight against alleged illegal policy cancellations by health insurance companies.

A three-judge panel of the 2nd District Court of Appeal unanimously ruled that the practice of reviewing individuals' applications after they have submitted claims and then pulling the coverage based on alleged errors "is flatly prohibited" under state insurance laws. The Dec. 4, 2007, decision gave the green light to a patient's class-action lawsuit alleging that Blue Shield of California tried to dodge claims by looking for supposed misstatements or omissions on patients' policy forms after approving treatment.

The ruling comes amid heavy scrutiny of various health plans' cancellation practices by state insurance regulators. Also, physicians and hospitals have turned to the courts.

The California Medical Assn., along with a group of hospitals, is suing Blue Cross of California to block alleged similar tactics. Blue Cross declined to comment on the case.

Physicians and lawyers involved in the issue say the recent decision signals that the courts are paying attention and are willing to hold insurers accountable.

"This is a good sign for patients and doctors," said CMA spokeswoman Karen Nikos. "The court has spoken and said that taking insurance away from patients is wrong, and we look forward to seeing [the Blue Shield] case go forward with this sentiment."

Not only are patients left uncovered when insurers pull policies, but doctors also are left uncompensated for authorized care they had provided in good faith, Nikos said. "It's a complete breakdown of the physician-patient relationship when patients have their insurance wrongfully taken away."

Blue Shield spokesman David Seldin called the appeals court ruling a "narrow" one and just one step in the litigation process. The company asked the court to reconsider its decision, and the 2nd District on Jan. 3 granted its request. No hearing date has been scheduled.

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Posted by healthinsurance at 07:56 PM | Comments (0)

November 11, 2007

Linking health plan to economy

SACRAMENTO -- Confronting the latest challenge to his effort to reshape California's healthcare system, Gov. Arnold Schwarzenegger argued Friday that the state's rapidly deteriorating financial outlook is extra impetus for action, not reason for pause.

"Some have said we shouldn't tackle healthcare reform with this year's shortfall," Schwarzenegger told a gathering of Latino healthcare advocates in Los Angeles. "I happen to totally disagree with that.

There is a real correlation between fixing the healthcare system and fixing our budget."Schwarzenegger's assertion that his plan to insure all Californians would help the economy -- and therefore the state's finances -- was questioned by leading legislators from both parties and by some independent analysts.

"If everything turns out in the governor's favor, that's one scenario," said Shawn Martin, who directs the health department of the nonpartisan Legislative Analyst's Office.

The analyst's office issued a report last month saying the state could end up with as much as $3.2 billion in additional costs if some of Schwarzenegger's assumptions don't pan out.

"If everything went wrong here, it would create, I think, more of a budget problem, but there's no way of knowing," Martin said.

The $14-billion healthcare plan the Republican governor favors would be built on new employer and hospital taxes, extra money from the federal government, selling off management of the state lottery, and requiring that all Californians obtain insurance. Schwarzenegger says the plan would pay for itself.

But even if the governor's proposal is enacted, it will not kick in until 2010, two years too late to affect the state's upcoming fiscal year, when officials anticipate a $10-billion shortfall.

The Assembly Republican leader, Mike Villines of Clovis, said the state's fiscal troubles require retrenchment, not ambitious new program.

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Posted by healthinsurance at 05:54 PM | Comments (0)

November 03, 2007

Governor's Health Plan Hides the True Cost of a Mandatory Purchase Requirement, Testimony Shows

California Health and Human Services Agency Secretary Kim Belshe indicated in legislative committee today that the financial estimate of the Governor's plan to require all Californians to buy private insurance policies does not consider the impact of double digit insurance company premium increases. The proposal does not add up to affordability, said the Foundation for Taxpayer and Consumer Rights.

In response to questions from Assemblyman Dave Jones (D-Sacramento), Belshe argued that costs would somehow be contained, yet the $14 billion estimate of the plan's cost appears to be based on annual medical inflation--doctor and hospital rates--which range from 4% to 6%. This does not take into account that insurance premiums have increased two to five times faster than medical inflation. Dramatic insurer premium increases of the last several years are due to huge profit increases, vast cash reserves and administrative waste, said FTCR.

"Californians deserve an honest debate of how much health care will cost under the governor's plan to require them to buy private insurance policies," said Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights (FTCR). "The bottom line is that governor's plan does not add up. Health care will never be affordable for patients, the system, or the state's taxpayers when insurers are allowed to charge whatever they choose."

Massachusetts passed a similar law requiring residents to buy private health insurance last year. That program, which goes into effect in January, has already experienced cost increases far beyond what was promised by policymakers when the bill was passed.

In response, Massachusetts Senate President Therese Murray (D-Plymouth) has proposed a plan to require health insurance to justify rate increases in excess of 7%. She also said that the state's insurers should spend down their $2 billion in excess reserves to keep premiums affordable.

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Posted by healthinsurance at 07:58 PM | Comments (0)

October 29, 2007

California Agencies Release Proposed Regulations To Prevent Improper Cancellations Of Health Insurance Policies

The California Department of Managed Health Care and Department of Insurance on Tuesday proposed new regulations intended to prevent insurers from improperly canceling individual health insurance policies, the Sacramento Bee reports (Chan, Sacramento Bee, 10/24). The agencies said the new rules reinforce existing laws prohibiting insurers from rescinding coverage unless they can prove policyholders intentionally omitted information or lied on a medical questionnaire (Girion, Los Angeles Times, 10/24).

Under the proposed regulations, advance notice would be required before any policy cancellations; coverage could not be suspended during an investigation of a policyholder; coverage could not be canceled for an entire group if only one person is responsible for submitting false information on a medical questionnaire; and the DMHC director could review policy cancellations (Sacramento Bee, 10/24). In addition, insurers would be required to simplify their applications to avoid confusing questions about medical history (Colliver, San Francisco Chronicle, 10/24).

The proposal will be reviewed during a public hearing sometime after mid-November (Sacramento Bee, 10/24). DMHC has fined Blue Cross of California and Kaiser Permanente for improper cancellations, and the agency is continuing investigations of Blue Shield of California, Health Net, Kaiser Permanente and PacifiCare (San Francisco Chronicle, 10/24).

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Posted by healthinsurance at 02:04 PM | Comments (0)

October 21, 2007

State Watch | California Health Care Reform Debate 'Divisive,' USA Today Reports

A proposal by California Gov. Arnold Schwarzenegger (R) that would require all state residents to obtain health insurance has become "increasingly divisive, possibly jeopardizing major health legislation this year and highlighting the difficulties other state or national reform efforts might face," USA Today reports (Appleby, USA Today, 10/17). Schwarzenegger last week introduced a revised $14 billion proposal that would require all state residents to obtain health insurance, through employers, the individual coverage market or public programs.

Under the proposal, the state would subsidize health insurance for individuals with annual incomes less than $25,525 and for families with annual incomes less than $51,625. Lower-income state residents who do not qualify for the subsidies but whose health insurance costs exceed 5% of their household incomes would receive a tax credit. Schwarzenegger said that he would finance the proposal in part through the lease of the state lottery program to a private company (Kaiser Daily Health Policy Report, 10/16).

On Friday, Schwarzenegger vetoed a bill (AB 8) proposed by state Democratic lawmakers that would have required employers to contribute as much as 7.5% of their payroll to cover the cost of health insurance for employees or pay into a state fund that would provide coverage. The legislation would not have required all state residents to obtain health insurance (Kaiser Daily Health Policy Report, 10/15).

Debate Details:

Enactment of the Schwarzenegger proposal would make California the second state after Massachusetts to require residents to obtain health insurance. However, "unlike Massachusetts, where a broad coalition of interest groups won a hard-fought battle for consensus, California lawmakers, the governor, consumer groups and labor unions have not agreed on two key issues: how much employers must pay if they don't offer health insurance to workers; and how much individuals should pay to buy their own coverage," USA Today reports.

Adam Mendelsohn, communications director for Schwarzenegger, said, "Everyone is very disappointed that labor unions have decided to poison the health care debate," adding, "No one is clear why labor unions have gone from sitting at the table and having an honest debate to opposition."

Betsy Imholz, special projects director for Consumers Union, said that the group has concerns about whether the Schwarzenegger proposal is "sustainable for the long term with a low employer contribution." Art Pulaski, head of the California Labor Federation, said, "The governor's proposal says that if you make more than 350% of poverty (about $35,735), there is no support for you whatsoever" (USA Today, 10/17).

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

October 18, 2007

California health reform gets sticky

Health reform efforts in California have become increasingly divisive, possibly jeopardizing major health legislation this year and highlighting the difficulties other state or national reform efforts may face.

Launched in January by Republican Gov. Arnold Schwarzenegger, the state's efforts aimed to be a model for others contemplating how to cut the number of uninsured. If the governor's plan is adopted, it would be the second state, after Massachusetts, to require all individuals to have health insurance.

But, unlike Massachusetts, where a broad coalition of interest groups won a hard-fought battle for consensus, California lawmakers, the governor, consumer groups and labor unions have not agreed on two key issues: how much employers must pay if they don't offer health insurance to workers; and how much individuals should pay to buy their own coverage.

Last week, Schwarzenegger vetoed a Democratic plan he said didn't go far enough toward covering all the state's estimated 4.8 million uninsured, partly because it did not require individuals to buy insurance.

In response to the expected veto, a coalition of consumer and labor groups said the governor's plan, which did not receive any sponsors in the Democrat-controlled legislature, doesn't do enough to help people who earn too much to qualify for his proposed low-income subsidies. They don't favor a requirement that individuals buy insurance without more cost control and affordability requirements, such as a 5% cap on how much of an individual's income must be paid toward insurance premiums.

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Posted by healthinsurance at 03:22 PM | Comments (0)

October 16, 2007

California voters would support tax to fund health insurance

A slim majority of California voters would support a one-cent sales tax increase to help fund health insurance, according to a survey by the Survey and Policy Research Institute at San Jose State University.

That might bode well for Gov. Arnold Schwarzenegger - if he decides to ask voters for such an increase to help pay for universal health care.

