Business as usual I guess.
In the Boston Globe (8/4), columnist Derrick Z. Jackson notes House Speaker Nancy Pelosi's (D-CA) comments on the insurance industry last week, during which she called them "the villains in" the healthcare reform debate "with their 'exorbitant profits.' She charged, 'they have been immoral all along how they have treated the people that they insure."
Great sound bite and certainly it will get some people's blood boiling. But let's look at some truth here.
In Ms. Pelosi's home state of California, there are currently seven health insurance carriers selling individual & family plans to the public state-wide. They are:
Anthem Blue Cross (formerly Blue Cross of California)
Blue Shield of California
Health Net of California
Aetna
Kaiser Permanente
Assurant Health
PacifiCare (UHC)
Of those seven carriers, four are not California-based carriers (Aetna, Anthem BC, Assurant and PacifiCare/UHC (now owned by UHC))
That leaves 3 domestic health insurance companies in the state of California (Blue Shield, Kaiser and Health Net).
Of those 3 carriers, 2 are NOT FOR PROFIT carriers--Kaiser and Blue Shield CA. So, it looks like in Nancy Pelosi's home state, 2/3 of the domestic health insurance carriers (and 1/3 of all carriers) are no allowed to operate and take "exorbitant profits".
When 2/3 of domestic health insurance carriers in a state are operating without profit motive, I fail to see how they can be labeled as "villains" who are taking "exorbitant profits".
Tuesday, August 4, 2009
Thursday, July 23, 2009
Health Net Sells Northeast Operations
Health Net Inc. has announced that its northeast operations will become part of United Health (UHC) upon regulatory approval. Health Net has stated that they intend to focus exclusively on their western US operations.
Wednesday, July 22, 2009
Healthy Families Imposes Waiting List
The California SCHIP program, Healthy Families, has now officially added a waiting list for new enrollments going forward into the new fiscal year. Shortfall for the program is $90M in the general fund with a total underfunding of $270M for the childrens health insurance program.
http://www.mrmib.ca.gov/MRMIB/HFP_Wait_List_Effective_7-17-09.pdf
http://www.mrmib.ca.gov/MRMIB/HFP_Wait_List_Effective_7-17-09.pdf
Wednesday, May 20, 2009
AB 98 Update
Looks like AB 98, the mandatory maternity bill, is being shelved for the remainder of the year. I will be curious to see if it is resurrected in the future.
Thursday, May 14, 2009
AB 23 Signed Into Law
California Assembly Bill 23 was signed into law today by Governor Arnold Schwarzenegger.
AB 23 legalizes the continuation subsidy for Cal-COBRA beneficiaries, which is intended to mirror the federal COBRA subsidy.
According to my information, this subsidy is to be provided directly by the health insurance carriers and only the carriers are allowed to take the tax credit to offset the subsidy.
I will blog with more details in the next few days. AB 23 was created and signed into law because the state mini-COBRA law needed a correction to approve the subsidy.
AB 23 legalizes the continuation subsidy for Cal-COBRA beneficiaries, which is intended to mirror the federal COBRA subsidy.
According to my information, this subsidy is to be provided directly by the health insurance carriers and only the carriers are allowed to take the tax credit to offset the subsidy.
I will blog with more details in the next few days. AB 23 was created and signed into law because the state mini-COBRA law needed a correction to approve the subsidy.
Thursday, May 7, 2009
California AB 98 & Individual/Family Health Plans
Happy Thursday! One more day to go then the weekend.
The California legislature is currently working on a new bill, AB 98, which, if passed and signed into law, will make a significant change to California individual health coverage.
The bill would require all individual & family health insurance plans in California, whether registered with the DMHC or the DOI, to contain mandatory maternity benefits. As I interpret the bill, any plan sold in 2010 would have to contain maternity benefits, and any plan sold prior to 2010 would be adjusted to include maternity at plan renewal.
