Lawmakers seek to strengthen, speed up health reform

March 23, 2011 11:29:32 AM PDT
A prominent California health advocacy group issued a report yesterday lauding the changes ushered in by federal health reform and highlighting a slate of legislation that would support and strengthen its effect in California.

The law has improved access to health insurance coverage to thousands of people who could not previously qualify for or afford insurance, according to the report [PDF] by Health Access California.

Included in the changes in California:

  • More than 100 employers, including the Walt Disney Company and Orange County, tapped into funds to help provide health coverage for retirees who are too young to qualify for Medicare.
  • Nearly 200,000 young adults gained access to health insurance through policies assigned to parents.
  • Children who have "pre-existing conditions" such as asthma or diabetes can get coverage, a concept strengthened by a California lawmaker last year.

Additionally, about 1,800 people who were previously denied health insurance because of pre-existing conditions, such as a round of cancer, signed up for private coverage.

The program covering high-risk patients has drawn attention for its limited enrollment, considering an estimated 250,000 Californians might qualify for such coverage. The San Diego Union-Tribune found that people haven't readily signed up for the program because they are not aware of it or because they have to wait six months after being denied health insurance coverage to enroll.

More broadly, the health reform law has enjoyed no shortage of controversy, even as about 53 percent of Americans, according to a recent poll, are unsure what it does.

Lawsuits over the "individual mandate" have grabbed headlines. The mandate would come into play in 2014 and essentially require everyone to carry health insurance coverage. The reasoning behind the mandate, which health insurers have supported, is that if everyone puts in $500, then insurers are better equipped to cover patients who cost $5 million.

The concept has been divisive, though, as many feel it is too great a burden and an affront to liberty. California lawmakers deftly avoided that hot-button issue, which is expected to be decided by the Supreme Court.

California lawmakers, though, have introduced legislation that would bolster the federal law.

Assemblyman Roger Hernandez, D-West Covina, and Sen. Noreen Evans, D-Santa Rosa, introduced bills that would speed up a requirement set to take effect in the federal law in 2014. Namely, their bills would mandate that health insurers include coverage for maternity services in plans submitted after Jan. 1, 2012.

As the Los Angeles Times reported, about 80 percent of the nearly 300,000 California women who buy health insurance on the individual market lack maternity coverage.

Still, then-Gov. Arnold Schwarzenegger vetoed a similar bill last year, saying it would raise costs and add to the ranks of the uninsured.

Another pending bill would update California law to reflect a new federal requirement that health insurers spend 80 to 85 percent of the premium dollars they collect on health services to patients.

Sen. Elaine Alquist, D-San Jose, is carrying the bill this year and authored a similar one last year. That bill, which had additional transparency requirements, fell to Schwarzenegger's veto pen, based on the cost of the disclosure requirements.

Finally, Assemblyman Mike Feuer is carrying a bill that would go well beyond the federal health reform law. The bill, almost certain to be controversial, would give state regulators power to approve or deny each proposed health insurance rate, co-pay or deductible hike.

In just the last year, federal health reform and a new state law gave the California insurance commissioner more power and resources to review proposed rate hikes. Both are tools that former Insurance Commissioners Steve Poizner and his successor, Dave Jones, have used to full effect.

Story courtesy of our media partners at California Watch (A Project of the Center for Investigative Reporting)

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