It's no secret that such a move was being considered - pushed by the California Restaurant Association and the California Small Business Association - but it appears the governor has decided instead to try and lease the state lottery and use money from that to help pay for his plan.

The survey showed that 52 percent of voters would approve, while 38 percent would vote against it.

The restaurant and small business associations like the sales tax proposal as a way to protect employers from payroll taxes, which will almost certainly be included in any proposal to provide universal health care.

The poll also showed that a majority of voters - 51 percent - would go along with a ballot measure that seeks to loosen term limits. But that's probably because the emphasis in the ballot summary is on shortening the amount of overall time a lawmaker can spend in office from 14 years to 12 years.

What's more difficult to explain is that the measure actually increases the overall time many lawmakers would spend in office, by allowing them to serve longer in either the Assembly or the Senate.

Perhaps the best evidence that voters believe the measure will reduce time in office is that it is supported most strongly by Republicans - 54 percent, compared to 49 percent of Democrats. Republicans traditionally advocate for limiting terms.

But the support for the measure also is slipping - across all party lines - down from 56 percent approval in a previous San Jose State poll.

The institute polled a random sample of 652 California adults Oct. 1-8 by telephone. Interviews were conducted in English and Spanish. The margin of error was plus or minus 4.9 percentage points among voters.

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Posted by healthinsurance at 12:31 AM | Comments (0)

October 12, 2007

Governor Schwarzenegger's Health Insurance Plan 2.0

ne of the things I've learned through the years as a negotiator is that regressive bargaining, besides being illegal in many cases, will always come back to bite you. That assumes, of course, that you have built up some trust with your adversary and can be depended on to at least honestly try to reach agreement. When regressive bargaining begins, the ability to reach an agreement is severely compromised and trust is on vacation.

Unfortunately, regressive bargaining is what I see from Governor Schwarzenegger on health care. He has "introduced" Health Insurance Plan 2.0, but instead of being better than the previous version 1.0, it takes at least a small step backward, though Art Pulaski of the California Labor Federation calls version 2.0 "an enormous step backward."

For instance; under the first plan employers would be required to contribute 4% towards employee health care, far short of the 7.5% that Democrats want. In the new plan Schwarzenegger moved backward, allowing employers to pay on a sliding scale, ranging from nothing to 4%, letting some employers off the hook. What happened to "shared responsibility?"

The individual share just got bigger. Everyone will still be required to "obtain" coverage, but the plan doesn't adequately protect middle-class individuals who may not be able to afford high premiums. "Middle-class families would be left on their own to figure out how to pay thousands of dollars in deductibles, premiums, co-pays, prescriptions and other out-of-pocket expenses," Pulaski said. Some may not see this as a step backward, but it sure isn't moving forward.

Doctors are taken off the hook for their 2%. This isn't necessarily a negative, though it had little opposition, even from doctors, but is a step backward from Health Insurance 1.0. To make up for lost revenue Schwarzenegger wants to lease the state lottery.

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Posted by healthinsurance at 03:49 PM | Comments (0)

October 01, 2007

To reform the health care system

Responding to Americans' desire for health care reform, a near-desperate desire in some quarters, almost all of the presidential candidates have put forth a plan to increase access to medical insurance. The resulting options range from market-based solutions to national health insurance. The most intriguing proposals, and possibly the most pragmatic, would build on the successes of the private health insurance market and mend the cracks of its failures.

All eyes are on Hillary Clinton's plan, which John Edwards' campaign claims is nearly identical to its own. These plans and several state reform efforts hinge upon requiring individuals to purchase health insurance. In the case of Clinton's plan this is coupled with a mandate to insurers to offer insurance to all who apply, regardless of health status or other qualifiers.

It is a clever plan. If realized, it would accomplish a return to an insurance market that does not discriminate by age, health status or other factors. By definition, it would eliminate the problem of the 47 million uninsured Americans.

Its implementation depends upon a realistic method for making the premiums affordable for the uninsured, most of whom certainly can't pay the going rate, which the Kaiser Family Foundation sets at $12,000 a year for a family of four. The Clinton plan promises people tax credits tied to a premium guaranteed not to exceed an "affordable" percentage of their incomes.

A reform so monumental will require the buy-in of both parties. The focus on private insurance reform raises interesting issues on both sides of the aisle. Conservatives are less likely to balk at a plan that maintains the choice and flexibility of the private market but will be less enthusiastic about the federal involvement in financing the purchase. Liberals will appreciate the progressive tax credits to subsidize the purchase, but will question the public-private venture. Libertarians will chafe at the requirement that individuals purchase insurance. There is a push-pull phenomenon at work in the plan's mechanism.

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Posted by healthinsurance at 11:40 AM | Comments (0)

September 19, 2007

Governors Push for Insurance Change

California Gov. Arnold Schwarzenegger lobbied the Bush administration Monday to roll back rule changes that limited the scope of a popular children's health insurance program.

In a letter to Health and Human Services Secretary Michael Leavitt, the governors said 28 other governors had joined their effort to pressure the administration to reconsider changes to the State Children's Health Insurance Program.

"The requirements amount to a unilateral restriction on state authority to provide health insurance coverage for children and undermine the foundation of the state-federal partnership upon which SCHIP was built," Spitzer and Schwarzenegger wrote to Leavitt.

Under the program, the federal government and the states subsidize the cost of health coverage.

The new guidelines, issued in August, are designed to keep families from dropping private health insurance in exchange for cheaper or better coverage through public programs.

Under the new guidelines, when a state expands eligibility to higher-income children, it has to show it has enrolled at least 95 percent of eligible poor children in public health programs.

Democratic lawmakers and governors from both parties have said the rules are misguided and will result in more uninsured children. The administration says the rules will refocus the program on the low-income people it was intended to serve.

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Posted by healthinsurance at 04:26 PM | Comments (0)

September 16, 2007

Health Insurance Premiums Vault Past Inflation

Health insurance premiums rose 6.1 percent this year — the lowest rate of increase since 1999 — but that fact offered little solace to employers and workers, who have seen overall premium increases rise far faster than wages or inflation during that same period.

The average cost of a family plan purchased by employers this year hit a new high, $12,106, according to a detailed annual survey of nearly 2,000 employers by the non-partisan Kaiser Family Foundation, a research group based in Menlo Park, Calif. Individual coverage premiums averaged $4,479.

“Health insurance is becoming increasingly unaffordable for many employers and working people in the country,” says Drew Altman, president of the foundation. “We’re seeing this more and more every year.”

While the percentage of the premiums paid by workers stayed about the same as last year, the dollar amount paid by workers toward their share of family coverage rose $308 to $3,281. Single employees paid an average of $694 toward their coverage, up $67.

The 6.1 percent increase in premiums was more than twice the annual rate of inflation in July of 2.4 percent.

Sharing The Pain

Premiums are just one part of the cost. Many workers also have annual deductibles they must meet before coverage kicks in. Those ranged from an average of $401 for individual workers in HMO-type plans to $1,729 in high-deductible plans.

Increasing those deductibles helped some employers keep costs down.

At Econ-O-Line Abrasive Products, a 23-employee shop that manufactures sandblasting equipment, owner Dan DePottey says his premium increases have averaged less than 5 percent in both of the past two years. During that time, the firm went from a zero-deductible HMO plan to one with a $1,000 deductible. To soften the blow, DePottey told employees they would be on the hook for only $250 of that deductible: The company would pick up the rest. So far, not very many of his workers have needed to take him up on the offer.

“I actually got lower costs this year than last,” says DePottey. His total health insurance premium bill fell from $147,000 last year to $141,000.

The number enrolled in high-deductible policies, which are often coupled with special tax-free savings accounts, did not increase in a statistically significant way, the survey found. Such plans cover about 5 percent of insured workers, or about 3.8 million people, up from 4 percent in 2006. Premiums are generally lower for such plans.

At The Community Builders, a non-profit company based in Boston that builds affordable housing, few workers signed up for a newly offered high-deductible plan, says Judy Lauch, who oversees benefits for the 500-worker firm.

The plan, with a $1,000 deductible for individuals and $2,000 for families, was offered to counter a steadily rising cost of the more traditional coverage.

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Posted by healthinsurance at 01:32 AM | Comments (0)

September 10, 2007

Employers Scrutinize Health Insurance Eligibility

If you're one of the millions of Americans who receives your health insurance through your employer, you would be wise to read the small print before signing up family members for coverage this enrollment season.

And if you've signed up your girlfriend as your "spouse," now's the time to cut her coverage.

Faced with rising medical costs, U.S. employers are starting to scrutinize the eligibility of dependents, such as spouses and children, who are covered under their health plans. Traditionally, employers relied on an honor system to manage enrollment. But now, in an effort to restrain rising health spending, a growing number of employers are requiring employees to provide documented proof.

Workers should be prepared to dig out copies of birth and marriage certificates, root around for tax returns and obtain a letter from their child's college. Employees who fail to provide supporting documents when asked risk losing health coverage for their loved ones and, in rare cases, their jobs -- if they knowingly seek coverage for family members they know to be ineligible. In cases of clear fraud, an employer may also seek to recoup plan-paid medical and prescription costs.

Large auto makers such as General Motors Corp., Ford Motor Co. and Chrysler LLC have dropped tens of thousands of ineligible dependents from their health plans by using audits. Now banks, hospitals and hotel chains -- where staff turnover can be high and benefits a major attraction of the job -- are following suit.

"It's an issue that's top of mind for employers," says Susan Johnson, a senior consultant at Watson Wyatt Worldwide in Chicago who oversees audits carried out by the consulting firm.

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Posted by healthinsurance at 10:56 PM | Comments (0)

September 09, 2007

U.S. eyes California’s universal health care plan

The prognosis for universal health care in California is grim this year, and experts say a failure could set back similar efforts nationwide for years to come.

Unions, doctors and other powerful interests are arrayed against Gov. Arnold Schwarzenegger's $12 billion-a-year plan to make medical insurance mandatory. He has threatened to veto the Democrats' less ambitious alternative and take his plan to the ballot instead.

