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"content": "\u003cp>Presidential candidates like to float solutions to long-standing problems. Making those solutions stick is another thing altogether.\u003c/p>\n\u003cp>When it comes to health care, the enactment of the Affordable Care Act, rather than tamping down chatter about how to insure people, seems only to have spurred more of it.\u003c/p>\n\u003cp>But you know what? There's a reason some problems are long-standing. They may have no easy solution. Or the solution isn't politically feasible. Or there's a solution that sounds good on the campaign trail but isn't likely to actually work.\u003c/p>\n\u003cp>In the first of a series of videos about health policy promises that sound like a good idea but maybe aren't, Julie Rovner explores why increasing competition in health insurance by allowing sales of policies across state lines might not be such a hot idea after all.\u003c/p>\n\u003cp>One of the seven planks outlined by Donald Trump in a health plan his campaign \u003ca href=\"http://www.npr.org/sections/health-shots/2016/03/03/469019745/trump-health-plan-recycles-gop-chestnuts-and-adds-a-populist-wrinkle\">released in March\u003c/a> calls for interstate sales of insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Watch and listen as Julie explains why selling insurance across state lines isn't all it's cracked up to be. Spoiler alert: Georgia, Maine and Wyoming already allow it, and insurers haven't taken advantage of the option.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Presidential candidates like to float solutions to long-standing problems. Making those solutions stick is another thing altogether.\u003c/p>\n\u003cp>When it comes to health care, the enactment of the Affordable Care Act, rather than tamping down chatter about how to insure people, seems only to have spurred more of it.\u003c/p>\n\u003cp>But you know what? There's a reason some problems are long-standing. They may have no easy solution. Or the solution isn't politically feasible. Or there's a solution that sounds good on the campaign trail but isn't likely to actually work.\u003c/p>\n\u003cp>In the first of a series of videos about health policy promises that sound like a good idea but maybe aren't, Julie Rovner explores why increasing competition in health insurance by allowing sales of policies across state lines might not be such a hot idea after all.\u003c/p>\n\u003cp>One of the seven planks outlined by Donald Trump in a health plan his campaign \u003ca href=\"http://www.npr.org/sections/health-shots/2016/03/03/469019745/trump-health-plan-recycles-gop-chestnuts-and-adds-a-populist-wrinkle\">released in March\u003c/a> calls for interstate sales of insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Watch and listen as Julie explains why selling insurance across state lines isn't all it's cracked up to be. Spoiler alert: Georgia, Maine and Wyoming already allow it, and insurers haven't taken advantage of the option.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California's Obamacare Premiums May Rise 8 Percent Next Year",
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"content": "\u003cp>California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases.\u003c/p>\n\u003caside class=\"pullquote alignright\">Final rates won’t be known until July after Covered California conducts private negotiations with health plans\u003c/aside>\n\u003cp>The projected rate increase in California, included in the \u003ca href=\"http://board.coveredca.com/meetings/2016/5-12/2016-17-CoveredCA-Proposed-Budget.pdf\" target=\"_blank\">exchange’s proposed annual budget\u003c/a>, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces.\u003c/p>\n\u003cp>Any increases in California, a closely watched state in the health law rollout, are sure to draw intense scrutiny during a presidential election. Republicans are quick to seize on rate hikes as further proof that President Barack Obama’s signature law isn’t doing enough to hold down health care costs for the average consumer.\u003c/p>\n\u003cp>Insurers in California have submitted initial rates for 2017, but the final figures won’t be known until July after state officials conduct private negotiations.\u003c/p>\n\u003cp>Peter Lee, executive director of Covered California, underscored that the estimate was preliminary but said some one-time factors under the Affordable Care Act mean “2017 will be an adjustment year” for rates.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We shouldn’t put too much focus on this 8 percent number when we will know the reality in two months,” Lee told California Healthline on Tuesday. “There are a number of reasons 2017 will have higher rate increases than the last few years. But we believe in California we won’t see the significant headwinds many other states are experiencing.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"Xh5FmUmlPmuJ7DvqU73CGLqck09caN8t\"]Lee said the expiration this year of two federal programs that have helped health insurers offset expensive medical claims and cover sick patients in general will affect premium rates across the country. In addition, he cited ever-increasing medical costs, particularly for expensive specialty drugs.