Many Californians currently covered on individual & family plans have chosen plans without maternity benefits to save premium. Maternity benefits on a health plan are assumed at 100% utilization, meaning that all plans with maternity benefits are priced with the expectation that every subscriber will use the benefit. Those who do not need maternity coverage would lose the choice of purchasing a non-maternity health plan and the premium savings that go along with it.
I will update as this bill moves through the Assembly.
The California legislature is currently working on a new bill, AB 98, which, if passed and signed into law, will make a significant change to California individual health coverage.
The bill would require all individual & family health insurance plans in California, whether registered with the DMHC or the DOI, to contain mandatory maternity benefits. As I interpret the bill, any plan sold in 2010 would have to contain maternity benefits, and any plan sold prior to 2010 would be adjusted to include maternity at plan renewal.
Many Californians currently covered on individual & family plans have chosen plans without maternity benefits to save premium. Maternity benefits on a health plan are assumed at 100% utilization, meaning that all plans with maternity benefits are priced with the expectation that every subscriber will use the benefit. Those who do not need maternity coverage would lose the choice of purchasing a non-maternity health plan and the premium savings that go along with it.
I will update as this bill moves through the Assembly.
Tuesday, May 5, 2009
Mini-COBRA Expansion States
Hope everyone is having a great spring. Just wanted to update on the increase in mini-COBRA state continuation coverage programs going on currently.
Last month Viriginia added a state mini-COBRA program which went into effect in early April, 2009. I found out today that Pennsylvania is also finishing legislation to add a mini-COBRA program. Virginia's program runs 9 months to coincide with the subsidy. I expect Pennsylvania to go 9 or 18 months, again with the first 9 being subject to the subsidy.
For those who are not aware, a part of the ARRA legislation requires state mini-COBRA programs to provide the same 65% subsidy to qualified beneficiaries as the federal COBRA program.
In California, we have a program called "Cal-COBRA" which is the state mini-COBRA program with a special feature not found in other states.
Cal-COBRA applies to groups 2-19 employees which fall below the federal COBRA size. Additionally, Cal-COBRA contains an extension of coverage provision under AB 1401 which can apply to groups of any size, not just 2-19. This was signed into law by Gray Davis when he was still the governor. Under AB 1401, certain groups above 20 are eligible for an extra 18 months on Cal-COBRA after the first 18 months of federal COBRA. Generally, the groups must be fully insured (not self-insured/self-funded) and must be covered by a carrier domiciled in California. Plans outside of California, like self-funded plans, are exempt.
For more information on Cal-COBRA extension and AB 1401, visit this page on my site.
For more information on Cal-COBRA and California mini-COBRA, visit this page on my site.
Before I forget, Happy Cinco de Mayo!
Last month Viriginia added a state mini-COBRA program which went into effect in early April, 2009. I found out today that Pennsylvania is also finishing legislation to add a mini-COBRA program. Virginia's program runs 9 months to coincide with the subsidy. I expect Pennsylvania to go 9 or 18 months, again with the first 9 being subject to the subsidy.
For those who are not aware, a part of the ARRA legislation requires state mini-COBRA programs to provide the same 65% subsidy to qualified beneficiaries as the federal COBRA program.
In California, we have a program called "Cal-COBRA" which is the state mini-COBRA program with a special feature not found in other states.
Cal-COBRA applies to groups 2-19 employees which fall below the federal COBRA size. Additionally, Cal-COBRA contains an extension of coverage provision under AB 1401 which can apply to groups of any size, not just 2-19. This was signed into law by Gray Davis when he was still the governor. Under AB 1401, certain groups above 20 are eligible for an extra 18 months on Cal-COBRA after the first 18 months of federal COBRA. Generally, the groups must be fully insured (not self-insured/self-funded) and must be covered by a carrier domiciled in California. Plans outside of California, like self-funded plans, are exempt.
For more information on Cal-COBRA extension and AB 1401, visit this page on my site.
For more information on Cal-COBRA and California mini-COBRA, visit this page on my site.
Before I forget, Happy Cinco de Mayo!
Subscribe to:
Posts (Atom)
