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Happy New Year! A calendar of lots to do in 2012...
Friday, December 30, 2011
HEALTH ACCESS UPDATEFriday, December 30, 2011 Happy New Year!
2012 CALENDAR: MANY OPPORTUNITIES FOR POLICYMAKERS AND VOTERS
TO IMPROVE OUR HEALTH SYSTEM IN THE NEW YEAR
Please Consider Health Access Foundation in Your End-Of-Year Giving
Beyond What We Did Together This Year, There's A Full Calendar of Work to Do:
* Expand Coverage to Californians in County-Based Low-Income Health Plans
* Win the Revenues Needed to Support Health, Education, and Other Vital Services
* Get CA's Exchange, Our New Health Insurance Marketplace of the Future, Ready for Reform
* Make It Law That Insurers No Longer Deny Or Discriminate Based on Pre-Existing Conditions
* Put In Place Maternity Coverage Requirements and Other Essential Benefits
* Defend Health Reform in the Courtroom and on the Campaign
Make the 12/31 Deadline and Contribute to Health Access to Help:
* Fight Budget Cuts, and Win the Reforms and Revenues to Sustain Our Health System
* Implement *and* Improve Health Reform in California
* Advocate and Organize for Consumers with Policymakers, the Press, and the Public
Read Our Health Access Blog for More Updates; Also Follow Us on Facebook!
New Updates Daily on Twitter @HealthAccess!
If You Appreciate These Updates, Join/Renew Your Health Access Membership!
SACRAMENTO-- The new year of 2012 will be a major year for health care, as policymakers and voters are set to make key decisions on health policy throughout the year. Policymakers and voters have the opportunity in 2012 to greatly improve the health care system that we all rely on. Californians will have an opportunity to demand a balanced solution to our budget crisis that brings in the revenues needed to sustain health, education, and other vital services. California will also continue to implement and improve upon the federal health law that has already provided new options and benefits to millions of Californians, and get ready for reform in 2014. We in California made significant advances toward the promise of health reform in 2011, but as this calendar of highlights from 2012 shows, there's a lot more work to do in 2012. As we approach the end-of-year deadline, we hope you can contribute to Health Access Foundation to continue the progress. Through our joint efforts in 2012, from expansions of coverage to essential benefits to the Exchange, Californians can get closer to the core goal of the law: to have confidence that our coverage and care will be there for us when we need it.
For the first half of 2012, here's a few dates to plan around on health issues in California: 1/1/2012: Over 35 counties are launching their Low-Income Health Programs (LIHPs), joining 10 counties already up and running with 225,000 Californians covered. This "bridge to health reform" is bringing new federal dollars into California and our struggling health system, and getting people the care they need, as a ramp-up to 2014 and the full implementation of the Affordable Care Act. Most of the remaining counties are slated to launch sometime in the first half of 2012. 1/10/2012: On or around this date, Governor Jerry Brown will unveil his proposed 2012-13 California state budget, which will likely include more cuts, on top of those already made (elimination of dental and other benefits, provider rate reductions, etc.) in past years. Part of the budget will be dependent on the passage of revenues through a ballot measure this November. If those revenues don't pass, then Californians can expect even more cuts to health, education, and other vital services they depend on. 2/24/2012: Deadline for legislation to be introduced. It is likely that there will be several bills to implement and improve upon the federal health law. Among the goals of such legislation will be to maxmize enrollment in federally-funded health coverage expansions on the first day of 2014, and to put in place the insurance market reforms and consumer protections, so that in 2014 and beyond, individuals are no longer denied or discriminated against because of their health status. 3/23/2012: This will be the 2nd anniversary of the enactment of the Affordable Care Act, a time to acknowledge the new options, benefits, and consumer protections that millions of Californians now have as a result of the new federal law. This will also provide the context for oral arguments in front of the Supreme Court on the Affordable Care Act, scheduled for March 26-28. Opponents of the law have seen many appeals court judges, including noted conservatives, uphold the law, including the requirement on individuals to get coverage. The work will continue, both at the federal level with new regulations and consumer protections rolling out, and at the state level. 4/20/2012: This is the deadline for signature petitions to be turned in on ballot initiatives, starting the certification process to see what will be on the November 2012 ballot. The ballot is likely to include revenues to prevent further state budget cuts, and may include health-related measures on everything from rate regulation to hospital accountability. And of course, the November election will greatly impact the continued progress on health reform, by the outcome of the Presidential and Congressional races. 5/2012: Legislative action heats up: Bills need to pass the first house of the legislature by the end of May. In addition, the Governor will release his May Revision of the budget, and the Legislature will go into daily hearings and negotiations toward the goal of passing a budget by the late June deadlines. 6/2012: The new California Health Benefits Exchange, our health insurance marketplace of the future, plans this month to submit a major grant application to the federal government to fund its operation through its first year of full operation in 2014. In preparation for this, the Board will be making several foundational decisions on its goals, capacity, infrastructure, and business model for getting Californians covered on day one and beyond. 7/1/2012: While some of the health laws passed in 2011 go into effect on January, like the state enforcement of the medical loss ratio, some notable benefit mandates come into place on July 1. This includes maternity coverage, which will on this date be required to be included in individual and small group policies--reversing a disturbing trend in the last decade that left many pregnant mothers and infants without this crucial, life-changing care. Federal guidance that came out in late 2011 allow states some flexibility in setting "essential health benefits" in 2014 and beyond, so that will be another significant topic for policymakers in 2012. Health Access looks forward to the new year, and the new opportunities to improve our health system. Through all these efforts, we look forward to your involvement, your partnership, and if possible, your contribution. Have a healthy and happy new year!Labels: Budget, HealthAccessCommunity, HealthReform
posted by Anthony Wright |
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12:27 PM
More holiday reading!
