Insurance


Why We Support Prop 45: Our Health Insurance Premium Went Up Over 1,300%

By Josh Libresco

I have a wife and two children. My daughter just finished her freshman year in college; my son is in high school. I have lived in California for most of my life, and have worked in marketing research most of my career. I spent the first 20 years of my career working for larger companies, but in 1997, I went off on my own. My health care was covered under COBRA for a while, and I started an individual (family) policy with Anthem Blue Cross in 1998 paying $151 each month for a plan with no deductible and a $10 co-pay for office visits.

Discriminatory Insurer Practices Jeopardize Access to Medication

By Liz Helms

California Chronic Care Coalition

California health insurance plans are jeopardizing patient health by moving vital medications to so-called “specialty tiers,” which place the cost of treatment beyond the reach of most patients and which may be illegal under both California and federal discrimination laws.

Rather than paying a fixed copayment, Californians whose medications are placed on specialty tiers are often forced to pay coinsurance – or a percentage of the total cost of the drugs – which can mean hundreds or even thousands of dollars per month in out-of-pocket costs for a single medication.

California’s Decision on Plan Extensions

By Anthony Wright

Health Access

Last Thursday, Covered California voted to provide more direct outreach and assistance to Californians who need to switch health plans at the end of the year. A special hotline number will be extended for consumers impacted, to walk them through their options:

Help with New Options

AB 889: California Must Act Now to Help Thousands with Debilitating Health Conditions

Dr. Wesley MizutaniBy Dr. Wesley Mizutani

Advances in modern medicine have precipitated a revolution in the treatment of chronic health conditions. Californians diagnosed with rheumatoid arthritis, for example, are no longer given the expectation that the progressive disability will end in a wheelchair.

Californians will only reap the benefits of these scientific breakthroughs, however, if the state Senate takes common-sense action now to ensure that all patients can have access to the treatments their doctors think best.

Barred from Federal Programs, DREAMers May Qualify for Medi-Cal

Viji SundaramBy Viji Sundaram

For years, DREAMer Rodrigo Perea, 18, lived under a threatening cloud of deportation. Now, Perea has legal permission to live and work in the U.S. - but until recently he was still in the dark about the low-income health programs he qualifies for.

He's not alone. Thousands of immigrants, and even many health care advocates in California who work with young immigrants, are unaware that recipients of the Deferred Action for Childhood Arrivals (DACA) program may qualify for state-funded-only Medi-Cal, identical in every way to the full scope federal and state funded program that shares the name.

Dramatic Day of Debate and Decision on Medi-Cal Expansion and the State Budget

Anthony WrightBy Anthony Wright

Saturday, the California Legislature passed historic legislation to expand Medi-Cal to over one million Californians, as well as key budget trailer bills that restore many dental services to over three million Californians and other key improvements in Medi-Cal.

The bills the Legislature passed included the major Medi-Cal expansion bills (AB1x1/SB1x1), and budget bills such as the main health trailer bill that includes the restorations to dental and other benefits (SB77/AB82), the reallocation of county safety-net dollars (SB80/AB85), and another to reinstitute the Managed Care Organization (MCO) tax to help fund health in the budget (SB78/AB83).

Debating Obamacare: How About Them Apples?

By Anthony Wright

The white hot spotlight on health reform in California continues. For the New York Times Room For Debate, we at Health Access were pleased to contribute an essay, "Obamacare is Working in California" as part of a package answering the question, "Is Obamacare Too Complicated to Succeed?" Here's part of our answer:

In fact, the law is a huge step toward a simpler and more straightforward system. One of the new insurance exchanges under the ACA, Covered California, will offer standardized plans to finally allow consumers and small businesses to make apples-to-apples comparisons among health plans.

The law will also provide subsidies so low- and moderate-income families can pay only a percentage of their income, on a sliding scale. It's a revolutionary change; premiums now can be based on what you can afford, rather than how sick you are.

Using its purchasing power, Covered California has just announced negotiated rates with a broad selection of plans - and there's good news: the rates are lower than expected. This is partially because California explicitly gave its insurance marketplace the power to bargain for the best price and value.

No "Sticker Shock" for Covered California Health Care Consumers

By Anthony Wright

Covered California held a press conference last week announcing plans and rates that will be available to consumers starting January 1. This is one of the most significant steps yet toward being ready to serve consumers by the federally mandated 2014 deadline for health exchange availability under the 2010 Affordable Care Act. You can watch the press conference on the Covered California website, where you can also download a booklet with a description of all the plans that will be offered and sample rates.

Governor Brown, Counties Need Money to Keep California Healthy

Viji SundaramBy Viji Sundaram

Under California Gov. Jerry Brown's revised budget, counties stand to lose crucial health care funding that would leave millions of people without access to care.

An estimated 3 to 4 million, or 10 percent of the state's population, the majority from ethnic communities, will remain uninsured in 2014, according to a study by UCLA and UC Berkeley. Some of them - an estimated 1 million - will be excluded from public health programs by federal law because they are undocumented. Some will not be eligible for Medi-Cal, the federal-state funded health care program for low-income people. Others who may qualify to buy coverage on the health insurance marketplace could miss the open enrollment period or simply not be able to afford it.

Governor's "May Revise" on Health Care: Progress, but with Continued Cuts

By Anthony Wright

Governor Jerry Brown announced his May Revision of the California State Budget on Tuesday, declaring for the first time in decades a multi-year balanced budget. In his brief remarks unveiling the proposal, the Governor highlighted planned investments in education, as promised in the campaign for Proposition 30 last fall, as well as the work to implement the federal Affordable Care Act (ACA).

In the May revision of the budget, Governor Brown moves towards a resolution for a timely Medi-Cal expansion as required under the Affordable Care Act. But the budget seeks a greater than 75 percent cut to county safety net funds, and would continue cuts to Medi-Cal provider rates and Denti-Cal.