\u003c/p>\n\u003cp>The nation’s largest health insurer, UnitedHealth Group, already has said it will exit all but a handful of state exchanges after suffering substantial losses on individual policies.\u003c/p>\n\u003cp>Lee declined to comment on whether UnitedHealth has submitted a bid to continue selling in Covered California next year.\u003c/p>\n\u003cp>Health-policy experts said the California rate projection mirrors an upward trend around the country as health insurers reassess their pricing and strategy under Obamacare.\u003c/p>\n\u003cp>“None of us should be surprised to see average rate increases that are slightly higher than last year,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. “It’s still really difficult to discern where we will end up.”\u003c/p>\n\u003cp>Robert Laszewski, a health care consultant in Alexandria, Virginia, and a frequent critic of Covered California, said Californians will be fortunate if the 8 percent projection holds up.\u003c/p>\n\u003cp>“That is not a troubling rate increase,” he said. “California is coming back toward the average. A bunch of states would die for just an 8 percent increase in 2017.”\u003c/p>\n\u003cp>A bigger concern, Laszewski said, is the tepid growth in Covered California’s enrollment and what that may mean for future premiums.\u003c/p>\n\u003cp>As part of its proposed budget for the next fiscal year, starting July 1, the state exchange expects its annual enrollment to grow by only 2 percent over the next year to 1.34 million. Covered California counts about 1.4 million as currently enrolled but that figure is expected to drop to 1.32 million as of June 30 through normal attrition as people get insurance elsewhere or drop coverage.\u003c/p>\n\u003cp>Sign-ups are crucial for keeping a diverse mix of enrollees and spreading the insurance costs across a pool of healthy and sick policyholders.\u003c/p>\n\u003cp>About 3 million Californians remain uninsured, but fewer than 1.4 million of them are eligible for premium subsidies under the Affordable Care Act, according to the exchange’s proposed budget.\u003c/p>\n\u003cp>[contextly_sidebar id=\"nFru5suNyUJbvUf5pa4fLByUhvOyuk0V\"]Lee said California already boasts one of the healthiest risk pools in the country, which insurers have cited as a main reason for the lower-than-average rate increases the past two years. He said the exchange signs up hundreds of thousands of new enrollees each year, but that’s offset by high turnover as many people leave the marketplace for job-based coverage, Medicare or Medicaid.\u003c/p>\n\u003cp>The average tenure of a Covered California enrollee is about 25 months, according to exchange data.\u003c/p>\n\u003cp>Over time, Covered California expects the gradual increases in the state’s minimum wage to $15 an hour could shift more low-income people from Medi-Cal, the state’s Medicaid program, to subsidized exchange policies as their pay increases. By 2020, the exchange expects to reach enrollment of 1.52 million.\u003c/p>\n\u003cp>“California grew very rapidly in the first few years and now we have reached a cruising altitude after three years. We are projecting modest net growth,” Lee said. “I think any questions about the sustainability [of exchanges] are just pure hot air.”\u003c/p>\n\u003cp>Covered California’s five-member board will discuss the proposed $308 million budget at a meeting Thursday and vote on it next month.\u003c/p>\n\u003cp>The proposed budget for 2017 is 8 percent lower than the current year budget, reflecting the slower enrollment growth and the fact that Covered California must operate next year without federal startup funds for the first time.\u003c/p>\n\u003cp>The exchange is planning to draw on $58 million in reserves for operations, and it wants to raise its surcharge on customer policies to 4 percent of premiums, up from 3.4 percent now, or $13.95 per member per month.\u003c/p>\n\u003cp>Covered California doesn’t receive money from the state’s general fund and relies on policyholder assessments to pay for marketing, service center operations and other expenses.\u003c/p>\n\u003cp>Health insurers have urged the exchange not to pass on any unnecessary costs to consumers.\u003c/p>\n\u003cp>[contextly_sidebar id=\"lRHYKQKJ0CMGRRDG5ZwtNzoEhBbgJplp\"]“Price is the number one factor impacting consumers when they enroll, so we must always keep an eye toward affordability,” said Charles Bacchi, chief executive of the California Association of Health Plans. “We urge Covered California to move cautiously before increasing this fee and look for cost savings.”\u003c/p>\n\u003cp>The exchange is proposing to spend $2 million to establish an ombudsman program to help resolve customer service problems.\u003c/p>\n\u003cp>Consumer groups have criticized Covered California for failing to fix long-standing enrollment and tax-related errors that have blocked people from getting coverage and left some with unforeseen bills.\u003c/p>\n\u003cp>Last month, \u003ca href=\"http://californiahealthline.org/news/lawmakers-demand-quick-action-on-covered-california-pregnancy-snafu/\" target=\"_blank\">federal lawmakers called on Covered California\u003c/a> to resolve a problem that has caused some pregnant women to be dropped from their health plans and enrolled in Medi-Cal without notice or consent.