Friday, December 23, 2011
Holiday reading...
Thursday, December 22, 2011
It's the future system by which Californians will easily sign up and get health coverage. The California Exchange will be soon be putting out a "request for proposals" (RFP) for vendors to design such a system. And this holiday season, the Exchange is asking for input on the draft. The daunting name is the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) Development and Operations Services Solicitation Input. Here's the link to the documents: http://www.healthexchange.ca.gov/Solicitations/Pages/Default.aspxComments are due December 30th. Don't say you didn't get anything for Christmas! Labels: Exchange, HealthReform, MediCal
posted by Anthony Wright |
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11:57 PM
More California counties set to expand coverage in January...
Over 35 California counties will be expanding health coverage to tens of thousands of Californians on January 1, under new federal approval granted yesterday. Ten large urban counties had already launched health expansions in July 2011. Just-released data show that now over 225,000 Californians are enrolled in these county-based Low-Income Health Programs (LIHPs), which are matched by new federal funds under the Affordable Care Act, and the state's new "bridge to reform" Medicaid waiver. Now, the County Medical Services Program (CMSP), a consortia of 34 mostly rural counties, got federal approval to expand health care coverage to an additional 30,000 low income adults beginning January 1, 2012 under Path2Health. This coverage expansion will increase the number of low income adults served by CMSP to nearly 90,000 by the end of 2013. These new county-based programs extend coverage to the uninsured using new federal matching funds, bringing dollars into local health systems and the California economy. These programs are a bridge to reform--helping our health system get ready for reform, linking uninsured people with a medical home, and helping every enrolled Californian get onto fully federally-funded coverage in January 2014. With this CMSP announcement about Path2Health, now over 45 counties will have Low-Income Health Progams up and running on January 1, 2012. with most of the remaining counties going forward in early 2012. Potentially over a half-million Californians could get coverage through these LIHPs by 2014, when they are rolled into coverage under the Affordable Care Act. Path2Health will provide no-cost health coverage to adult Californians who reside in the 34 counties and are at or below 100 percent of the federal poverty level, or about $10,890 annually for a single person. Path2Health will provide coverage for medically necessary health care services, including primary care, emergency and hospital care, pharmacy services, and limited dental and vision care. It will also cover a set number of mental health and substance abuse counseling visits. Coverage will generally follow coverage provided under CMSP, a long-standing health coverage program serving indigent adults in the 34 counties. CMSP currently serves more than 60,000 low income adults each month. Californians qualify for Path2Health if they are: a resident of one of the 34 counties Path2Health serves, have an income of up to 100 percent of the federal poverty level, are between 19 and 64 years of age, do not qualify for Medi-Cal, and meet federal citizenship and documentation requirements. More information about Path2Health is available at http://mypath2health.org. Labels: ExpandingCoverage, HealthReform, LIHP
posted by Anthony Wright |
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8:26 AM
The 2012 All-Star Consumer Representatives at the NAIC
Wednesday, December 21, 2011
We at Health Access California are really pleased that our Director of Administrative Advocacy, Elizabeth Abbott, has been reappointed as a designated consumer advocate at the National Association of Insurance Commissioners (NAIC). Today, the NAIC has named 28 consumer liaison representatives for 2012. These handful of consumer advocates attend the conference calls and in-person meetings of the Insurance Commissioners from around the country, where they are typically outnumbered by hundreds (yes, hundreds--sometimes 1500 or more) insurance lobbyists and representatives. The NAIC is a critical venue in the implementation of health reform, and is actually cited and given a specific role at least a dozen times in the Affordable Care Act. Beth Abbott and others have been very active in everything from the very contentious battle on the definition of the medical loss ratio, to the development of "model legislation" on the implementation of other key consumer protections. There work next year will be crucial in the development of policy to transition states to a new world where insurers will no longer be allowed to deny people for pre-existing conditions. Here's the list of your 2012 all-star consumer representatives, some who focsu on health issues, others who focus on property & casualty, and other lines of insurance. The three from California include: * Elizabeth Abbott: Director of Administrative Advocacy, Health Access * Amy Bach: Executive Director, United Policyholders * Bonnie Burns: Training and Policy Specialist, California Health Advocates The others include: * Deeia Beck: Public Counsel, Office of Public Insurance Counsel/Texas * Brendan M. Bridgeland: Director, Center for Insurance Research * Sabrina Corlette: Research Professor, Georgetown University Health Policy Institute * Brenda J. Cude: Professor, University of Georgia * Joseph P. Ditre: Executive Director, Consumers for Affordable Health Care * Timothy Stoltzfus Jost: Professor, Washington and Lee University School of Law * Kathleen Gmeiner: Project Director, UHCAN Ohio * Karrol Kitt: Associate Professor, University of Texas at Austin * Peter Kochenburger: