FROM THE FOUNDATION

Physician Supply and Demand in California

While physician supply has increased in recent years, California as a whole barely meets the national recommended minimum range. And future demand is expected to outpace supply due to a confluence of factors. Read details in a new CHCF Almanac report.

Where Big Money Goes in Medi-Cal Spending

Seven percent of Medi-Cal beneficiaries accounted for more than three-quarters of fee-for-service program expenditures in fiscal year 2008. This snapshot profiles this small but expensive population and uses the findings to suggest ways to slow spending growth.

Gauging the Physician Shortage in Medi-Cal

This report uses survey data to measure physician participation in the Medi-Cal program and examine differences across specialties and regions. It finds that low participation rates are a persistent problem and discusses the implications for low-income patients.

Health Plans

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07/29/2010

Editorial: End Brand-Name Rx Makers' Control of Market

The practice of allowing brand-name prescription drugmakers to pay makers of generic drugs to delay market entry of generic products should be stopped, a Washington Post editorial states. The editorial supports legislation before the U.S. Senate Appropriations Committee that would ban such practice for competitive reasons, concluding that consumers could wind up saving billions of dollars. Washington Post.

07/29/2010

HHS Clarifies Rules for Children's Health Care Insurance Policies

HHS has issued new rules on how health insurers can structure coverage for children's plans. The agency released the updated policy after hearing confusion about how insurers can offer children's insurance policies under the health reform law. The Hill, CQ HealthBeat.

07/29/2010

WellPoint Posts 4% Increase in Profit for Second Quarter

On Wednesday, health insurance company WellPoint reported a second-quarter profit increase of 4% on $722.4 million in revenue, a 26% increase in earnings from the same period in 2009. However, CEO Angela Braly said she expects losses in California -- possibly at more than $100 million -- because of obstacles preventing Anthem Blue Cross from going through with planned rate increases. Braly called the situation in California "unsustainable" and said there is need for rate hikes to cover the growth in medical costs. Los Angeles Times, Indianapolis Star.

07/28/2010

Lawmakers Stump for Role of Insurance Agents in Reform

Last week, a 25-member bipartisan group of lawmakers sent a letter to HHS Secretary Kathleen Sebelius calling for the soon-to-be launched health insurance exchanges and federal health care website to include information on health insurance agents and brokers. The lawmakers wrote that agents and brokers have a role "both inside and outside health insurance exchanges" and could serve as a consumer resource when the government's Web portal -- healthcare.gov -- is finalized on Oct. 1. Politico.

07/27/2010

Anthem Blue Cross Hires New President Following Predecessor's Departure

Pam Kehaly, a former Aetna executive, has been named president and general manager of Anthem Blue Cross after former president Leslie Margolin resigned last week. Anthem has faced intense criticism this year over proposed rate hikes. Los Angeles Times, Sacramento Bee.

07/27/2010

Kaiser, Anthem Show Little Interest in New Federal High-Risk Pool

Two major California insurers said they do not plan to participate in the new high-risk health insurance pool that the state is creating under the federal health reform law. Both insurers already participate in the state's existing high-risk pool. Sacramento Business Journal.

07/27/2010

SEIU Says Rival Union Deal Would Set Poor Precedent

Leaders of the Service Employees International Union Local 721 in Los Angeles are criticizing a contract proposal being voted on by the Engineers and Architects Association union that would have members of the engineers' union pay higher health care costs. SEIU Local 721 argues that the proposal contains "unprecedented and dangerous" concessions by union members. Health care costs in Los Angeles are expected to grow from $361 million to $514 million across five years, according to budget analysts, and city officials view the contract proposal as one way to rein in costs. Los Angeles Times.

07/26/2010

NAIC: Some Insurers No Longer Writing Plans for Kids' Coverage

Some insurers have stopped offering plans specifically for children because of the reform law's requirement that insurers cover kids regardless of pre-existing conditions, according to the National Association of Insurance Commissioners. The Hill's "Healthwatch" et al.

07/26/2010

Poizner Announces New E-mail Program Alerting Residents to Rate Hikes

California Insurance Commissioner Steve Poizner recently announced that residents can sign up to receive e-mails notifying them when health insurers file rate increases for individual health insurance policies. Modern Healthcare, California Department of Insurance release.

07/23/2010

BCBS Surpluses Higher Than Recommended, Report Says

A majority of 10 not-for-profit BlueCross BlueShield insurance plans from across the country had more than triple the amount of surplus funds than regulators recommend to ensure plan solvency, according to a Consumers Union report published on Thursday. The report recommends that states cap not-for-profit insurers' surpluses or consider large surpluses when deciding on potential rate increases. Reuters.

07/23/2010

Insurance Officials Say Medical-Loss Regulations Could Come by August

By next month, the National Association of Insurance Commissioners plans to have rules in place to address how health insurers can spend money collected from premiums. Some lawmakers are calling for tight restrictions. CQ HealthBeat, The Hill's "Healthwatch."

07/22/2010

Bill Would Establish New Ombudsman Office for Post-Reform Market

California lawmakers are reviewing a bill that would create an ombudsman office to help consumers navigate their health plans post-health care reform. Opponents contend that the duties of the proposed office already are performed by other agencies. Payers & Providers.

07/22/2010

Democrats Might Revisit Public Option for Insurance Exchanges

House Democrats plan to introduce a bill to create a government-run insurance plan through states' health insurance exchanges. The so-called public option was considered during the health reform debate and ultimately was dropped. Los Angeles Times, CongressDaily.

07/22/2010

Obama Administration Relaxes Rules on Claims for Denials of Insurance

The Obama administration's newly released regulations aim to make it easier for individuals to appeal denials of health insurance coverage. Under the new rules, states will be eligible for millions of dollars in federal funding to fortify consumer assistance agencies. Kaiser Health News/Washington Post.

07/21/2010

Anthem CEO Resigns From Post Following Rate Hike Controversy

A few months after Anthem Blue Cross drew fire over proposed rate increases, Leslie Margolin announced that she has stepped down as CEO of the company. Both Margolin and Anthem deny that her departure is related to the rate hikes. Los Angeles Times et al.

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