A showdown could come as early as Thursday, when the Democrats plan to put Schwarzenegger's proposal to a vote in the state Assembly. The aim is to show how little support it hasA record 6.8 million Californians, nearly 1 in 5 of the state's residents, went without health insurance at some time during 2006, according to figures released Tuesday by the U.S. Census Bureau.

Nationally, a record 47 million Americans, including 8.7 million children, lacked health coverage, the report said.

With the campaign for the White House under way, what happens in America's most populous state could have especially wide repercussions.

"If we fail, it will have the effect of a wet blanket on health reform nationally," said Robert Ross, president of the California Endowment, a foundation devoted to health care. "I think the presidential candidates will all look with a very watchful eye at what happens in California."

Following the lead of Massachusetts, which passed universal health care last year, Schwarzenegger announced his own plan last January to provide health insurance to all California residents.

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Posted by healthinsurance at 04:57 PM | Comments (0)

September 06, 2007

California Measure To End Retroactive Cancellations Of Health Plans

The California Department of Managed Health Care on Tuesday said new rules to prevent HMOs from retroactively canceling individual policyholders' coverage are taking longer than expected to draw up because of the variety of plans involved, the Los Angeles Times reports. In January, the agency, which regulates California HMOs, said it would introduce in the spring regulations to stop the practice of HMOs retroactively canceling coverage because of a failure to disclose pre-existing medical conditions.

DMHC spokesperson Lynne Randolph said the delay in issuing the new rules is a result of the time required to survey the plans to make sure the rules fit them all. "These regulations need to get out in a timely way, but we also feel that consumers deserve to have regulations that will be able to be quickly adopted so that thousands of people who are now being denied health insurance or are afraid of obtaining health insurance because of possible rescission can get relief," Randolph said.

A survey of Blue Cross of California was the first to be completed in March, but the company is disputing the findings, as well as the department's decision that the HMO routinely violated state law by rescinding policies. Surveys of other plans are ongoing.

Proposed rules could take up to a year to be made public and then approved, revised or discarded. Randolph said rescission regulations would be sought even if Gov. Arnold Schwarzenegger's (R) health reform proposal is approved because major changes to the state's health care system would take a long time to implement and could face legal hurdles. Schwarzenegger's (R) plan would require that insurance be sold to all residents, regardless of medical history.

Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights on Tuesday in a letter to DMHC criticized the delay, writing, "Patients cannot afford for you to allow another company's rescission policy to leave more Californians uninsured, uninsurable and facing unpayable medical bills."

Chris Ohman, executive director of the California Association of Health Plans, said the state's efforts to pursue the regulations are "kind of silly," adding, "Let's focus on issues that are going to be relevant to health care reform" (Girion, Los Angeles Times, 8/29).

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Posted by healthinsurance at 02:18 PM | Comments (0)

September 04, 2007

Health insurance debate: 47 million Americans at risk?

Thanks to a combination of laziness, incompetence with numbers and (especially) ideological crusading, we are in the middle of a stretch of the most pervasive and dishonest bad journalism I have ever seen in the United States. I refer to the stories which assert that 47 million Americans (or 6.8 million Californians) are without health insurance.

No, they're not.

At some point over the past 12 months, an estimated 47 million people in this country and 6.8 million people in California have been without health insurance. At any single point in time, the number of people without health insurance has been estimated at 5 million for California. I haven't seen a national figure, but if the California ratio works nationally, that would mean about 34.5 million people are without health insurance at this moment.

Are they all Americans? Do you consider illegal immigrants and resident aliens to be Americans? There are some people out there who will see this as racist. There are more people who will see this as common sense.

Page 29 of this Census Bureau report shows that 10.2 million of the 47 million people who at some point within the past year didn't have health insurance are noncitizens.

OK, so we're down to 36.8 million Americans who at some point within the past year didn't have health insurance. The snapshot in time number, if the California ratio held up: 27 million Americans are, at this moment, without health insurance.

Sure seems less scary than 47 million Americans, huh?

But let's take it further. According to the research of one of the biggest advocates of expanding health coverage in the nation -- the Henry Kaiser Family Foundation -- 19 percent of the uninsured have family incomes more than triple the federal poverty level but choose for their own reasons to go without health insurance.

19 percent of 27 million is 5.13 million.

The Kaiser research also documents that 25 percent of the uninsured are eligible for Medicaid or the State Children's Health Insurance Program but do not sign up. This is the single part of the health insurance debate that drives me most bonkers. A gigantic hunk of the problem is oblivious individuals -- and irresponsible parents. How often do you hear about this? Never.

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Posted by healthinsurance at 12:05 PM | Comments (0)

August 30, 2007

California Measure To End Retroactive Cancellations of Health Plans

The California Department of Managed Health Care on Tuesday said new rules to prevent HMOs from retroactively canceling individual policyholders' coverage are taking longer than expected to draw up because of the variety of plans involved, the Los Angeles Times reports. In January, the agency, which regulates California HMOs, said it would introduce in the spring regulations to stop the practice of HMOs retroactively canceling coverage because of a failure to disclose pre-existing medical conditions.

DMHC spokesperson Lynne Randolph said the delay in issuing the new rules is a result of the time required to survey the plans to make sure the rules fit them all. "These regulations need to get out in a timely way, but we also feel that consumers deserve to have regulations that will be able to be quickly adopted so that thousands of people who are now being denied health insurance or are afraid of obtaining health insurance because of possible rescission can get relief," Randolph said.

A survey of Blue Cross of California was the first to be completed in March, but the company is disputing the findings, as well as the department's decision that the HMO routinely violated state law by rescinding policies. Surveys of other plans are ongoing.

Proposed rules could take up to a year to be made public and then approved, revised or discarded. Randolph said rescission regulations would be sought even if Gov. Arnold Schwarzenegger's (R) health reform proposal is approved because major changes to the state's health care system would take a long time to implement and could face legal hurdles. Schwarzenegger's (R) plan would require that insurance be sold to all residents, regardless of medical history.

Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights on Tuesday in a letter to DMHC criticized the delay, writing, "Patients cannot afford for you to allow another company's rescission policy to leave more Californians uninsured, uninsurable and facing unpayable medical bills."

Chris Ohman, executive director of the California Association of Health Plans, said the state's efforts to pursue the regulations are "kind of silly," adding, "Let's focus on issues that are going to be relevant to health care reform"

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Posted by healthinsurance at 10:51 AM | Comments (0)

August 25, 2007

Small-business owners favor health care plan, survey says

More small-business owners in California back proposals being considered in Sacramento to revise the state's health insurance system than oppose them, according to a survey commissioned by a coalition of small-business organizations.

Officials with Small Business for Affordable Healthcare yesterday offered the results of its scientific survey as a counterweight to earlier, unscientific polling by the National Federation of Independent Businesses – an influential voice in the state's insurance-reform debate – that indicated opposition to the proposals from a majority of small business owners.

About 47 percent of the business owners surveyed by the coalition said they support Assembly Bill 8, which would charge businesses that don't sponsor employee insurance plans a 7.5 percent payroll tax to fund a statewide pool from which their employees would buy insurance.

The same amount of small businesses support a similar proposal by
Gov. Arnold Schwarzenegger that would charge a 4 percent payroll tax for businesses with at least 10 workers.

The survey questioned 506 randomly selected small-business owners and senior managers between Aug. 2 and 15. The telephone poll, done by Core Strategies of Laguna Hills, has a margin of error of plus or minus 4 percent.

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Posted by healthinsurance at 08:18 PM | Comments (0)

August 22, 2007

Health care for all should be the goal in California

Whenever the discussion heats up about whether California should be the first state in the nation to adopt a single-payer health care system - known among its opponents as "evil socialized medicine" - the first thing we hear is how satisfied millions of Americans are with their current health care. The knee-jerk rationale goes: Why would we want to risk the privileges of the most sophisticated health care in the world?

Let's set aside the fact that in 2000 when the World Health Organization surveyed the health systems in 191 countries, the United States ranked a relatively pathetic No. 37. (In many areas, we rank behind countries such as Canada and England that have government-run health care.)

Lots of double talk

If you really think your health insurance is so hot, let me ask you this. When is the last time you had to use it for anything other than a routine doctor's visit? If you think that dealing with a state-run health care system would be a nightmare bureaucracy, have you tried navigating the maze of double talk at your health insurance company lately?

The odds are that the health insurance you think you have has changed a lot in the past few years since costs have continued to skyrocket and employers have not been able to continue to foot the bill. In the five years since I've been writing about the health care mess, I've heard horror stories from people who have been denied care by their health

insurance carriers
that are as bad as the stories from people who don't have insurance at all.

The latest such story to grab the spotlight is the plight of Cynthia Campbell, a nurse in San Francisco who is fighting two kinds of cancer. She had a short-term health insurance policy with Blue Shield, which she purchased when she had left one job and was a few weeks away from starting another. During that time, she was diagnosed with cancer, and she fell into "pre-existing condition" hell.

She could not renew her policy, even though she had always had insurance and never missed a premium payment in 30 years. "What you find is that once you actually get sick, no insurance carrier wants to touch you," Cynthia told me. "They do everything they can to get rid of you."

Live in California? Need a free health insurance quote now? Click here!

Posted by healthinsurance at 08:09 PM | Comments (0)

August 20, 2007

US NetCare Launches Health Care Insurance for Non-US Citizens in California

US NetCare, an online administrator of healthcare and medical insurance for non-US citizens living in the United States, announced its plan to launch its services in Southern California. "California has the largest immigrant population in the United States and our products have been custom designed to be affordable and easy to apply. Our hope is that the Immigrant population which is in dire need of healthcare coverage will welcome us and our products," according to Jacob Harel, chairman of US NetCare Corp.

US NetCare, an online administrator of healthcare and medical insurance for non-US citizens living in the United States, announced its plan to launch its services in Southern California. "California has the largest immigrant population in the United States and our products have been custom designed to be affordable and easy to apply. Our hope is that the Immigrant population which is in dire need of healthcare coverage will welcome us and our products," according to Jacob Harel, chairman of US NetCare Corp.

