Debating the model contract of Covered California plans…

Covered California’s Board of Directors met today in Sacramento to consider a number of issues related to the establishment of the health benefits exchange.

The Board heard regular status reports on a variety of issues, with some notable progress and some notable setbacks.

The Service Center Update announced exciting progress in the establishment of 3 service center locations across the state.  The Rancho Cordova site is going to be up and running in June (and already got 4200 applications for their 500 available jobs), discussions are in progress related to a Fresno site, and the Concord (Contra Costa County) location is also moving forward.

Staff announced that the Outreach and Education grant awardees would not be announced this Friday as expected, but sometime in mid-May, with contracts beginning in July.

In an update on Qualified Health Plan Contracting, staff provided an overview of some changes to the model contract based on some previous stakeholder feedback. Consumer advocates were disappointed and concerned about the number of concessions made to health plans.  First, Covered California made a number of changes to reflect concerns from plans that they were “acting as a third regulator” including pulling back on a requirement that plans submit marketing materials for approval to protect consumers from deceptive marketing.  Additionally, Covered California proposes deferring to regulators on issues such as utilization review and network adequacy.  Also, the newest draft of the model contract rolls back language access requirements in marketing and enrollment by plans and eliminates the requirement that plans work to reduce health disparities (though it still requires some data collection).  Board Member Bob Ross stated that though he was in favor of taking a long view and working toward some of these goals, he was mindful of needing to include some requirements in the contract in order to create change, and not conceding to all resistance to change.  A version of the Model Contract will be voted on in the May 7 Board Meeting.

A number of issues were raised in the Eligibility and Enrollment report that will be decided in the May 23rd meeting that will become regulations.  Some of these issues include whether initial premium payments are required in order to effectuate coverage, how to verify residency, how to collect Social Security Numbers, and what reading level materials will be provided in. Covered California is seeking stakeholder input on these regulations and will be holding a webinar on these issues in early May.

The discussion on the Assisters program will be deferred to May 7th.

As always, you can see the broadcast at www.hbex.ca.gov, and follow our live-tweeting @HealthAccess using the hashtag #CoveredCA. Upcoming opportunities to engage with and provide feedback to Covered California include:

Town Hall with Peter Lee, Kim Belshe, and Bob Ross
Thursday April 25, 2013 4-6pm
UC Riverside Extension

Covered California Board Meeting (newly added)
May 7, 2013
Sacramento

Town Hall
Friday, May 10
San Jose, CA (Subject to change)

Town Hall
Friday, May 17th
San Diego, CA

Covered California Board Meeting
May 23, 2013
Sacramento

Health Access California promotes quality, affordable health care for all Californians.
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