Executive Director, Insurance Law Center, University of Connecticut School of Law * Sonja L. Larkin-Thorne: Consumer Advocate, Avon, CT * Sarah Lueck: Health Policy Analyst, Center on Budget and Policy Priorities * Jennifer Mishory: Deputy Director, Young Invincibles * Andrea J. Routh: Missouri Health Advocacy Alliance * Daniel Schwarcz: Associate Professor of Law, University of Minnesota Law School * Barbara Yondorf: President: Colorado Consumer Health Initiative * Birny Birnbaum: Executive Director, Center for Economic Justice* * Stephen Finan: Senior Director of Policy, American Cancer Society Cancer Action Network * Carrie Fitzgerald: Senior Policy Advisor for Health, First Focus * Howard Goldblatt: Director of Government Affairs, Coalition Against Insurance Fraud * Marguerite Herman: Consumer Advocate, Project Healthcare * Adam Linker: Health Policy Analyst, North Carolina Justice Center * Stephanie Mohl: Government Relations Manager, American Heart Association * Lynn Quincy: Senior Policy Analyst, Consumers Union * Stuart Spielman: Senior Policy Advisor and Counsel, Autism Speaks * Cindy Zeldin: Executive Director, Georgians for a Healthy Future Labels: Federal, HealthReform, NAIC
posted by Anthony Wright |
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4:41 PM
Saying Goodbye to Junk Insurance: The Benefit of Essential Health Benefits in California...
Health Access has fought a long battle against junk insurance, the kind of limited benefit policies that leave patients in significant medical debt, even after paying premiums--and leave the rest of us in fear of the fine print, wondering if what we come down with is actually covered. Former Insurance Commissioner John Garamendi sometimes called these "skeleton policies." Some policies permitted under California's Insurance Code cover only hospital care, but not doctor care, or only the second day in the hospital, but not the first, or that provide no coverage for prescription drugs except for a handful of generic drugs. These policies are not permitted for coverage regulated by the Department of Managed Health Care under the Knox-Keene Act: these policies must cover medically necessary doctor visits, hospitalization, lab, radiology, etc. On Friday, Dec. 16, HHS issued a “bulletin” seeking comment on a proposed approach to “essential health benefits” that would in California outlaw junk insurance in the individual and small employer markets where it has been most prevalent. Essential health benefits (or EHB) are the minimum benefits that insurers must sell to individuals and small employers. Other, earlier action by HHS on annual and lifetime limits had already made it clear that "mini-meds" and other limited benefit policies will not be allowed in the large employer market after 2014 and HHS re-affirmed that policy on Friday. Federal Proposal: Not as Good as a Strong National Standard but Likely Okay for California
Like other consumer advocates, Health Access California had hoped for a strong national standard on essential health benefits. We have been comforted to learn that nationally most employers, both large and small, cover a similar set of services that is very similar to what the vast majority of employers provide in California. The difference between large employers and small employers is that small employers tend to pay a smaller share of the premium or have higher copays and deductibles but they usually cover the same benefits as large employers. A strong national standard was our first choice. But we had begun to be worried by what we heard from other states and from the national level. Some advocates talked about limits on hospital stays or caps on doctor visits as a possibility. The Institutes of Medicine recommended a dollar cap far below what is spent in California. So we were worried. In our testimony to the federal HHS listening session in November, we pointed out that limits on medically necessary care would be a take-away for the nearly 20 million Californians who have coverage regulated by the Department of Managed Health Care. Coverage regulated by DMHC must by law and regulation cover medically necessary care, including hospitals, physicians, laboratory, radiology, hospice and other basic services. The bulletin released on Friday indicates a proposed regulatory approach from the federal government. Similar to what was done for CHIP (Healthy Families in California), states are offered a menu of “benchmark plans” including: · One of the three largest plans for small employers by enrollment · One of the three largest state employee plans by enrollment · One of the three largest federal employee health plan options by enrollment · The largest HMO plan offered in the state’s commercial market by enrollment. This gives each state flexibility, but within limits. National consumer advocates are appropriately concerned about what states will do with such flexibility. Each state has to pick one: what is California likely to do? What should advocates support? Knox-Keene plus drugs (plus mental health/substance abuse plus more)
California's current standards have both gaping holes in the Insurance Code, but actually most of the market abides by a comprehensive standard in the Health and Safety Code called "Knox-Keene." The plans regulated by DMHC under the Knox-Keene Act cover more than 90% of Californians with coverage regulated at the state level. DMHC is the sole regulator of HMOs. Over two-thirds of small employer coverage is regulated by the Department of Managed Health Care. All of this suggests that the kind of benefits most Californians get from their employer, benefits that cover medically necessary doctors, drugs, hospitalizations, lab/radiology, etc., should and will be the benchmark for essential health benefits. In the shorthand of advocates, this is known as Knox-Keene plus drugs (plus mental health and substance abuse treatment plus pediatric dental and vision). The addition of medications would mostly follow industry practice: The Knox-Keene which was enacted in 1975 did not include prescription drugs as a basic benefit though today over 95% of employers, large and small, purchase comprehensive prescription drug coverage. Benefit Mandates: Mammograms, maternity, autism, and more