US NetCare plans to reach out to the Hispanic community in Southern California through grass roots marketing programs targeted to the communities where they live. The Multi-media marketing plan will be comprised of TV, radio, direct mail, shared mail, door hangers, and Online advertising.

There are over 30 million non-US citizens currently living in the US, many of whom have come seeking employment or other opportunities to better their lives and the lives of their families. Health insurance for them has been unavailable in the past. For the first time, US NetCare offers comprehensive, flexible and affordable plans that support this diverse group and their needs. The plans have been streamlined to give the right coverage at the most efficient price.

Non-citizens residing in the US can include immigrants, foreign workers, exchange scholars, international executives, expatriates, green card holders, international students, undocumented individuals, and diplomats, among others. Through US NetCare, these individuals and their families can obtain coverage during their stay in the United States.

US NetCare's medical services are provided by First Health PPO, an extensive, nationwide network of medical professionals that share US NetCare's commitment to the well-being of the non-US citizen population. Non-US Citizens residing in the US are eligible, and there are no long medical history forms to submit for enrollment. US NetCare also features multi-lingual customer service representatives to assist individuals during the enrollment process and throughout the duration of their coverage.

Live in California? click here for you free health insurance quote today!

Posted by healthinsurance at 02:13 PM | Comments (0)

August 17, 2007

Valuable Health-Care Benefits You May Be Overlooking

Exploring your health-care plan comes naturally when you need it to cover treatments for an illness or injury. But some of its features are best used — and often overlooked — when you're well.

Even in an era of rapidly rising health-care costs, employers often offer a host of free or low-cost preventive-care and wellness benefits, either directly through their health plans, their health plan's negotiated discounts with a network of third-party providers or employee-assistance programs, benefits experts say.

But many go unused because workers assume they don't have them or don't think to ask about them.

Especially when it comes to lesser-known discounts, insured people may be passing up significant savings on expenses such as laser vision correction surgery, braces, infertility treatments, weight-loss programs, massages — even electric toothbrushes. Discounts often range from 10 percent to 40 percent and can translate into personal savings of thousands of dollars.

"There are great benefits available to people that they don't even realize they have," said Mary Jo Case, president of Alliance Resources Inc, a human-resources consulting firm in Kalamazoo, Mich.

Here are nine valuable benefits you might be missing out on from your insurer, employer or both:

Paid preventive-care benefits

Those could encompass age-appropriate screenings like colonoscopies and mammograms; regular checks of blood pressure, cholesterol and blood sugar; and prenatal vitamins for pregnant women.

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Posted by healthinsurance at 12:12 PM | Comments (0)

August 13, 2007

State fears insurance for children in jeopardy

SACRAMENTO – President Bush's plan to veto a children's health insurance bill could leave about 200,000 California children uninsured and disrupt Gov. Arnold Schwarzenegger's goal of providing universal coverage, state officials said.

Bush has threatened to veto a pending Senate bill that would add $35 billion over the next five years to the State Children's Health Insurance Program, which provides coverage for children of the working poor. In California, the program is called Healthy Families.

Children enrolled in these programs have parents whose income is too high to qualify for Medicaid, called Medi-Cal in California, but not high enough for them to afford health insurance.

Bush also opposes a House bill that would add even more money to the program. Instead, he favors an alternative that would add $5 billion and reduce eligibility.

Bush's position set up a clash with Schwarzenegger, who has made expanding the program a top priority. It is a critical component of Schwarzenegger's plan to provide health insurance to the state's 6.5 million uninsured residents.

Schwarzenegger, who campaigned for Bush in 2004, repeatedly has disagreed with the Republican president on a variety of issues, including California's attempts to limit air pollution and greenhouse gases.

Californians, click here for your free California health insurance quote now!

Posted by healthinsurance at 01:25 PM | Comments (0)

July 10, 2007

BC Life & Health Insurance Company Adds Additional Face Amount

THOUSAND OAKS, Calif., July 10 /PRNewswire/ -- Financial security for the future is a worry item for many Americans, and life insurance is an affordable solution. According to LIMRA International (LIMRA), life insurance leads all other sources of financial assets or income that Americans expect to use to help pay bills and to maintain their lifestyle if the primary wage earner dies. BC Life & Health Insurance Company, through affiliate company Blue Cross of California, today announced an increase in individual term life insurance benefit amounts options to $15,000, $30,000, $50,000, $75,000 or $100,000 for most ages.

A BC Life & Health Insurance Company individual term life insurance policy can help protect loved ones and cover such costs as mortgage repayments, salary replacement and child care costs. BC Life & Health Insurance Company individual term life insurance policies are available to applicants at the same time they apply for Blue Cross of California individual medical coverage or if already a Blue Cross of California individual medical member. When BC Life & Health Insurance Company's individual term life insurance policies are purchased with individual medical coverage members benefit from:

- One bill for all of life and health insurance needs
- No additional forms to fill out
- No medical exams
- Coverage for children for as little as $1.50 per month
- Coverage for adults for as little as $2.80 per month

"It is important to ask yourself, 'Have I prepared for my family's financial future? How much coverage do I need to maintain my family's current standard of living?' The new face amounts BC Life & Health Insurance Company is offering will help families better prepare for their financial future," said Nicholas L. Brecker, president of BC Life & Health Insurance Company. "We recommend that you review your life insurance coverage annually to be sure your family's financial needs will be met now and in the future."

BC Life & Health Insurance Company individual term life insurance policies are designed to pay out the policy face amount in the event of the policyholder's death. The policy stays in-force until age 65, and as long as the premium payments are made. The face amount is guaranteed, and remains unchanged throughout the life of the policy.

"No one can predict the future or likes to plan for the worst," said Brian A. Sassi, president and general manager of BCC. "With BC Life & Health Insurance Company, you can enjoy security and peace of mind, knowing your family will have financial support at a difficult time."

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Posted by healthinsurance at 08:18 PM | Comments (0)

July 03, 2007

Long Term Care Health Insurance - A Closer Look

Kids today face an ever growing number of temptations ranging from drinking and smoking, drugs, gambling and pre-martial sex. Unfortunately, due to their youth and inexperience they fail to realize that what they do in their youth can have a great effect on their quality of life as they grow older.

On the other hand, as people grow older and approach retirement age they begin to realize that the carelessness of their youth did have a profound effect on the quality of their life but now they are ready to do whatever it takes to remove as much risk as they can. As a result, an ever increasing trend has been the purchasing of long term care health insurance as one way of reducing the financial risk a prolonged illness poses.

Long term health insurance is one the best ways to reduce whatever fears you may have in terms of how you'll be able to take care of your health after (and in some cases at a much younger age if you are the victim of an untimely accident) retirement as well as ensure your family (your spouse, children and even your grandchildren) that they won't get saddled with the potentially huge amount of debt that can result from the high-cost of medical care. Long term care health insurance is one of the best ways to guarantee that not only will you receive higher quality care but that you won't lose a lifetime worth of savings in the process.

Because health care costs continue to rise at dramatic rates nearly every year, it's becoming increasing advisable to begin coverage much earlier in life. Traditionally, individuals wouldn't even consider long term care until nearing retirement or even until after retirement but you may want to reconsider your thinking if that's been your plan. A few big reasons you may want to consider looking into long term care health insurance as early as your mid 50's are premiums and approval. Policies taken out when someone is in their early 50's (this is still seen as a favorable age group ) is much less expensive then one initiated in their early to mid 60's and the older you get the higher the premiums.

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Posted by healthinsurance at 12:22 AM | Comments (0)

June 26, 2007

Women Must Be Taken Into Account In California Health System

The economic, logistical and social "obstacles" women face in obtaining access to a "full range of health services" must be "taken into account" as California lawmakers consider overhauling the state's health system, a San Francisco Chronicle editorial says (San Francisco Chronicle, 6/24).

Gov. Arnold Schwarzenegger (R) in January announced a proposal that would require all state residents to obtain health insurance and would share the cost among employers, individuals, health care providers, health insurers and the government (Kaiser Daily Health Policy Report, 1/9). A measure (AB 8) proposed by California Senate President Pro Tempore Don Perata (D) and Assembly Speaker Fabian Núñez (D) excludes a requirement in Schwarzenegger's proposal that all state residents obtain health insurance. Both chambers of the California Legislature earlier this month approved Democratic plans to overhaul the state health care system and provide coverage for more uninsured residents. Following the vote, Democratic lawmakers and a spokesperson for Schwarzenegger said that they will work during the summer to negotiate a compromise plan. (Kaiser Daily Health Policy Report, 6/25).

According to the Chronicle, the proposals should maintain current programs -- including the family planning services program Family PACT and the Medi-Cal breast and cervical cancer treatment program -- and boost financing for the "woefully underfunded" state hospitals and clinics that provide care to "millions of low-income" women. In addition, women should be provided access to "affordable coverage" for part-time workers, as well as protection from high out-of-pocket costs for "routine events," such as pregnancy, the editorial says. Also, any program that includes individual health plans should cover maternity services, preventive services and prescription drugs, according to the editorial.

Lawmakers "should remind themselves that women are the major consumers of health care" and "make sure to sustain and strengthen the heath care safety net that exists for millions of women," the editorial says (San Francisco Chronicle, 6/24).

Live in California? Click here to get your free California health insurance quote right now!

Posted by healthinsurance at 06:17 PM | Comments (0)

June 22, 2007

Snapshot: Health Insurance: Can Californians Afford It?

The California Health Care Foundation has released a 32 page document with relatively little in the way of words to read but with simple graphs and charts showing how Californians with individual and small markets fare in the health insurance they have. "Snapshot: Health Insurance: Can Californians Afford It? 2007 Edition" shows, the premiums paid for both types of insurance, the out of pocket costs of individuals covered, how chronic illnesses affect these, and in the case of employment how much the employer and the worker each pay.