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Absolutely, some consumers have had problems with customer service,” Lee said. “We are making significant investments to do better.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases.\u003c/p>\n\u003caside class=\"pullquote alignright\">Final rates won’t be known until July after Covered California conducts private negotiations with health plans\u003c/aside>\n\u003cp>The projected rate increase in California, included in the \u003ca href=\"http://board.coveredca.com/meetings/2016/5-12/2016-17-CoveredCA-Proposed-Budget.pdf\" target=\"_blank\">exchange’s proposed annual budget\u003c/a>, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces.\u003c/p>\n\u003cp>Any increases in California, a closely watched state in the health law rollout, are sure to draw intense scrutiny during a presidential election. Republicans are quick to seize on rate hikes as further proof that President Barack Obama’s signature law isn’t doing enough to hold down health care costs for the average consumer.\u003c/p>\n\u003cp>Insurers in California have submitted initial rates for 2017, but the final figures won’t be known until July after state officials conduct private negotiations.\u003c/p>\n\u003cp>Peter Lee, executive director of Covered California, underscored that the estimate was preliminary but said some one-time factors under the Affordable Care Act mean “2017 will be an adjustment year” for rates.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We shouldn’t put too much focus on this 8 percent number when we will know the reality in two months,” Lee told California Healthline on Tuesday. “There are a number of reasons 2017 will have higher rate increases than the last few years. But we believe in California we won’t see the significant headwinds many other states are experiencing.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Lee said the expiration this year of two federal programs that have helped health insurers offset expensive medical claims and cover sick patients in general will affect premium rates across the country. In addition, he cited ever-increasing medical costs, particularly for expensive specialty drugs.\u003c/p>\n\u003cp>The nation’s largest health insurer, UnitedHealth Group, already has said it will exit all but a handful of state exchanges after suffering substantial losses on individual policies.\u003c/p>\n\u003cp>Lee declined to comment on whether UnitedHealth has submitted a bid to continue selling in Covered California next year.\u003c/p>\n\u003cp>Health-policy experts said the California rate projection mirrors an upward trend around the country as health insurers reassess their pricing and strategy under Obamacare.\u003c/p>\n\u003cp>“None of us should be surprised to see average rate increases that are slightly higher than last year,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. “It’s still really difficult to discern where we will end up.”\u003c/p>\n\u003cp>Robert Laszewski, a health care consultant in Alexandria, Virginia, and a frequent critic of Covered California, said Californians will be fortunate if the 8 percent projection holds up.\u003c/p>\n\u003cp>“That is not a troubling rate increase,” he said. “California is coming back toward the average. A bunch of states would die for just an 8 percent increase in 2017.”\u003c/p>\n\u003cp>A bigger concern, Laszewski said, is the tepid growth in Covered California’s enrollment and what that may mean for future premiums.\u003c/p>\n\u003cp>As part of its proposed budget for the next fiscal year, starting July 1, the state exchange expects its annual enrollment to grow by only 2 percent over the next year to 1.34 million. Covered California counts about 1.4 million as currently enrolled but that figure is expected to drop to 1.32 million as of June 30 through normal attrition as people get insurance elsewhere or drop coverage.\u003c/p>\n\u003cp>Sign-ups are crucial for keeping a diverse mix of enrollees and spreading the insurance costs across a pool of healthy and sick policyholders.\u003c/p>\n\u003cp>About 3 million Californians remain uninsured, but fewer than 1.4 million of them are eligible for premium subsidies under the Affordable Care Act, according to the exchange’s proposed budget.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Lee said California already boasts one of the healthiest risk pools in the country, which insurers have cited as a main reason for the lower-than-average rate increases the past two years. He said the exchange signs up hundreds of thousands of new enrollees each year, but that’s offset by high turnover as many people leave the marketplace for job-based coverage, Medicare or Medicaid.\u003c/p>\n\u003cp>The average tenure of a Covered California enrollee is about 25 months, according to exchange data.\u003c/p>\n\u003cp>Over time, Covered California expects the gradual increases in the state’s minimum wage to $15 an hour could shift more low-income people from Medi-Cal, the state’s Medicaid program, to subsidized exchange policies as their pay increases. By 2020, the exchange expects to reach enrollment of 1.52 million.