There have also been lots of questions about what happens with benefit mandates. Insurers in California complain that California has 46 benefit mandates: our response is to ask them which do they want to repeal? Pap smears, mammograms, childhood immunizations or diabetes supplies? Maternity coverage (enacted in 2011) or autism coverage (also enacted in 2011)? The new federal guidance says that if the benchmark plan picked by a state includes benefit mandates, then the state can leave those in place, at least through the year 2016. This means that if California picks either the largest HMO plan or one of the three largest plans offered to small employers, then the benefit mandates in place today remain in place. Because the recently enacted autism mandate does not include CalPERS, it is less likely that the state public employee plans offered by CalPERS will be the standard for benefits in California. And because federal employee health benefits limit reproductive services in a manner not permitted by the privacy clause of the California Constitution, as repeatedly interpreted by the California Supreme Court, it is less likely that the federal employee health benefits plans will be the benchmark chosen in California. More to learn
We do not yet know precisely which products meet the standards proposed by the feds. We have some pretty good guesses but we await the regulators gathering solid information. We also need to understand better what this means for autism, for mental health parity, for substance abuse treatment and for rehabilitative services as well as pediatric services, particularly vision and dental. But for now, we can say that the proposed approach on essential health benefits is probably okay for California and certainly better than what we feared. And at long last, it means the end of junk insurance. No longer will people who buy “catastrophic” coverage find it does not cover breast cancer like Susan Braig of Altadena. No longer will people who buy health insurance find that it does not cover $98,000 of hospitalization for a rattlesnake bite. Health insurance will actually cover the health care people need. Labels: Federal, HealthReform, Insurers
posted by Beth Capell |
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8:30 AM
The Exchange Board's Final Meeting of 2011
Tuesday, December 20, 2011
The California Health Benefit Exchange Board held it’s last meeting of 2011 today! We would be remiss to not acknowledge the tremendous amount of work that was accomplished in 2011. But of course, we’ve got ten miles behind us and ten thousand more to go. One exciting change this meeting was that they used a conference line to allow people who watch the webinar because they are unable to attend in person to make comments as well. The report from Executive Director Peter Lee included some modifications to the contract with IT RFP vendor ClearBest, expanding the responsibilities to include reviewing of responses to the RFP as well as project management. Lee also introduced 6 new staff members,with a number of familiar faces including David Maxwell Jolly, Chief Operations Officer, David Panush, and Gabriel Ravel. Lee acknowledged that neither the Board nor the senior staff currently appointed to the Exchange reflects the diversity of California, and that there would be 9 additional senior position descriptions to be posted tomorrow. He asked that stakeholders help spread the word and assist in the recruitment of quality applicants from diverse backgrounds. He also reported back on a number of meetings that he, the Exchange Board members, and staff from DHCS and MRMIB have conducted across the state in the last 4 weeks. They have been conducting this outreach effort to inform both the IT RFP and the coordinated outreach and marketing efforts they will undertake next. The solicitation for that will be released later in the week. Katie Marcellus from the Exchange staff then made a brief presentation related to the Essential Health Benefits guidance that the Federal government released late last week. She described the options that the federal government is allowing states to use as benchmark plans upon which to base essential benefits and outlined some potential next steps that the Exchange should take. The next and most highly anticipated item of discussion was the IT RFP which will be used to solicit IT vendors to create the California Healthcare Eligibility, Enrollment, and Retention System or CalHEERS. Staff provided an overview of what the RFP would contain, but the actual RFP was not released until this evening. Of importance to advocates interested in providing comments on the RFP, it can be found at the Exchange website: www.hbex.ca.gov and comments must be made through the comment matrix and submitted no later than December 30 at 5pm. The solicitation will officially be released on January 18. Director Bob Ross commented that this is beginning to feel “awfully real” with so many pieces falling into place. The last item on the agenda was a presentation from Pacific Community Ventures about small businesses and the Exchange. The presentation centered around the results of survey and research data they collected from small business owners across the state. Their data indicates that many small business owners have little knowledge about the Exchange (or even about the small business tax credits that have been in place as a result of ACA for a year now). Given adequate information however, many said that they would likely participate, understanding the benefits of group purchasing, and of better apples-to-apples comparability. The study’s findings also indicate that reaching out to small businesses owned by ethnic minorities will be very important. The Exchange Board will meet again in the new year on January 17, 2012. Until there, many advocates will be pouring over the RFP to make comments by the December 30th deadline. Happy Holidays! Labels: Exchange, HealthReform
