Covered Calif. Seeks Consumer Data, Triggers Privacy Concerns


Health care stakeholders are concerned about Covered California's plans to collect and use private consumer data to address health care disparities in the state, the Sacramento Bee reports.


In contracts with health insurers, the state health insurance exchange requires health plans to work with Covered California "to determine how data can best be collected and used to support improving health equity."

The exchange seeks to reduce health disparities across:

  • Disability status;
  • Ethnicity;
  • Gender;
  • Gender identity;
  • Primary language;
  • Race; and
  • Sexual orientation.

Covered California Executive Director Peter Lee earlier this year said that the exchange seeks to be "a results-driven organization, including looking at how we are promoting better health and health equity while lowering costs for all Californians."

Privacy Concerns

Although Covered California said its insurer contracts do not violate HIPAA privacy rules and regulations, some experts think efforts to collect private data could be problematic for the exchange.

Sally Pipes, president of the Pacific Research Institute, said collecting such data puts exchange officials on a path to "a place that they definitely should not be going." She said the task of collecting such information should be handled by research institutions.

Pipes added that "[t]he more information people have to give out, the more room there is for fraudulent activity."

In addition, Emily Rusch -- state director for the California Public Interest Research Group -- said, "We support the sharing of this information if and only if this information is aggregated and de-identified when the insurers provide it to the exchange, so that individual consumer information is kept confidential."

Stephen Shivinsky -- spokesperson for Blue Shield of California -- said the insurer would not release enrollee-specific confidential data unless the exchange is able to demonstrate that it is lawful to do so.

Meanwhile, Christian Stenrud -- spokesperson for Kaiser Permanente -- said the insurer has not yet had detailed conversations with the exchange about providing personal data. However, any data that the insurer provides to Covered California will be de-identified and comply with all federal and state laws, according to Stenrud.

In addition, some insurers say they are willing to work to boost health equity in the state, but they want to receive financial incentives for doing so.

Stenrud said, "Data collection is only the first step," adding, "If we want to eliminate health disparities, health care payers like Covered California should reward health plans and delivery systems when they can show superior, or greatly improved, performance for populations that have historically shown poor health outcomes" (Cadelago, Sacramento Bee, 12/2).

Ernesto A Sanchez
It would be nice to have experts in health disparities perspectives on the issue of the use of consumer data and the existing laws/regulations that govern how that data can be used. Existing privacy laws tend to require that consumer data be used in a de-identified and aggregate ways to protect consumer privacy while still allowing the ability to measure health disparities amongst different population groups. CHCF should be able to find experts such as those in the Office of Health Equity within the CA Department of Public Health to provide factual analysis of how consumer data can be used to measure and improve health disparities rather than seeking opinions from paid thinktanks from either the right or left who have their own biased views. We expect better reporting and analysis from the healthline on a very important topic. Thanks for letting me put in my two-cents on the topic!!
Jonathan Savell
Covered California is not content to just offering low quality narrow network plans with limited competition in each county, but now wants to abuse your personal information. It is the California legislature that has created this monopolistic monster and should take action, but will never do so because nothing will stand in the way of the legislature giving away our tax dollars.
Clem Kadiddlehopper
The solution to this problem is legislative. I know that's never the answer. But what would happen if a law was passed declaring "Personally identifying information is under the exclusive copyright of the person identified by it. It may be transferred once, but no more, without explicit written consent (and written means on paper). Any personally identifiable information that is shared must be tagged with the source and all destinations. Upon a takedown request, the person issuing the takedown shall be provided with all sources and destinations of the information requested. Keeping information after a lawful takedown is received is a felony." Some laws like that, and our privacy will return. But such laws would be great for the people and bad for the billionaire business owners who exploit personal information. So it'll never happen until Americans stop voting for Democrats or Republicans.
Clem Kadiddlehopper
So you want sensitive customer information, from race and ethnicity to sexual orientation and gender identity. Hmmm. Sorry boy and girls it is none of your business what my sexual orientation is or if I am Mexican or White or my gender. The only thing you guys are doing is Kingdom Building and of course building a very large data base on every human in the United States

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