There is also a comparison of these figures between 2003 and 2006 with the trends showing an increase in premiums and out of pocket expenses, something most of us already know. The different figures for HMO's and PPO's are also broken out.

Among their major findings:

• The individual and small group markets are where the greatest number of uninsured Californians would get their coverage, if they could afford it. And these markets are particularly sensitive to price pressures.

• The costs of coverage and care represent a large share of income, particularly for individual purchasers. In 2006, a single person with median household income ($30,623) buying coverage in the individual market would have spent 16% of income on health care expenses. In the small group market, that same person would have spent 3.5% of income covering health care expenses. A full-time minimum wage worker would have spent 35 percent of income

• In exchange for lower monthly premiums, those purchasing coverage through the individual market bear a greater share of the costs of care. Insurance covered 54.6% of a typical consumer's medical bills in the individual market, compared to 83.3% in the small group market.

• For those with chronic conditions, annual out-of-pocket medical expenses are high. In 2006, a person with diabetes spent an estimated $3,275 if covered through the individual market or $1,101 if covered through a small group, well above the health insurance premium.

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Posted by healthinsurance at 06:40 PM | Comments (0)

June 20, 2007

Health insurance gap puts grads to the test

As graduates filed into the Mondavi Center for UC Davis commencement exercises last week, many chatted about what's possibly their last carefree summer before new careers limit them to two-week vacations.

What's not on their minds is the reality that between graduation and full-time employment, young people often lose health insurance. Some go uncovered for a year or more.

In California, 41 percent of people ages 18 to 35 are uninsured, according to a 2005 California Health Care Foundation survey.

Nationwide, 30.6 percent of 18- to 24-year-olds are uninsured, making them the largest population without coverage in 2005.

The numbers reflect an increase from 2004, when an estimated 13.7 million people ages 19 to 29 had no coverage. As recently as 2000, just 2.5 million were without health insurance, according to a 2005 survey by the Commonwealth Fund, a private health advocacy group based in New York.

Often students lose eligibility for school coverage after graduation and their parents' plans when they reach a certain age or are no longer full-time students. These are details that students and parents excited about the arrival of Graduation Day often overlook.

Today, as Gov. Arnold Schwarzenegger pushes a universal health plan and presidential candidates are pressed to take a stance on insurance, many students face the choice of buying often costly short-term policies or gambling on their health and simply winging it without a safety net.

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Posted by healthinsurance at 10:29 AM | Comments (0)

June 15, 2007

California needs fed help on kids' health care

If California is to achieve the goal of ensuring that all children have health insurance, as Gov. Arnold Schwarzenegger and the Democratic leaders of the Legislature propose, Congress must do its part, too. Congress will soon consider reauthorization of the State Children's Health Insurance Program (SCHIP). To make universal health coverage for children a reality in California, Congress must expand funding for the program and give states flexibility to tailor their programs to local needs and conditions.

Created with bipartisan support in 1997, the health insurance program is a federal-state partnership aimed at expanding health care for children in working families that make too much to qualify for Medi-Cal, but not enough to afford health insurance.

California's program, known as Healthy Families, has been a major success. Healthy Families has helped reduce the number of uninsured children in the state by providing low-cost health coverage to about 800,000 children. Also offers free health insurance quotes to anybody who lives in California.

Children covered by Healthy Families are more likely to receive preventive care, such as immunizations, less likely to pass up going to the doctor when they are sick, and are healthier overall. But the state cannot sustain this success, and build upon it, without help from Washington.

California's SCHIP allotment for the current federal fiscal year is $274 million, less than the cost of covering the number of children enrolled in Healthy Families. The state makes up the difference with funds carried forward from the program's early days when enrollment and costs were lower.

Click here for your free California health insurance quote now!

Posted by healthinsurance at 06:29 PM | Comments (0)

June 13, 2007

High Loss Ratios Undermine the Affordability of Health Insurance

Nationwide, states are unveiling health reform proposals dealing with insurance company loss ratios. California Gov. Arnold Schwarzenegger (R) and Pennsylvania Gov. Ed Rendell (D) have both introduced reforms that require insurance companies to increase their loss ratios to 85 percent--meaning at least 85 percent of collected premiums must be used to pay direct health expenditures.

Conversely, the North Dakota legislature and Gov. John Hoeven (R) on April 13 enacted Senate Bill 2154, which actually lowers the legally allowed medical insurance loss ratio for individual and small group coverage to 55 percent and 70 percent, respectively.

Which reform will be more effective?

Loss Ratios

A loss ratio is the percentage of premiums spent on direct patient care. Loss ratios are, in effect, price controls, seeking to limit the cost of insurance by controlling one of its primary components--administrative costs.

Administrative expenses include all the costs required to conduct the business of health insurance and provide customer services to the insured. These expenses include:

* the cost of collecting premiums and crediting them to the correct accounts;

* the cost of processing medical claims accurately, including cutting and sending checks for services and providing payment explanations;

* monitoring efforts to ensure patients, especially those with chronic medical conditions, are getting appropriate care;

* customer service staff to answer questions--often 24 hours a day, seven days a week;

* agent commissions;

* costs imposed by state laws, including premium taxes, as well as fees paid to independent providers to review claims, assessments for high-risk pools, and timely claims payment requirements; and

* profit and general overhead costs.

Insurers and health plans incur significant costs in their efforts to process and monitor claims and care. Unfortunately, while those efforts surely reduce claims--thereby reducing upward pressure on premiums--critics see only the "costs," not the benefits. They are ignorant of the fact that those "costs" may actually save money.

Contributing Factors

Loss-ratio laws often refer to the individual and group health insurance markets as if they are synonymous. They aren't. Many factors--including group size, premium amount, and plan design--may affect the cost of administering a plan.

For example, agents selling health insurance to individuals will need to meet separately with each client to asses his needs. To cover their added time and costs, agents selling individual insurance will generally command higher commissions than agents selling in the group market. Selling to individuals is a very time-consuming and expensive process, but necessary for those without access to group coverage.

Other administrative expenses are associated with processes that help reduce health care costs and improve health outcomes.

Proper claims payment systems, for example, can reduce duplicate payments. Preferred provider networks provide discounts on medical services in exchange for access fees. Managed care departments work with doctors and patients to find the most cost-effective care--sometimes even if that care is more expensive in the short run.

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Posted by healthinsurance at 11:03 AM | Comments (0)

June 11, 2007

Blue Cross of California Agrees to Settle Rescission Class Action Lawsuit

Blue Cross of California recently entered a settlement agreement to resolve a class action lawsuit against the health insurer concerning the nature of its individual health insurance business practices. Blue Cross had been accused of using innocent mistakes on poorly worded insurance applications to rescind policies after insureds submitted costly claims. After concluding that it would lose money based on costly claims, the company allegedly undertook a campaign to find the slightest misrepresentations on the application for insurance and rescind the policy leaving individuals without coverage and with thousands of dollars in unpaid medical claims.

As a condition of the settlement, Blue Cross agreed to modify its health insurance application form to make it more readable and user friendly. Also, Blue Cross agreed to only rescind individual health insurance policies when policy applications contained intentional and wilful lies. In other words, insurers in California who make honest mistakes in an application for health insurance cannot have their policies taken away from them when they submit claims and need insurance the most.

According to the Los Angeles Times, Blue Cross of California agreed to a series of changes in business practices to help the consumer health insurance policy-holders:

The move is part of an effort to settle a class-action lawsuit on behalf of as many as 6,000 people canceled since late 2001. It is an about-face for Blue Cross in what had become known as "use-it-and-lose-it" health coverage because the cancellations were often triggered by patients' claims for treatment.

The insurer's new stance is aimed at ending rescissions based on policyholders' honest mistakes, inadvertent errors and other inconsistencies about their medical histories on applications for coverage. Consumers contend that the forms are purposely confusing, increasing the odds that applicants will make mistakes.

"This is a very significant consumer health victory ... something we believe they should have been following all along," said Cindy Ehnes, director of the state Department of Managed Health Care.

Californians, click here for your free health insurance quote now!

Posted by healthinsurance at 03:01 PM | Comments (0)

June 09, 2007

Regulation of rising health insurance rates passes US Assembly

The US California Assembly approved a bill that would bring health insurers in line with other kinds of insurance in California, requiring companies to defend and get permission for increases in their premiums.The bill, AB1554 by Asm. Dave Jones, will protect Californians against double-digit yearly health premium increases and outrageous fees and co-pays, said the Foundation for Taxpayer and Consumer Rights.

The bill faced ferocious opposition from insurance companies, said FTCR, congratulating the Assembly majority that stood up to the corporate pressure, as well as attempts by Gov. Arnold Schwarzenegger to ki ll the bill before it proceeds to the Senate. AB1552 faces the same opposing forces in the Senate, but if passed intact by both houses it will be difficult for Schwarzenegger to veto.

"California insurance companies are funneling billions of dollars to out-of-state corporate owners, even as health insurance premiums increase at a rate far ahead of medical inflation in general," said Jerry Flanagan, health policy director of the nonprofit, nonpartisan FTCR. "Without enactment of this bill, companies like Blue Cross, which mailed off nearly $1 billion of its California profits to a parent company in Indiana over three months, will keep using California health insurance purchasers as their corporate ATM."

Public review and regulation of rate increases is the underpinning of other proposed health care reforms, said FTCR. The group noted that when Californias auto insurance rates became the second most expensive in the nation, Proposition 103 cut rates and California fell to 21st in the pack even as costs soared in other states. The rate regulation of AB1554 would do the same for health insurance, while preserving the kind of vibrant, competitive market that rules auto insurance.

Click here for your free California health insurance quote now!

Posted by healthinsurance at 08:58 PM | Comments (0)

June 08, 2007

Health Net of California Redefines "Consumer-Directed Health Plans"

Building on the historical strengths of the California Health Maintenance Organization (HMO), Health Net of California is launching a plan that combines the affordability and focus on preventive care of the traditional HMO with the innovative tools and health education components of a "consumer-directed" plan.