posted by Linda Leu |
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9:16 PM
This Holiday Season, Contribute to the Progress & Promise of Health Reform
HEALTH ACCESS APPEALTuesday, December 20, 2011 CONTRIBUTE TO THE PROGRESS AND PROMISE OF HEALTH REFORM
Please Consider Health Access Foundation in Your Holiday Giving
Help Win the Budget and Policy Changes so Californians Get the Care We Need, When We Need It, Without Fear of Financial Ruin
What We Did Together This Year:
* Expanded Coverage to 200,000+ Californians in County-Based Low-Income Health Plans
* Got Insurers to Cover California Children with Pre-Existing Conditions
* Helped Ensure New Access for 5,000+ in the Pre-Existing Condition Insurance Program
* Won New Consumer Protections, from Maternity Coverage to Medical Loss Ratios
* Helped Save Ratepayers Hundreds of Millions as Health Insurance Rates Scrutinized
* Worked to Improve Consumer Assistance, Eligibility and Enrollment, to Be Ready for 2014
Health Access Needs Your Contribution to Help:
* Fight Budget Cuts, and Win the Reforms and Revenues to Sustain Our Health System
* Implement *and* Improve Health Reform in California
* Advocate and Organize for Consumers with Policymakers, the Press, and the Public
Read Our Health Access Blog for More Updates; Also Follow Us on Facebook!
New Updates Daily on Twitter @HealthAccess!
If You Appreciate These Updates, Join/Renew Your Health Access Membership!
Tough budget cuts at the state and federal level. Efforts to roll back recent progress in the courts and Congress. An uncertain economy and political environment. Yet despite these challenges, we in California are still making advances toward the promise of health reform, that all Californians get the care they need, when they need it, without fear of financial ruin. With your help, Health Access helped lead the fight to pass reform in California--but there's much more to do. We hope you can contribute to Health Access Foundation to continue the progress. Our efforts to implement and improve the Affordable Care Act have yielded real results for Californians, both in immediate benefits in 2011 and in investments that will yield fruit in 2014. Here are some examples: * When the ACA provision forbidding children being denied insurance due to pre-existing conditions went into effect, some insurers decided to withdraw “child-only” health policies altogether. Health Access developed, advocated, and won new rules so that insurers that don’t sell to children can’t sell to adults either. This got insurers this year to serve *all* children--and to provide price protections against overcharging as well. * Californians saved millions of dollars as health insurers retracted, rolled back, and rebated their rate hikes, in part due to the new review of rates that we won, which require public disclosure of rate changes and their justifications. We are continuing to push for a broader rate regulation, to allow regulators to not just review but also to reject unjustified rate increases. * Today in California, less that 15% of individual insurance market plans include maternity coverage. Our research showed women in some counties have only one option for maternity coverage; a $5,000 deductible plan. This will change next year, after a decade of Health Access, working with women's groups and others, supporting multiple efforts in California to require maternity care is part of the basic health benefit. The ACA does include maternity as a basic benefit in 2014, and Governor Brown signed bills this year to set the requirement early, in mid-2012, to the benefit of California families. * In the midst of a budget crisis, California is actually expanding health care coverage using new federal funds, with over 200,000 getting care now. As part of the Medicaid waiver stakeholders advisory committee, Health Access helped develop the idea of allowing counties to use the federal matching dollars available under the ACA. These new county-based Low Income Health Programs could cover over a half-million Californians in the next two years, and then every enrolled person will be transferred into fully federally-funded coverage in January 2014. Health Access has actively organized in key counties to reach that goal. These are just some of the advances where Health Access has had an impact. As you can see, Health Access plays an integral role in all of these efforts and more; fighting to protect California health care consumers; working with policymakers to achieve timely implementation of ACA provisions; and advocating for additional improvements in health care policies to ensure quality, affordable health care is accessible to everyone. As we are moving forward to implement and improve federal health care reform, the state’s ongoing budget crisis threatens devastating cuts that jeopardize California’s existing health care safety-net on which millions already rely. We will make sure that the real cost and impacts of proposed cuts are understood, offer alternatives to them, and work with grassroots groups to make sure the voices of their constituents are heard. Because the challenges and opportunities are so great, I urge you to make a tax-deductible gift to Health Access Foundation and become a partner in our efforts to fulfill the promise of reform here in California. On our website, you can contribute online, or download a form. At this crucial time, we need to both prevent the worst, such as budget cuts and efforts to repeal reform; as well as organize and advocate for the best, including better implementation and improvements that go beyond the federal law. With your support, Health Access Foundation will continue to empower Californians to engage in the debate, and to win policy victories on behalf of health care consumers. We would greatly appreciate your contribution to help make it a happy and healthy holiday season. Thank you for your consideration. Sincerely, Anthony E. Wright Executive Director P.S. Opponents of health care reform are aggressively working to gut the ACA and undo the progress already made. Your support will not only help us continue efforts to implement and improve the ACA; you will also help us fight back and defend this historic law and the millions of Californians who benefit from it Labels: HealthAccessCommunity, HealthReform, Updates