\u003c/p>\n\u003cp>“California grew very rapidly in the first few years and now we have reached a cruising altitude after three years. We are projecting modest net growth,” Lee said. “I think any questions about the sustainability [of exchanges] are just pure hot air.”\u003c/p>\n\u003cp>Covered California’s five-member board will discuss the proposed $308 million budget at a meeting Thursday and vote on it next month.\u003c/p>\n\u003cp>The proposed budget for 2017 is 8 percent lower than the current year budget, reflecting the slower enrollment growth and the fact that Covered California must operate next year without federal startup funds for the first time.\u003c/p>\n\u003cp>The exchange is planning to draw on $58 million in reserves for operations, and it wants to raise its surcharge on customer policies to 4 percent of premiums, up from 3.4 percent now, or $13.95 per member per month.\u003c/p>\n\u003cp>Covered California doesn’t receive money from the state’s general fund and relies on policyholder assessments to pay for marketing, service center operations and other expenses.\u003c/p>\n\u003cp>Health insurers have urged the exchange not to pass on any unnecessary costs to consumers.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“Price is the number one factor impacting consumers when they enroll, so we must always keep an eye toward affordability,” said Charles Bacchi, chief executive of the California Association of Health Plans. “We urge Covered California to move cautiously before increasing this fee and look for cost savings.”\u003c/p>\n\u003cp>The exchange is proposing to spend $2 million to establish an ombudsman program to help resolve customer service problems.\u003c/p>\n\u003cp>Consumer groups have criticized Covered California for failing to fix long-standing enrollment and tax-related errors that have blocked people from getting coverage and left some with unforeseen bills.\u003c/p>\n\u003cp>Last month, \u003ca href=\"http://californiahealthline.org/news/lawmakers-demand-quick-action-on-covered-california-pregnancy-snafu/\" target=\"_blank\">federal lawmakers called on Covered California\u003c/a> to resolve a problem that has caused some pregnant women to be dropped from their health plans and enrolled in Medi-Cal without notice or consent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Covered California Helps Keep Premiums in Check, UC Berkeley Study Finds",
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"content": "\u003cp>Covered California's Obamacare exchange has helped consumers get a better deal on health insurance in part because of its negotiating power -- power that other Affordable Care Act marketplaces don't have -- according to a \u003ca href=\"http://content.healthaffairs.org/content/35/5/880.abstract?rss=1&related-urls=yes&legid=healthaff;35/5/880\" target=\"_blank\">new analysis\u003c/a> published Monday.\u003c/p>\n\u003cp>California is one of the few states that created an \"active purchaser\" exchange, where the marketplace negotiates premiums and benefits with insurers. Most other states, as well as the federal healthcare.gov, accept any plan that seeks to participate.\u003c/p>\n\u003cp>Researchers compared California and New York and looked at the growth in premiums in 2014 and 2015 in the face of hospital competition and health plan competition.\u003c/p>\n\u003cp>While less hospital competition was associated with higher premium increases in both states, the effect of reduced insurance plan competition played out differently.\u003c/p>\n\u003cp>In New York, less competition in insurance resulted in higher premium growth. But in California, similar \"low competition\" areas had a slower rise in premiums.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Richard Scheffler, a health economist at UC Berkeley and lead author of the study, said one reason for the slower growth is California's negotiating power.\u003c/p>\n\u003cp>\"What happens here is an exchange that's competitive, but is helped by regulation,\" Scheffler said, \"that clears up the market in the sense that consumers can make apples-to-apples choices.\"\u003c/p>\n\u003cp>Scheffler called it \"a problem\" that in New York, there were so many plans available \"that it became very difficult, if not impossible, for a lot of consumers to be able to make good choices.\"\u003c/p>\n\u003cp>The two states' experiences highlight a division in the two visions in running an exchange, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>\"The approach of not negotiating, of just letting any insurer sell its wares, some would call it 'the free market,' \" Wright said. \"We call it the 'flea market' approach.\"\u003c/p>\n\u003cp>He likened Covered California to a human resources department for the \"rest of us that don't work at Google.\"\u003c/p>\n\u003cp>Covered California plans \u003ca href=\"https://www.coveredca.com/PDFs/2016-Health-Benefits-table.pdf\" target=\"_blank\">all have identical benefits\u003c/a>. The only difference between plans are price and the hospital and physician networks, making comparison straightforward.