"Health Net's Optimizer HMO is a consumer-directed plan with no deductible that provides tools to help make better health care decisions and incentives for demonstrating healthy behaviors," said Stephen Lynch, president of Health Net of California. "And because we know that those who make smart health care decisions spend fewer health care dollars, Optimizer HMO can cost significantly less than existing traditional HMOs."

Commenting on the Optimizer HMO, Peter V. Lee, chief executive officer of the Pacific Business Group on Health, a coalition of employers seeking to improve the quality, availability and affordability of health care, said, "We applaud efforts to build on the strengths of California integrated medical group models by bringing innovative benefit designs that focus on wellness and health improvement, rewards for healthy behaviors and risk reduction."

The Optimizer HMO comes with a Health Reimbursement Arrangement (HRA) allowing employers to provide accounts their employees may use to cover their out-of-pocket medical expenses using a special debit card. Members may easily track their HRA balances and out-of-pocket expenses online.

In addition to helping customers optimize their health care spending, the Optimizer HMO rewards healthy behavior. Customers receive $100 in their HRA if they complete a health risk questionnaire that provides a snapshot of their current health status, and an additional $100 if they have called a health coach through Health Net's Decision Power(SM) program within six months prior to a hospitalization.

Decision Power tools - including health coaches - educate customers about the full range of possible medical treatments and procedures so they may work more closely with their physicians in making health care decisions. Filling out the health risk questionnaire enables customers to access information on health improvement, maintain personal health records, and obtain information on health topics of the individual's choice.

Click here for your free California Health Net quote now!

Posted by healthinsurance at 12:36 PM | Comments (0)

June 07, 2007

Activists' health-care remedy

The same consumer group that spearheaded the ballot battle to regulate auto, home and other property insurers in California two decades ago is now targeting the health care industry.

With AB 1554 by Assemblyman Dave Jones, D-Sacramento, the Foundation for Taxpayer and Consumer Rights wants the Legislature to allow the state to set rates for medical coverage.

The bill would require health plans and health insurers licensed by the California Department of Managed Health Care and the California Department of Insurance to submit annual proposed rate increases for prior approval.

AB 1554 cleared an Assembly committee last week but still faces long odds in the Capitol, where health care insurers are among the biggest contributors to the campaign coffers of elected officials.

But supporters are preparing to take their cause to the ballot -- just as they did in 1988 when the Legislature declined to regulate auto and other property insurers, and voters approved Proposition 103.

Supporters estimate that landmark measure, which requires insurers to get prior rate approval from the state's insurance commissioner, has saved consumers billions of dollars while allowing insurers to make reasonable profits.

If consumer groups once again turn to the ballot, the issue of regulating health care insurers could be on the same ballot as next February's presidential primary, which promises to generate a large voter turnout.

Click here for your free California health insurance quote now!

Posted by healthinsurance at 12:28 AM | Comments (0)

June 05, 2007

Health Insurance Coverage in Times of Need

In May, I wrote about problems with health insurance companies in California. Specifically, an insured with Blue Cross and Blue Shield of California sued the company alleging bad faith arising out of the company's decision to rescind a health insurance policy based on high claims expenses. In the lawsuit, the plaintiffs alleged that the carrier accused the insureds of misrepresenting responses to questions contained in the application for health insurance only when it became clear the company would have to pay over $450,000 in medical expenses.

Across the country, health insurance companies make decisions to take away health insurance policies which have become too expensive based upon allegedly false statements contained in policy applications. If an insured truly misled an insurance company in the insurance policy application and in reliance on material misrepresentations, the carrier issued a health insurance policy, Arizona law allows the carrier to rescind the policy. I am curious whether carriers are using minor variations in application questions which have been prepared in good faith as a basis for decisions to rescind unprofitable health insurance policies.

Imagine diligently preparing an application for health insurance answering all questions as best as you can. You timely pay premiums believing that your carrier will provide benefits when needed. Suddenly, you suffer injuries in an accident and require costly medical care. When you or your medical providers submit these medical bills to the carrier for payment, the company decides that your claims expenses are just too costly. As a result, the insurance company undertakes a review of your policy application to see if you made any material misstatements in it. Why? The insurance company entered into a contract with you and promised to pay your medical expenses according to the terms of its policy. However, if a policy has become unprofitable, the company may decide to investigate to determine whether it may properly rescind your health insurance policy and eliminate claims payouts on this money-losing policy if you made false statements on your application for coverage. If you made a false statement of a material fact on your insurance application, the insurance company will likely attempt to deny your medical expense claims and rescind your insurance policy.

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Posted by healthinsurance at 04:29 PM | Comments (0)

June 03, 2007

Health Insurer Cost Curb Takes Major Step in California Legislature

A bill by California Assemblymember Dave Jones that would require health insurance companies to justify and defend their rates and profits passed the Assembly Appropriations Committee today on a 12-5 vote, meaning that it will get a vote of the full Assembly this week. It was a significant defeat of powerful insurance industry lobbying. The Foundation for Taxpayer and Consumer Rights is a strong supporter of the bill, AB 1554.

No matter what health reforms are ultimately passed this year in California, Assemblyman Jones’ bill would keep down costs to the state, to employers and to individuals. It is particularly important to have these curbs on spiraling insurance premiums if either employers or individuals are required to buy health insurance.

The legislation is similar to requirements in the auto insurance market under Proposition 103 that have saved drivers billions of dollars since 1988 and driven down California auto premiums in relation to other states. AB 1554 would control the administrative waste and profiteering that allowed Blue Cross of California to keep, as overhead and profit, 50% of every premium dollar collected from individual policyholders, and that has increased insurance premiums to levels far above the increases in overall medical inflation.

The proposed legislation, AB 1554:

• Requires health plans to provide detailed financial information to the regulator with each premium increase request.

• Establishes a clear legislative directive that no rate, co-payment or deductible shall be approved or remain in effect which is deemed to be “unfair or excessive.”

• Allows consumers and consumer groups to intervene in rate review proceedings to ensure that the legislative intent is implemented.

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Posted by healthinsurance at 09:35 PM | Comments (0)

May 31, 2007

Health insurance regulation proposed

An effort to regulate California's health insurance premiums like auto coverage faces a key challenge today in the state Assembly.

A bill authored by Assemblyman Dave Jones, D-Sacramento, would require state regulators to approve increases in premiums, co-payments and deductibles proposed by insurers.

Gov. Arnold Schwarzenegger's health care reform proposal would require all Californians to obtain health insurance. As part of the governor's plan to control the costs of coverage, insurers would have to spend at least 85 percent of all premium dollars on medical care.

But a number of consumer and labor groups say the governor's plan doesn't go far enough to control costs. Californians who do not receive coverage through an employer or qualify for government subsidies would be required to purchase individual insurance. Rates for such coverage have been far outpacing inflation for years.

Jones' bill faces stiff opposition from the insurance industry. It needs enough votes to move out of the Assembly Appropriations Committee to stay alive.

"This is the big showdown," said Jerry Flanagan, health care advocate for the Foundation for Taxpayer and Consumer Rights, a consumer group supporting the bill. "The insurers want to kill it ... because the cost savings are huge for California consumers and they don't want that fact to be public."

The California Association of Health Plans, which represents the state's health insurers, doesn't believe rate regulation is the right way to control costs.

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Posted by healthinsurance at 06:24 PM | Comments (0)

May 30, 2007

SoCal Doctors Post Prices Of Procedures Online

Breaking with long-held medical tradition, a Southern California physicians group has become one of the first and largest health organizations in the nation to make prices for procedures easily available to the public.

HealthCare Partners put an itemized price list on its Web site last week, with little fanfare.

"It feels like the right thing to do," said Robert Margolis, a founding physician and chief executive of the medical group.

The Torrance-based company serves more than 500,000 patients, who can now learn without asking that a flu vaccine runs $15, a chest X-ray goes for $61, and a colonoscopy costs $424.

The page can be accessed easily by clicking on "fees for basic services."

The move was spurred in part by the growth of walk-in clinics at malls and Wal Marts that provide simple medical services like vaccines and ultrasounds and make no secret of their prices.

Doctors have at times thought the practice of publicizing prices was undignified and crassly commercial, and patients with insurance often haven't cared about particular prices beyond their co-payments and premiums.

But with employers increasingly shifting more costs to workers, the numbers have begun to matter more.

"Before, if you had a $10 or $5 co-pay, it didn't hit your pocketbook," said Chris Ohman, chief executive of the California Association of Health Plans, a trade group that represents insurers. "But if now you have to pay the first $2,000, the cost of an office visit matters to you a lot more."

Some insurance companies, including Aetna Inc., have posted prices online for some regions.

HealthCare Partners hopes potential customers will appreciate their tranparency and recognize the value of a physicians group over a walk-in clinic.

"It shows them, 'This is why I'm paying more,' "said health care consultant Mary Kay Scott. "They are giving me more."

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Posted by healthinsurance at 04:11 PM | Comments (0)

May 29, 2007

California Health Care Advocates Launch Investigation of Long-Term Care Insurers' Claims-Handling Policies

The House Energy and Commerce Committee last week sent letters to long-term care insurers Conseco and Penn Treaty American to request documents as part of an investigation into the business practices of such companies, the San Francisco Chronicle reports. The committee launched the investigation in response to a March New York Times article that examined issues related to long-term insurance (Colliver, San Francisco Chronicle, 5/26).

In the article, the Times reviewed more than 400 complaints and lawsuits filed against long-term care insurers and found that some of the companies have developed practices to limit the ability of policyholders to receive claims payments (Kaiser Daily Health Policy Report, 3/26). Bonnie Burns, training and policy specialist for California Health Advocates, said, "Seven, eight, nine years later they are looking at claims and saying, 'gee whiz, is there anything on that application we can use to deny this claim,'" adding that the investigation "will shed light on practices that have been going on far too long without any regulatory response."

In a statement, Penn Treaty officials defended company business practices and said the company "sees this as an opportunity to highlight the value of long-term care insurance to America's seniors." Conseco officials in a statement said, "We agree that every long-term care policyholder deserves assurance that their claim will be handled timely and in accordance with the terms of their contract," adding that the company seeks a "thorough and fair" investigation.