posted by Anthony Wright |
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11:04 AM
A Glimmer of Good News for California’s Kids
Sunday, December 18, 2011
By Mike Odeh, Children Now cross posted from Moms Rising and The California Progress Report With the state’s unemployment rate hovering above 11 percent, impending state budget triggers that are inciting rallies across the state, and 52% growth in health insurance premiums for California families over nearly the past decade, it’s hard to find truly good news…but here’s some: at a time when the economic recession hit hardest (2008 to 2010), over 97,000 fewer California children were uninsured, according to a new report by the Georgetown Center for Children and Families. This is good news because we know that kids grow healthier and learn better when they have quality health care coverage. Much of the reduction in the number of uninsured kids can be attributed to the existence of Medi-Cal and the Healthy Families Program. These critical programs provide comprehensive health coverage for eligible low-income children that the vast majority of parents are satisfied with. Medi-Cal and the Healthy Families have filled the insurance void for children left by the shedding of employer-sponsored insurance, as an analysis by the UCLA Center for Health Policy Research points out. There are good reasons to believe that more children will see this trend of increasing insurance coverage: First, the Patient Protection and Affordable Care Act (ACA) of 2010 is already in full effect in California. In 2011 alone, hundreds of thousands of Californian children and youth gained coverage when children were no longer allowed to be denied coverage due to pre-existing conditions and when young adults could remain on their parents’ coverage up to age 26. The California Health Benefit Exchange (HBEX) is working in overdrive to get up and running by 2014. In part, that means developing a seamless eligibility and enrollment system that will make it easier for families to enroll in health coverage – including for the 2 out of 3 uninsured California children who are eligible and could enroll in Medi-Cal or Healthy Families today but have not yet enrolled. There’s also a lot of good work being done to figure out how to make the enrollment experience work best for consumers and ensure there is appropriate and adequate assistance available to help families navigate the complex health care world. Hundreds of thousands of kids will get affordable coverage through the HBEX’s individual and small business markets, and even more will have more secure coverage through their parents’ employers as a result of the ACA. A new Health Affairs article finds that upon full ACA implementation, an estimated 3.2 million children can be expected to gain health care coverage nationally, and up to 95% of all children will have health coverage. Despite the enormous amount of work that still needs to be done, the ACA opportunities before California can bring us much closer to the more than decade-long goal of 100%coverage for all children…and that’s some good news for California’s kids! Read more: http://www.momsrising.org/blog/a-glimmer-of-good-news-for-california%e2%80%99s-kids/#ixzz1geVXCJO6Labels: Exchange, HealthReform, MediCal, SCHIPHealthyFamilies
posted by Linda Leu |
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4:21 PM
Still ending Medicare as we know it...
Thursday, December 15, 2011
GOP Budget Committee Chair Rep. Paul Ryan came out with another proposal today that fundamentally undermines the guarantee and protections in Medicare. It wouldn't be notable, other than he did it with Democratic Senator Ron Wyden. This shouldn't be surprising: Senator Wyden has always gone his own way on health policy, especially if it was something that could be labelled "bipartisan." Unlike others, I was never a fan of his version of health reform that he co-authored with Republican Sen. Bennett of Utah--and thankfully, it really wasn't the basis for the Affordable Care Act; even the small provision that Sen. Wyden stuck in for a narrow slice of the population get stripped out in a more recent budget deal. But his efforts served a political functions, which was to get GOP Senators to even have the conversation about health reform--until it was toxic, so much so that Sen. Bennett was denied his shot at re-election. But I don't see any merit in this Ryan-Wyden proposal. Just read Jonathan Cohn, Ezra Klein, and Austin Frakt to understand why this makes no sense as a policy or as a political proposal. The White House, and key members of Congressional delegation (who happen to be from California), agree, and pushed back hard today. From The Hill:
House Minority Leader Nancy Pelosi (D-Calif.) charged that the plan shows Republicans want Medicare to “wither on the vine,” quoting remarks Gingrich made in 1995 about how Medicare would fare if faced with competition from private insurers. The White House also invoked Gingrich’s quote in a statement opposing the Wyden-Ryan proposal.
