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California Has Its Work Cut Out on “Subprime” Health Insurance
By Anthony Wright
Executive Director of Health Access California
It's an evocative term. In fact, "subprime" is the "Word of the Year," according to the American Dialect Association. (It beat out other noteworthy words, including Googleganger, vegansexual, and waterboarding.)
Typically used in reference to mortgages, it's clear that such a designation is needed in the world of health insurance. There's lots of "junk" health insurance out there, where people pay a premium and may not realize how little it covers--until it is too late. This includes disease- or treatment-specific coverage, "bare-bones" or "skeleton" plans, coverage that is capped, etc. It includes products sold by companies like Mega with daily caps and other significant cost-sharing, and simply some of the high-deductible policies, like Tonik, sold by Blue Cross.
Some represent a trade-off that some wealthier people can afford to make, to have greater cost-sharing in order to get cheaper premiums. But other plans are, frankly, close to consumer fraud, and should not be certified to be sold in the market. In the interest of disclosure, some of these plans should, at the very least, be clearly marked as "subprime," so people know what they are buying the first place. Right now, there's no minimum standard for health insurance--It's just "let the buyer beware."
With support from the national group Community Catalyst, Health Access is working with Western Center on Law and Poverty and several other consumer and community groups over the next several years to work on issues of "underinsurance." This Health Initiative on Overcharging and Underinsurance ("Health IOU" for short) will work to prevent medical debt that too many insured people face.
We will work to better implement AB774, the law against hospital overcharging we passed in 2006. But we also want to do a better job providing oversight of these "subprime" insurance plans as well.
The proposed health reform does set a minimum standard for coverage, that is inclusive of "physician, hospital, and preventative services," as well as "existing coverage requirements under law." It doesn't do all we wanted, but it does much more than what exists in the status quo, including creating a process to set more specific standards, including on cost-sharing. It establishes a framework to work from, including organizing the insurance market in tiers, so people have a much better sense of what kind of coverage they are buying in the first place.
In other words, if health reform passes, there still will be work to do. If health reform does not pass, there will be a helluva lot of work to do, to protect consumers from the perils of subprime insurance.
Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.
Comments
"Subprime Healthcare"
I luv the title of this Article, the sad part is that it is true. Here is the bottom line, I have been involved in Health Insurance since the 80's. I have worked with Large Self Funded Groups, HRA's, HSA's, PPO's, HMO's, TSA's. Since 1991 I have worked an average of 10hr-12hrs a day, studying and reading about plan designs and I cannot honestly say that I know every plan being sold in California. With companies putting exclusions on "Maternity services" "Mental Health Outpatient Care" Limited Physical Therapy, and others putting limited UCR fee schedules on procedures the public is completely in the dark.
I volunteered for years, speaking to young adults about the basics on healthcare (ie. how to pick a plan) the basic differences between HMO and PPO plans some basic termology such as "Out of pocket max's" "Plan limitations" "UCR Payment". What I found is that as a public we are very un-informed about health insurance.
The only advice I can honestly give anyone buying health insurance is at the very least, ask the agent you are buying a plan from to please furnish you with a EOC- (Evidence of Coverage) these are normally between 50-100 pages and outline the plan you have chosen completely, it will detail specific plan exclusions (which may alarm you). Please do not pick out a health plan like you are picking out a piece of fruit at the market. Most plans are created after hours of research, going through boards and committees and of course much legal review. "Stay informed".
Happy New Year,
Rudy Rivas, President
Health Insurance Expert in Ca. since 1991
Ca Lc. 082739
1 800 459 0515
1 562 947 2502
www.HispanicInsure.com
Posted by: Rudy Lehder Rivas at January 8, 2008 06:02 PM
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