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Posted by healthinsurance at 07:21 PM | Comments (0)

May 28, 2007

Health Benefits Direct to Enter California Market

Health Benefits Direct Corporation (OTCBB: HBDT), a leading innovator in the direct marketing and distribution of a wide range of health and life insurance products in the individual market, today announced that it has entered into an agreement with PacifiCare, a UnitedHealthcare company, to market a number of PacifiCare's health insurance plans for individuals and families in California.

"We are continuing to selectively and strategically expand our health insurance portal with leading providers like PacifiCare," said Alvin H. Clemens, Chairman and Chief Executive Officer. "As an advocate for individual insurance consumers, we want to line our customers up with the best, most reliable coverage offered by the most highly rated carriers. Adding PacifiCare enables us to enter the large California market with a premier offering of health insurance products."

In addition to PacifiCare, Health Benefits Direct's major medical insurance carriers include UnitedHealthcare's Golden Rule Insurance Company, Aetna, Humana, Time Insurance Company (marketed as Assurant Health), and UniCare (a Wellpoint company). The company offers life insurance through Fidelity Life and AIG American General (an AIG company). Indemnity, short-term major medical, and critical illness insurance is offered through various additional partners.

About Health Benefits Direct Corporation

Health Benefits Direct Corporation is an insurance agency that operates an interactive online marketplace and contact centers enabling consumers to shop for, compare, and purchase health and life insurance and related products for individuals and families. Health Benefits Direct's sales platform combines its proprietary, integrated online technology and dialing application to connect consumers who express an interest in purchasing health or life insurance or related products with its knowledgeable, licensed agents housed in one of its contact center locations.

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Posted by healthinsurance at 09:23 PM | Comments (0)

May 21, 2007

Advantages of single-payer plans

America's health care system is broken. While attempts at reforming it have stalled due to the ideological differences between the two major political parties, the number of Americans without health insurance has risen steadily to the point where we now have 47 million people, approximately one-sixth of the population, uninsured.

Several states have begun to propose various plans to increase the number of people covered by insurance. The most recent of these proposals have come from Massachusetts and California. While developing a patchwork of coverage across every state might have a certain appeal for proponents of states' rights, access to at least a minimum level of health care ought to be a right of every citizen of the richest country in the world, and it is a problem that ought to be tackled at the federal level.

Under the current system, the United States spends the equivalent of $6,280 for every American each year on health care -- twice the average spent by other OECD countries. In spite of that, it is the only rich country that does not guarantee universal health coverage.

One plan that proposes to provide universal coverage is the Single Payer National Health Insurance plan. This is a system where a single public or quasi-public entity is responsible for health financing while delivery of services remains private. While the primary benefit of this plan is that it provides for universal coverage, there are several other ancillary benefits.

Since the main purpose of such a plan is delivering needed health care, it tends to be more about the patient and less about maximizing profits for the insurance companies. So individuals would have the ability to go to the doctor or hospital of their choice.

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Posted by healthinsurance at 02:56 PM | Comments (0)

May 16, 2007

Small Businesses Struggle To Afford Employer Health Insurance

American Public Media's "Marketplace" on Monday examined how small businesses are dealing with rapidly rising employee health insurance costs. "Marketplace" profiled Lincoln Precision Machining, a Massachusetts company with about 20 employees that has seen health insurance premiums for each worker increase from $460 per month in 1999 to nearly $1,500 per month today. The company used to pay the entire premium but now requires workers to pay about $300 per month.

John Arensmeyer, head of the Small Business Majority, said, "Many times, entrepreneurs can't get health insurance because they're too high a risk," adding, "If you run a small business and you can get rated just based on yourself or a few other employees, you may be out of luck finding affordable insurance at all." Arensmeyer also said that small businesses need a system that guarantees access to affordable health insurance.

Gary Claxton, vice president of the Kaiser Family Foundation and director of the Kaiser Family Foundation Health Care Marketplace Project, said there is national momentum towards broad-based health plans like initiatives in Massachusetts and California, adding that there "be some business opposition, because most of the proposals that we see do require businesses to do something" (Ryssdal, "Marketplace," American Public Media, 5/14).

Californians, click here for your free health insurance quote now!

Posted by healthinsurance at 05:11 PM | Comments (0)

May 14, 2007

Blue Cross to stop retroactive insurance cancellations

Blue Cross of California — under scrutiny for retroactively canceling health insurance policies leaving patients with unpaid medical bills — has agreed to a class-action settlement that would sharply alter its practice and could set a precedent for other insurers.

At issue is an infrequently used, but longstanding industry practice: Canceling coverage after patients make costly claims, if insurers find mistakes or omissions on application forms completed by policyholders. The practice, called "rescission," affects people who buy their own insurance, not those covered under group plans, such as job-based coverage.

The proposed settlement, which must be approved by the courts, comes amid increased scrutiny of the practice, particularly in California. State regulators there are reviewing many insurers and have issued fines against two: Blue Cross, which is a subsidiary of WellPoint; and Kaiser Permanente.

In the proposed settlement, presented in Los Angeles County Superior Court on Friday, Blue Cross agreed not to retroactively cancel coverage unless policyholders "intentionally misrepresented" information on their applications.

In March, the California Department of Managed Health Care fined Blue Cross $1 million, saying a review of 90 canceled policies found that the insurer had failed to conduct thorough pre-enrollment investigations on 39 of them and found none in which the insurer had proven the applicant was intentionally deceptive. Blue Cross is contesting that fine.

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Posted by healthinsurance at 05:02 PM | Comments (0)

May 11, 2007

Blue Cross and Canceled Policyholders Agree to Settlement

A major class action settlement has been reached with Blue Cross of California, a Wellpoint subsidiary, concerning the cancellation of health insurance policies that occur after a claim for pre-authorized medical treatment. From now on, Blue Cross has agreed that it will not retroactively cancel insureds' health insurance policies unless the insured "intentionally misrepresented" information on the insurance application. "This will stop the practice of canceling health insurance policies for honest mistakes, inadvertent errors, or other inconsistencies that often appear on health insurance applications," said William Shernoff of the Claremont law firm of Shernoff, Bidart & Darras, who represents a class of approximately 6,000 Blue Cross policyholders.

The settlement also includes a new individual health insurance application that is designed to minimize mistakes and new procedures to be followed at Blue Cross that will assure customers that cancellation of insurance policies will only take place upon a finding of "willful misrepresentation." Additionally, Shernoff said, "Even if a cancellation occurs upon such a finding, the insured will still have a right to appeal that decision to either the Department of Insurance or the Department of Managed Health Care."

Shernoff praised the Department of Managed Health Care and the Department of Insurance for becoming involved in the negotiations leading up to the settlement saying they "gave tremendous input and support to help this settlement become a reality." Both the Department of Managed Health Care and the Department of Insurance had representatives involved in the lengthy mediation process, presided over by former California Supreme Court Justice Edward Panelli.

"In addition to the new procedures that Blue Cross will put in place in the future to end most cancellations, the settlement also provides remedies for approximately 6,000 Blue Cross insureds that have already been cancelled under such circumstances," said Shernoff who called the settlement "a major breakthrough." "Blue Cross should be credited for recognizing this problem and their willingness to fix it." Shernoff said, "It will be interesting to see if other health insurance companies like Blue Shield, Health Net and others will follow suit."

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Posted by healthinsurance at 02:29 PM | Comments (0)

April 30, 2007

C.A.R. Teams With Blue Cross of California to Offer Guaranteed Medical Insurance to Members

LOS ANGELES--(BUSINESS WIRE)--April 30, 2007--The CALIFORNIA ASSOCIATION OF REALTORS(R) (C.A.R.) today announced it has teamed up with Blue Cross of California to provide guaranteed medical insurance to its members beginning June 1.

"After many months of intense searching and negotiations with numerous health care providers, C.A.R. identified Blue Cross of California as the best fit to meet the diverse needs of our members," said C.A.R. President Colleen Badagliacco. "Throughout the months-long process, C.A.R. remained committed to doing everything possible to preserve medical insurance for our members."

Blue Shield of California, after underwriting health insurance for C.A.R. members for more than seven years, abruptly terminated its medical coverage with C.A.R. effective May 31, adversely impacting more than 8,000 members and their families.

"While we continue to believe that Blue Shield terminated medical insurance coverage without cause, I am especially pleased that we are able to offer our members an excellent medical plan from a reputable industry leader like Blue Cross, the nation's largest health benefits company," Badagliacco said.
Blue Cross of California is a subsidiary of WellPoint, Inc. (NYSE: WLP), whose mission is to improve the lives of the people it serves and the health of its communities. It is the largest publicly traded commercial health benefits company in terms of membership in the United States. Additional information about Blue Cross of California is available at

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Posted by healthinsurance at 01:45 PM | Comments (0)

April 25, 2007

Blue Shield CEO Praises Legislatives For Pushing Health Insurance Coverage Expansion

With hearings on health insurance coverage expansion bills scheduled in both houses of the California Legislature this week, Blue Shield of California CEO Bruce Bodaken offered a comment on the prospects for reform this year.

"When Governor Schwarzenegger signs a coverage expansion bill this fall, we'll all look back on this week as a moment when the movement for reform gained momentum. These hearings are tangible proof that the legislative leadership is serious about keeping healthcare reform moving forward, and that's the best possible news for every Californian who wants an end to hidden taxes, overcrowded emergency rooms, and the fear of losing coverage."

Bodaken and Blue Shield have long been recognized as leaders within the health insurance industry on promoting health care reform. In 2002, he became the first health plan CEO in the country to call for health care for all, introducing a well-received "Universal Coverage, Universal Responsibility" plan.

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Posted by healthinsurance at 12:04 PM | Comments (0)

April 23, 2007

Hospital leaders team up on health insurance for kids

Dr. Nan Mickiewicz and Dr. Larry DeGhetaldi lead different local hospitals but on this they agree: Health insurance for children is a good investment.