“We are concerned that Wyden-Ryan, like Congressman Ryan’s earlier proposal, would undermine, rather than strengthen, Medicare,” White House Communications Director Dan Pfeiffer said in a statement. “The Wyden-Ryan scheme could, over time, cause the traditional Medicare program to ‘wither on the vine’ because it would raise premiums, forcing many seniors to leave traditional Medicare and join private plans.”
Some congressional Democrats were upset with Wyden, saying he risked providing cover for Ryan’s unpopular Medicare plan.
Rep. Pete Stark (Calif.), the top Democrat on the Ways and Means Health subcommittee, said the substance of the new proposal is no better than Ryan's earlier effort. "Despite Wyden's claims otherwise, the Wyden-Ryan plan ends Medicare as we know it, plain and simple," Stark said in a statement.
Rep. Henry Waxman (D-Calif.) said he had not fully reviewed the proposal but that the premium support model, in general, often threatens seniors with higher costs. “I have serious doubts about what they’re proposing,” Waxman said.
Labels: Budget, Federal, HealthReform, Medicare
posted by Anthony Wright |
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4:59 PM
News on essential benefits, tomorrow...
On Friday, December 16, 2011, Richard Kronick, the Deputy Assistant Secretary for Health Policy in the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services (and former UC-San Diego professor) will be joined by Steve Larsen, Director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services, to make an important announcement about the Affordable Care Act. We understand it will provide information on the development of an "essential benefits" definition. WHO: * Richard Kronick, Deputy Assistant Secretary for Health Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services * Steve Larsen, Director, Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services WHEN: Friday, December 16, 2011 at 2:45 p.m. (EST) DIAL IN: 888-790-2012 PASSCODE: Healthcare Labels: Federal, HealthReform, Insurers
posted by Anthony Wright |
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4:49 PM
Trigger pulled, but who gets the bullet?
Wednesday, December 14, 2011
Governor Brown, with Director of Finance Ana Matosantos, pulled the budget "trigger" yesterday on a series of "Tier 1" and some "Tier 2" cuts, totalling around $1 billion, added to nearly $16 billion made early this year. Here's the video of Governor Brown. The trigger cuts include $100 million in services to the developmentally disabled, and $100 million to home care, and $15 million in Medi-Cal provider rates. Since 2008, $15 billion in cuts have been made to vital health and human services in California, hurting our state’s most vulnerable families, seniors, children, and people with disabilities. The trigger cuts will only add to that damage – further weakening our social safety net at a time when Californians are already struggling. A recent poll shows the nearly two-thirds of Californians agree that trigger cuts are a bad idea. Let’s be clear about how we arrived at this unfortunate situation of trigger cuts in the first place – this past year Republicans in the Legislature took the Grover Norquist no-tax pledge and blocked revenue solutions rather than working for the betterment of our state. It’s a travesty that they would prioritize politics over the needs of millions of Californians. Health and human services provide jobs that our state so badly needs and supports families and communities as they weather these tough economic times. Without these services our economic recovery will be hampered and poverty rates will continue to grow. Now more than ever California needs revenue to rebuild our social safety net and restore vital services – and momentum is building for revenue solutions. A new poll shows that 60% of likely voters support the Governor’s ballot initiative to raise revenue – one of several such initiatives on the table. As always, Health Access and the HHS Network will stand to support leaders who will champion viable revenue solutions and prevent cuts to critical services. Revenue solutions are the only way to balance our budget, restore our social safety net, and steer California towards economic recovery. As the Wall Street Journal reported, advocates from the HHS Network and elsewhere, plan to protest Thursday from Sacramento to San Luis Obispo. Labels: Brown, Budget
posted by Anthony Wright |
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5:53 PM
Questions for you, about our future health system...
Monday, December 12, 2011
The California Health Benefit Exchange, along with the California Department of Health Care Services (DHCS), and the Managed Risk Medical Insurance Board (MRMIB), are soliciting thoughts about how to outreach to, enroll, and retain Californians into coverage in our new health care system in 2014 and beyond. In fact, they have questions--pages of 54 questions, as they attempt to develop policies for marketing, eligibility, enrollment, and retention for the millions of Californians who will be eligible for coverage under the Affordable Care Act in 2014. The questions are appropriately thought-provoking, and worth considering. As Exchange Director Peter Lee offers, don't feel you need to answer each one--if you have an answer to a specific question--or in fact, a handful of questions, feel free to submit that as well. Here are the materials: Overview: Stakeholder Input Request
Fact Sheet: Building the System – Acquiring a Systems Integrator
Stakeholder Questions: Assuring Maximum Enrollment - California Marketing, Eligibility, Enrollment, and Retention
Stakeholder Comment FormLabels: Exchange, HealthReform, MediCal
posted by Anthony Wright |
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3:08 PM
What Matters--and Doesn't--in Hiring?
