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July 30, 2008

California Governor Signs Health Care Protection Bill

California Governor Arnold Schwarzenegger signed AB 1150 by Assemblymember Ted Lieu (D-Torrance) which bans health insurance companies from rewarding their employees for canceling or limiting a patient's health insurance. While the Governor signed AB 1150 because of the urgent need to protect consumers from unfair health care rescissions, he continues to believe that health care reform must be comprehensive.

To that end, he has proposed legislation that would be the building blocks of comprehensive health care reform and is working with the legislature on a joint solution that will protect consumers, control costs and promote prevention.

"Until we achieve comprehensive health care reform, stopping unfair health care rescissions is an urgently needed consumer protection," Governor Schwarzenegger said. "This terrible practice further illustrates the erosion of the California health care system and the need for comprehensive health care reform. Today we are standing up for consumers by putting an end to a deplorable practice, and I will continue working with my partners in the legislature to stop unfair health care rescissions once and for all."

The Governor's goal of comprehensive health care reform would make health care rescissions a problem of the past. The Governor's AB x1 1, the Health Care Security and Reduction Act, would have required that all Californians take responsibility for their health coverage while guaranteeing that no Californian is turned away from buying Calfiornia health insurance based on their age or medical history.

Click here for your free California health insurance quote now!

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

July 18, 2008

Insurance Cancellation Questions Could Spread Beyond California

Today’s Health Blog jargon of the day is rescission, the California insurance industry’s practice of revoking individual insurance policies because of health-related mistakes or omissions on the application for coverage.

The companies say this is a key step for fighting fraud, but they’ve come under criticism in California by those who accuse them of going over applications with a fine-tooth comb after members who’ve been enrolled for a while get sick or injured and start submitting claims.

Now it looks like the push-back against rescission may be spreading. Henry Waxman, a Democratic California Congressman, held a hearing on the subject yesterday and said his oversight committee plans to investigate the issue nationally.

“I understand that California insurance companies need to protect themselves from fraud,” Waxman said in his opening statement. But “insurers are using technicalities or trumped-up ‘misrepresentations’ to rescind policies after individuals get sick and accumulate hundreds of thousands of dollars in medical bills.”

The health insurance industry supports third-party review, established by the states, for rescission decisions, Stephanie Kanwit, special counsel to the trade group America’s Health Insurance Plans, said at yesterday’s hearing.

Kanwit said the practice is very rare. And, she said, collecting accurate information on applicants’ health history is essential for the insurance market to function. “When individuals wait until they are ill before purchasing health insurance, costs are increased for other policyholders who pay into the system on a regular basis,” she said.

Meanwhile, back in California, the industry’s rescission problems are rolling on. The state’s Anthem Blue Cross and Blue Shield yesterday agreed to pay the state $13 million in fines and to offer new coverage to more than 2,200 Californians the companies dropped after they became ill, the Los Angeles Times reports. As part of the agreement the companies didn’t admit wrongdoing.

And earlier this week, Los Angeles’ city attorney announced a lawsuit against Blue Shield over the rescission issue. The city attorney launched an investigation into the issue earlier this year, and has already filed lawsuits against a few other insurers.

Click here for your free California health insurance quote now!

Posted by healthinsurance at 05:55 PM | Comments (0)

July 09, 2008

Health-care crisis looms in California

To quote hospital administrator Jim Raggio, “Last year, California hospitals provided $9.7 billion in uncompensated care, including $3.5 billion in Medicare shortfalls, and $2.7 billion in losses from the MediCal program.”

Thus, nearly 64 percent of uncompensated care comes from those insured by government, not the uninsured. Physicians also fare badly under said government and private insurance programs.

There is not one nationwide or statewide price for services. Supposedly higher cost-of-living counties get higher rates, but this isn't true for Santa Barbara and San Luis Obispo counties, which are grouped in the cheapest rates paid in California.

As for a health-care crisis, expect it to be severe in Lompoc. Several primary-care physicians have left or are contracted to leave Lompoc shortly.

It is time for the citizens of the Lompoc Valley to realize they face a local health-care crisis, one that government health care in California does much to cause. Our local hospital suffers from HMOs routinely referring specialist examinations and elective in- and out-patient hospital services to Santa Barbara, about 65 miles away, while, by law, HMOs must offer care within 30 miles. HMO patients can insist on their right to be cared for locally when appropriate health care service is available.

Click here for your free California health insurance quote today!

Posted by healthinsurance at 10:43 PM | Comments (0)

July 06, 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 California 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 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."

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Posted by healthinsurance at 04:25 PM | Comments (0)

July 01, 2008

Californians Not Getting the Health Care They Need

Call them stoic, call them cost-conscious, call them under- or uninsured...but almost 20 percent of the U.S. population either went without or delayed needed medical care at sometime during 2007. That figure is up from 14 percent in 2003, and if you are counting, is an additional 9.5 million Americans who didn't get the medical care they needed in 2007.

People had numerous reasons why they had postponed or had completely forgone medical care for themselves during the year. Chief among them was out-of-pocket medical costs and deductibles they couldn't afford to pay, followed by a list that included things like a lack of acceptable clinic hours of operation, difficulty getting to clinics during working hours, problems with doctors being overbooked that resulted in difficulty getting timely appointments, and doctors and hospitals not accepting their insurance plans.

It wasn't just people without medical insurance that were avoiding medical visits, but both people with and without insurance that were either delaying or forgoing medical care, according to a random national phone survey. The survey was conducted by the Center for Studying Health System Change, a nonpartisan policy group, who called 18,000 people, with a 43 percent response rate.

The study's lead author, Peter Cunningham, noted that as health care costs increase, a larger share of cost, often in the form of higher deductibles, is being shifted to people and families, requiring them to pay more out of their own pockets. "To the extent that health insurance cost increases are passed on to individuals, continued declines in access to care are inevitable," wrote the co-authors of the study.

Karen Ignagni, chief executive of America's Health Insurance Plans, an insurance-industry trade group, feels that a variety of issues need to be addressed by policy makers to make surgery, medical imaging, and specialty drugs more affordable to the general public, and to standardize quality of care among providers. The cost of drugs and services has risen at a rate at least twice that of inflation for several years, making it more difficult for even those with health insurance to pay for medical care.

Click here for your free California health insurance quote now!

Posted by healthinsurance at 01:13 PM | Comments (0)