Their facilities, Dominican Hospital and Sutter Santa Cruz, each made an additional $25,000 contribution to an insurance program called Healthy Kids.

The two physicians announced the gifts Friday in connection with Cover the Uninsured Week, which takes place April 23-29. Now in its fifth year, Cover the Uninsured Week is a national effort to find solutions for nearly 45 million Americans living without health insurance.

The Healthy Kids program provides health care coverage for children at prices designed to be affordable for families who don't qualify for other public programs like Healthy Families or MediCal. About 17 percent of the Santa Cruz County population, including 5,000 children, are without health insurance.

A family's share of the cost depends on household income and ranges from $12 to $36 per quarter per child. For one child, the cost for the family could be as low as $48 per year.

The program picks up the rest of the tab, $1,620 per year for a child under 5 and $1,020 for a child 5-18.

Because of funding constraints, more than 100 children in Santa Cruz County are on a waiting list. One example: A 16-year-old girl struggling with mental illness and thoughts of suicide. She has been hospitalized twice this year. Her father, a roofer, can't afford to pay $300 more per month for dependent health coverage available through his employer. He looks at his unpaid bills and worries about his financial solvency.

It costs $2.6 million per year to cover 2,000 children in Santa Cruz County. First 5 Santa Cruz County, a nonprofit, supports coverage for kids under 5. The county Health Services Agency, foundations, and local individuals and corporations fund coverage for older children.

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Posted by healthinsurance at 01:39 PM | Comments (0)

April 20, 2007

Health Insurance for College Grads

Before you pick up the cap and gown or send out invitations for the college graduation party, make sure you (or your child) will have health insurance after the walk across the stage.

Many insurance companies drop dependents from their parents' policies once they grab that sheepskin. Others limit a child's coverage to a specific birthday, usually ranging from 22 to 25 (check your policy's rules).

A student health insurance offers an affordable fix. It fills the gap in coverage between graduation and that beautiful day when health insurance benefits from the new job kick in.

You'll have to act fast, though, if you're graduating this spring because student health insurance is only available to full-time students younger than 30 (but continues after graduation). Assurant Health, the largest provider of student health plans, stipulates that coverage must begin at least 31 days before graduation. With most spring commencements set for the second half of May or first part of June, you need to apply now.

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Posted by healthinsurance at 11:13 AM | Comments (0)

April 18, 2007

Top healthcare officials testify before Senate Public Health and Human Services Committee on the urgent need for Governor Blagojevich's Illinois Covered plan

SPRINGFIELD – The Senate Public Health and Human Services Committee today heard testimony from top healthcare officials from around the state on the urgent need for Governor Rod R. Blagojevich’s historic “Illinois Covered” plan to give every Illinoisan access to affordable and quality health coverage. The Governor’s plan will provide affordable coverage to the 1.4 million uninsured adults in Illinois and will also help many middle-income families and small businesses that are currently enrolled in health insurance plans save thousands of dollars a year on healthcare costs. It would also mean nearly $1.7 billion in new funding for hospitals and healthcare providers around the state. The Governor’s plan has been endorsed by the Illinois Hospital Association and numerous other medical provider organizations.

“For too long, working families in Illinois have gone without healthcare coverage – hurting their livelihood, their health, and their families. Millions of others who do have coverage are just one illness or job-change away from losing it. We’ve put together a plan that will give every uninsured person in Illinois access to the coverage they need, and will help bring down costs for everyone else,” said Gov. Blagojevich. “We know that the time is now for healthcare reform in Illinois, and we’re pleased to have top health providers and experts from around the state on board to help us achieve our goal of healthcare for all Illinoisans.”

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Posted by healthinsurance at 08:36 PM | Comments (0)

Prior Approval of Health Insurance Premium Increases Legislation Passes Committee--First Time in California History

Yesterday evening, the Assembly Health Committee on a 10-5 vote passed AB 1554 by Assemblymember Dave Jones regulating health insurance premiums. The bill requires that prior approval be obtained before health insurance rates can be increased. According to the author, this is the first time that legislation on this topic has passed a California legislative committee.

Voting for the bill were Assemblymembers Karen Bass, Patty Berg, Hector De La Torre, Kevin de Leon, Loni Hancock, Mary Hayashi, Ed Hernandez, Dave Jones, Sally Lieber, and Fiona Ma, all Democrats. Those voting against the measure were Assemblymembers Alan Nakanishi, Bill Emmerson, Ted Gaines, Bob Huff and Audra Strickland, all Republicans. Not voting were Democratic Assemblymembers Mary Salas and Mervyn Dymally.

Rates requiring approval include premiums, co-payments, coinsurance obligations and deductibles. HMOs and health insurers would need to receive approval from the California Department of Managed Health Care (DMHC) or the Department of Insurance (DOI) for increases.

Proposed rate increases would be denied if they were deemed excessive or unfair. Any proposed rate that is not challenged by a consumer within 45 days of it being posted on the Department website and not acted on by the Department on its own discretion within 60 days would be deemed approved. This rate regulation would begin January 1, 2009.

“Californians face skyrocketing health insurance premiums. Increasingly, Californians cannot purchase health insurance because it is unaffordable. This measure will require health insurers to justify their premium increases and seek approval for their rates. I look forward to working with my colleagues in the Legislature to ensure that this proposal becomes part of the health care reform package that is sent to the Governor,” explained Assemblymember Jones.

Jones emphasized that this bill is critically important to Californians, especially as the legislature considers health care reform proposals by the legislative leadership and the Governor. More than 6.5 million Californians are uninsured, while others are underinsured.

Polls show that the majority of people with health insurance fear that ongoing premium increases will cost them their health insurance coverage. Health insurance premium increases are soaring far above the rate increases for wages and inflation. According to the Kaiser Family Foundation, health insurance premiums for employer-sponsored policies have increased by an average of 87% over the last six years. That far surpasses the 20% rise in wages and the 18% rise in overall inflation during that time period.

The legislation is similar to requirements in the auto insurance market under Proposition 103 that have saved drivers $23 billion since 1988. The measure would control the type of administrative waste and profiteering that allowed Blue Cross of California to keep, as overhead and profit, 50% of every premium dollar collected from individual policyholders.

Jerry Flanagan, the Health Care Advocate for the Foundation for Taxpayer and Consumer Rights (FTCR), hailed the committee's approval of AB 1554. He said: “The legislature has taken an important first step to provide health care affordability for Californians by reining in waste and profiteering."

In addition, Flanagan said that AB 1554 would provide the public more information about where health care dollars are spent. For example, California’s most profitable insurer, Blue Cross, reported $1.3 billion paid to a subsidiary company for “claims processing” as a medical expense. FTCR said that such transfers most be scrutinized to determine that companies are not claiming unjustified medical expenses, or overpaying affiliated companies for services as a strategy to move profit out of California.

He compared Jones' bill to Proposition 103, authored by consumer activist Harvey Rosenfield, founder of FTCR, and approved by voters in 1988, which established a similar “prior approval” system for many lines of insurance. During the decade after Proposition 103 was adopted, the uninsured motorist population declined by 38%. Between 1989 and 2004, California auto insurance premiums decreased 7% while premiums in the rest of the country increased 47%.

He said that since just 2003, the Foundation for Taxpayer and Consumer Rights has saved homeowners, motorists and doctors $800.95 million in premiums under Proposition 103 by challenging proposed rate increases. A similar process for challenging rate increases would be provided for health rates under the Jones bill.

Mark Leland, a small business owner from Santa Monica, endured a 264% increase in his health insurance rates in the last five years, including a 69% increase when he turned 40 and another 15% increase this year.

“To find out where my 69% premium rate hike went, I looked into the financials of the Big 5 HMO’s in California and I found something the public should be aware of: administrative expenses increased 23% this year. But enrollment in these HMO’s is declining, so how can you have these yearly 23% administrative cost increases?” asked Leland.

Steve Blackledge, legislative director CalPIRG, the California Public Interest Research Group, said: We're pleased with those who stood up to the insurance industry and their lobbyists and voted for the bill. And since the bill is still alive, we'll have new opportunities to persuade those who aren't yet on board that the policy is a strong and needed one."

AB 1554 is supported by individuals who have been the victim of dramatic health insurance rate increases and organizations such as California Public Interest Research Group (CALPIRG), Consumer Federation of California, Foundation for Taxpayer and Consumer Rights, California Federation of Teachers, California State Employees Association (CSEA) and Gray Panthers California.

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Posted by healthinsurance at 08:20 PM | Comments (0)

July 25, 2006

Allianz Life Seeks Buyer For Health Care Unit

Copyright 2006 Star Tribune Star Tribune (Minneapolis, MN)
Distributed by Knight/Ridder Tribune News Service

Jul. 25--Allianz Life Insurance Co. of North America is looking to sell its health care division, which has 185 employees and underwrote about $281.1 million in premiums last year. That represents about 2 percent of Allianz Life's total premiums of $13.85 billion.

In a brief statement, the Golden Valley-based company, a subsidiary of Allianz Group, a large German financial services conglomerate, said it wanted to focus on its core life insurance businesses.

Allianz "has decided to divest our health products line of business, as it is a very specialized business that does not fit the overall strategic direction of our company," the statement said. "We are working diligently to identify a suitable company to purchase this business and transition operations to the new owner."

The health care division reinsures HMOs, employers and insurance companies against catastrophic losses. The division also includes Allianz's LifeTrac Network, a national network of 40 transplant facilities used by HMOs, insurance companies and self-funded health plans that enroll about 23 million patients. LifeTrac processes more than 2,400 bone-marrow and organ transplants a year.

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Posted by healthinsurance at 02:08 PM | Comments (0)

February 05, 2006

Welcome to our new web site

On behalf of we would like to invite you to our new web site,

From time-to-time, we will be using this web site to post the latest happenings in the health insurance industry as it relates to providers, doctors, brokers, and most importantly, the health insurance consumer.

So check in often for your dose of Health Insurance News, and if you have any questions, or to compare health insurance rates, visit us over at

Posted by healthinsurance at 07:20 PM | Comments (0)