Sunday, December 11, 2011
Sometimes what politicians say need to be checked. The debate in Congress over tax policy is one such area, as some politicians oppose a millionaire's surtax, on the premise that the few of the millionaires that are small business owners would be negatively impacts, harming their ability to hire. In a masterful report by NPR's Tamara Keith, a former Capitol reporter in Sacramento, she asked actual small business people--"job creators"--the impact on higher marginal tax rates for the upper-income. Neither the GOP politicians, nor strangely the business associations themselves could some up with somebody. When she put public solicitations online, she got a different answer than from the associations. As one business owner said: "It's not in the top 20 things that we think about when we're making a business hire." It's not to say that any business wouldn't appreciate lower taxes, regulation, or oversight. But 1) they are put in place to achieve a purpose, often that is business friendly (to provide a level playing field between companies, to prevent abuse of consumers, to lower health costs in the long-term, etc.) and 2) the negative impacts of certain policies, modestly done, is so often overstated to the extreme. This is a compelling example of important journalism, to follow-up to actually test some of these campaign bromides. Labels: Budget
posted by Anthony Wright |
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11:23 PM
Thanks to the ACA, Over 5800 Californians with Pre-Existing Conditions Now Getting Care
Wednesday, December 07, 2011
By now most of you have read the op-ed written by Spike Dolomite Ward, a woman in the San Fernando Valley who believes that "ObamaCare" may have saved her life. Ward was uninsured when she was recently diagnosed with breast cancer. But she found relief from PCIP, the Pre-Existing Condition Insurance Plan, one of the early provisions of the Affordable Care Act. In her own words: "Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate nothing like the people I have dealt with over the years at other insurance companies.) It's not perfect, of course, and it still leaves many people in need out in the cold. But it's a start, and for me it's been a lifesaver — perhaps literally." This op-ed highlights the importance of spreading the word about some of the benefits of health care reform that are already available, but not widely known. The California Pre-Existing Condition Plan is now providing coverage to over 5,800 Californians who have been denied coverage due to pre-existing conditions. PCIP has made some significant first strides in spreading the word about the program, but there are thousands more Californians that could benefit from it. To find out more about PCIP eligibility or to enroll, you can reach the PCIP program at: PCIP Website: http://pcip.ca.gov/Home/default.aspxPhone: 1-877-428-5060
Email: PCIP@maximus.com
For more information about other provisions of the Affordable Care Act that have been implemented in California, click here for a Health Access fact sheet on the progress of implementation efforts. Labels: GuaranteedIssue, Insurers, PCIP
posted by Linda Leu |
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5:09 PM
Beyond the F bombs...
Tuesday, December 06, 2011
Last night's Daily Show had a remarkable segment on California's budget and governance problems. Most will remember it for the colorful vernacular of California Democratic Party Chairman John Burton. And it's great that many across the country will be introduced to Burton, who has been a health reform hero, as the author of SB2 in 2003 when he was State Senate President Pro Tem. But the segment illustrates some real issues with our budget and initiative process, spotlighting the attempt of Amazon.com to run a ballot initiative to avoid taxes. We are proud of our work with the HHS Network to counter Amazon's effort to defund core services (which would have been the impact if they succeeded). Our website and effort, ThinkBeforeYouClickCA.org, was part of a much bigger campaign that got Amazon to come to a negotiated legislative agreement: the tax collection policy was modified and delayed, and Amazon agreed to not file the signatures that they spent millions, at $3/name, to collect. The segment doesn't get into the settlement, rather questioning an initiative process taken over by corporate interests, and the budget gridlock that results. The Daily Show spared nobody, from politicians (like Assemblyman Tim Donnelly) and their overstated rhetoric, to voters themselves. Their traditional foil of the media was spared, but that was the subject of one of their earlier visits to California that I remember vividly. If it takes a few curse words to get people interested and engaged in budget and governance issues, then more power to them. Labels: Budget
posted by Anthony Wright |
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11:46 AM
You've got mail...
Here's Governor Brown's " Open Letter to the People of California," on the California budget situation. He talks about the progress made in the dealing with the budget deficit--including the severe cuts made, the obstruction from GOP legislators in placing revenue solutions on the ballot, and his plan now on an initiative to raise certain taxes to prevent further cuts to education and public safety. Labels: Brown, Budget
posted by Anthony Wright |
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11:40 AM
Staying strong on protecting premiums dollars for patient care!
Friday, December 02, 2011
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