Capell, Beth

Beth Capell provides policy analysis, legislative advocacy, and other strategic input to Health Access and to other consumer, labor and public interest organizations on health care issues.

Saying Goodbye to Junk Insurance: The Benefit of Essential Health Benefits in California

By Beth Capell
Health Access California

Health Access has fought a long battle against junk insurance, the kind of limited benefit policies that leave patients in significant medical debt, even after paying premiums--and leave the rest of us in fear of the fine print, wondering if what we come down with is actually covered.

Former Insurance Commissioner John Garamendi sometimes called these "skeleton policies." Some policies permitted under California's Insurance Code cover only hospital care, but not doctor care, or only the second day in the hospital, but not the first, or that provide no coverage for prescription drugs except for a handful of generic drugs. These policies are not permitted for coverage regulated by the Department of Managed Health Care under the Knox-Keene Act: these policies must cover medically necessary doctor visits, hospitalization, lab, radiology, etc.

People Will Die, And Other Budget Cut Consequences

By Beth Capell
Health Access

Over the years we have written about many proposed health care cuts and the impacts, both human and economic. After a thorough hearing about the health cuts, we write to describe proposed cuts that will result directly and quickly in patient deaths as well as homelessness and institutionalization.

People will die

Ten doctor, clinic and outpatient visits per year.

Adios to the Junkiest of Junk Health Insurance

By Beth Capell
Health Access

Health Access has waged a long fight to eliminate “junk” insurance: insurance that costs less because it does not cover basic health services.

On June 22, the three month anniversary of health reform, the U.S. Department of Health and Human Services released new rules on annual and lifetime limits as well as rescissions and pre-existing condition exclusions.

The new rules on annual and lifetime limits effectively eliminate the junkiest of junk insurance effective September 23 of this year.

The rules require health insurers to cover all minimum essential benefits up to an annual limit of no less than $750,000 effective Sept. 23, 2010, no less than $1.25 million in 2012, no less than $2 million in 2013 and with no annual limits at all in 2014.

When seeds sprout...

By Beth Capell

Some back story on the Anthem Blue Cross rate hike story...
From little acorns, mighty oaks grow.
We here at Health Access California do lots of things—we work on bills and regulations, we organize rallies and write blog posts, we send out media releases and talk to reporters, we write policy papers and even have staff meetings. We have a twenty-year record of accomplishment and we keep trying to plant seeds for the future.
2005 was a pretty dark year. The year before, we had just barely lost a major health reform ballot fight. The drug companies were spending $80 million to defeat another ballot initiative we sponsored to give low income uninsured real discounts on drugs. If we had a policy idea, we had few hopes the Governor would sign it. The state budget was not pretty. And there were little chance that anything happy for consumers would happen at the federal level.

A timely bonus on timely access...

By Beth Capell

An end of the year bonus—and one that we really earned!

On Friday, December 18, 2009, Health Access received word that the timely access regulations will be final effective January 17, 2010.

We have worked on this issue for more than a decade. The original HMO Patient Bill of Rights, a package of more than twenty bills, included timely access in AB 497 (Wildman).

AB 497 was vetoed in the face of bitter opposition from the HMOs and the Wilson Administration. The legislative staff for the Department of Corporations which was responsible for regulating at that time told us that whatever an HMO decided was timely access was the standard. That was not nearly good enough for Health Access.

AB 497 set specific standards for timely access, standards that are remarkably similar to those that are now in effect. AB 497 required that:

* A telephone call be answered within four minutes
* A non-urgent appointment be provided within ten days

An orange for your stocking...

By Beth Capell

Finally, some good news!

Word has come that the federal government will permit, for a limited time, California to take advantage existing federal rules to implement AB1422 (Bass) which would help to fund the Healthy Families program.

This is a great relief. Until now, we heard very discouraging words from those in DC about the prospects for approval of federal matching funds through the extension of the gross premiums tax to Medi-Cal managed care plans.

As you may recall, the health coverage of almost a million children was put at risk as a result of the budget adopted by the Legislature and the further line item vetoes by the Governor back in July.

The Medicare Buy-In Option

By Beth Capell
Health Access

The other night on the PBS Newshour, our colleague Jacob Hacker, who was briefly at UC Berkeley and has now returned to Yale, said that the Senate compromise on the public option was a bit Dickensian, a tale of two public options, the best of times and the worst of times---that is a public option that was an expansion of Medicare to a new population, those aged 55 to 64 was the best of the public option while he was disappointed by the trigger on a public option available in the exchange. (He's also not impressed with another part of the deal, national nonprofit plans offered by the Office of Personnel Management.)

Stinking badges: Pseudo-public meetings at the NAIC

By Beth Capell
Health Access

Last Friday, two intrepid Health Access staffers took a field trip to San Francisco to venture into the wilds of the National Association of Insurance Commissioners which was holding a “public” forum on health care reform, as part of their regular quarterly conference that moves around the country.

We thought this was important to do since the Senate version of federal reform gives the NAIC considerable responsibility in implementing health reform. We joined colleagues from AARP and Consumers Union, organizations that have worked closely with NAIC over the years on the regulation of Medi-Gap and Medicare Advantage policies.

So what did Health Access observe?

Facing Tough Health Care Choice with Our Children

Beth-Capell.gifBy Beth Capell

The New York Times reports on a study that found that children without health insurance who are hospitalized are much more likely to die—how much more likely? Well, almost half the kids who died after hospitalization were uninsured, far out of proportion to their numbers in the general population.

The story notes that kids are not especially likely to be hospitalized and that most kids who are recover and that is all good.