Health Insurance

Early this morning, the California Legislature approved a budget proposal for fiscal year 2008-2009 that avoided some cuts to health care and other programs, the San Jose Mercury News reports. Democrats widely opposed the proposed cuts (Zapler, San Jose Mercury News, 9/16).

The proposal does not eliminate dental services for adult Medi-Cal beneficiaries or impose new restrictions on Medi-Cal services for undocumented immigrants. Medi-Cal is California’s Medicaid program (Halper/Rau, Los Angeles Times, 9/16).

Beyond those already introduced by Senate Democrats, the budget agreement does not include cuts to California health care, human services or education programs, according to information Ventura County officials received from the California State Association of Counties (Biasotti, Ventura County Star, 9/16).
Healthy Families, Medi-Cal

The budget retains a provision to increase monthly premiums for Healthy Families, California’s version of the State Children’s Health Insurance Program (Los Angeles Times, 9/16).

The proposal would restore most of the 10% cut in Medi-Cal payments to health care providers beginning in March 2009 (Lin, AP/San Francisco Chronicle, 9/16). California’s Medicaid reimbursement rates will remain the lowest in the U.S. even after the cuts are restored, according to the Los Angeles Times.

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Private California 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 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 Californian 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.

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Check it out over at Colorado Health Insurance Insider. Thanks to Louise for compiling! Continue to read more…

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Check it out over at Colorado Health Insurance Insider. Thanks to Louise for compiling! Continue to read more…

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Check it out over at Colorado Health Insurance Insider. Thanks to Louise for compiling! Continue to read more…

Early this morning, the California Legislature approved a budget proposal for fiscal year 2008-2009 that avoided some cuts to health care and other programs, the San Jose Mercury News reports. Democrats widely opposed the proposed cuts (Zapler, San Jose Mercury News, 9/16).

The proposal does not eliminate dental services for adult Medi-Cal beneficiaries or impose new restrictions on Medi-Cal services for undocumented immigrants. Medi-Cal is California’s Medicaid program (Halper/Rau, Los Angeles Times, 9/16).

Beyond those already introduced by Senate Democrats, the budget agreement does not include cuts to California health care, human services or education programs, according to information Ventura County officials received from the California State Association of Counties (Biasotti, Ventura County Star, 9/16).
Healthy Families, Medi-Cal

The budget retains a provision to increase monthly premiums for Healthy Families, California’s version of the State Children’s Health Insurance Program (Los Angeles Times, 9/16).

The proposal would restore most of the 10% cut in Medi-Cal payments to health care providers beginning in March 2009 (Lin, AP/San Francisco Chronicle, 9/16). California’s Medicaid reimbursement rates will remain the lowest in the U.S. even after the cuts are restored, according to the Los Angeles Times.

Click here for your free California health insurance quote now!

Continue to read more…

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A bill was recently approved in both the Connecticut state House of Representatives and Senate which would broadly expand the state’s health insurance pool. If Governor M. Jodi Rell signs the measure, would up the number of people covered in the pool to around 600,000 people.

With this expansion, argue the bill’s proponents, members will have more bargaining power with insurance companies and could drive down rates.

Under the measure, municipalities, non profit organizations, and small businesses with fewer than 50 employees could buy into the pool, reported the Hartford Courant.

“Finally passing the pooling bill shows that our lawmakers truly do care about the healthcare burden on Connecticut’s towns, school districts and small businesses,” said Michael O’Brien, the president of a Connecticut worker’s union.

But the bill is facing strong opposition from insurance companies, business associations, and Governor Rell’s administration.

One insurer estimated the expansion will cause rates to increase by 4 percent, and they would have to re-negotiate previously agreed upon rates for 2009 and 2010.

Governor Rell has indicated that she is considering using her veto power to strike down the bill.

“We believe the bill could damage competition in the current private market, put an unfunded burden upon the state, and prevent municipalities from having the flexibility to control their employees’ health costs,” said a spokesman for ConnectiCare, a state-based insurer.

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