\u003c/p>\n\u003cp>\"We create a marketplace where consumers are in the driving seat,\" said Covered California executive director Peter Lee. \"[In] New York City, the consumers would be picking between 50 different products. What's the difference between them? Tweaks on co-insurance and insurance babble that most consumers don't understand.\"\u003c/p>\n\u003cp>\"The folklore in economics is that more choice is better,\" economist Scheffler said. If offered too many choices in health insurance, \"it becomes too much for consumers to look at and analyze and really absorb. So you're better off having a smaller number of choices to plan on and pick from.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scheffler and his co-authors say that the Affordable Care Act marketplaces provide a \"natural laboratory\" to continue studying the effects of competition among hospitals and insurers.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Covered California's Obamacare exchange has helped consumers get a better deal on health insurance in part because of its negotiating power -- power that other Affordable Care Act marketplaces don't have -- according to a \u003ca href=\"http://content.healthaffairs.org/content/35/5/880.abstract?rss=1&related-urls=yes&legid=healthaff;35/5/880\" target=\"_blank\">new analysis\u003c/a> published Monday.\u003c/p>\n\u003cp>California is one of the few states that created an \"active purchaser\" exchange, where the marketplace negotiates premiums and benefits with insurers. Most other states, as well as the federal healthcare.gov, accept any plan that seeks to participate.\u003c/p>\n\u003cp>Researchers compared California and New York and looked at the growth in premiums in 2014 and 2015 in the face of hospital competition and health plan competition.\u003c/p>\n\u003cp>While less hospital competition was associated with higher premium increases in both states, the effect of reduced insurance plan competition played out differently.\u003c/p>\n\u003cp>In New York, less competition in insurance resulted in higher premium growth. But in California, similar \"low competition\" areas had a slower rise in premiums.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Richard Scheffler, a health economist at UC Berkeley and lead author of the study, said one reason for the slower growth is California's negotiating power.\u003c/p>\n\u003cp>\"What happens here is an exchange that's competitive, but is helped by regulation,\" Scheffler said, \"that clears up the market in the sense that consumers can make apples-to-apples choices.\"\u003c/p>\n\u003cp>Scheffler called it \"a problem\" that in New York, there were so many plans available \"that it became very difficult, if not impossible, for a lot of consumers to be able to make good choices.\"\u003c/p>\n\u003cp>The two states' experiences highlight a division in the two visions in running an exchange, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>\"The approach of not negotiating, of just letting any insurer sell its wares, some would call it 'the free market,' \" Wright said. \"We call it the 'flea market' approach.\"\u003c/p>\n\u003cp>He likened Covered California to a human resources department for the \"rest of us that don't work at Google.\"\u003c/p>\n\u003cp>Covered California plans \u003ca href=\"https://www.coveredca.com/PDFs/2016-Health-Benefits-table.pdf\" target=\"_blank\">all have identical benefits\u003c/a>. The only difference between plans are price and the hospital and physician networks, making comparison straightforward.\u003c/p>\n\u003cp>\"We create a marketplace where consumers are in the driving seat,\" said Covered California executive director Peter Lee. \"[In] New York City, the consumers would be picking between 50 different products. What's the difference between them? Tweaks on co-insurance and insurance babble that most consumers don't understand.\"\u003c/p>\n\u003cp>\"The folklore in economics is that more choice is better,\" economist Scheffler said. If offered too many choices in health insurance, \"it becomes too much for consumers to look at and analyze and really absorb. So you're better off having a smaller number of choices to plan on and pick from.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scheffler and his co-authors say that the Affordable Care Act marketplaces provide a \"natural laboratory\" to continue studying the effects of competition among hospitals and insurers.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Read this story in English: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/09/medi-cal-expands-to-undocumented-children-heres-how-it-works/\" target=\"_blank\">Medi-Cal Expands to Undocumented Children. Here's How It Works\u003c/a>\u003c/em>\u003c/p>\n\u003cp>En poco tiempo, California comenzará a proveer cobertura completa de Medi-Cal para los niños de familias de bajos ingresos, independientemente de su status migratorio.\u003c/p>\n\u003cp>Dependiendo de a quien le pregunte, un número de entre 170.000 y 250.000 niños que viven en California, y están en el país indocumentados, calificarán.\u003c/p>\n\u003cp>Si piensa que su hijo calificará, o conoce a un padre cuyo hijo pueda ser elegible, oficiales de salud y defensores del cuidado de salud tienen un simple mensaje para usted: tome medidas ya. “Regístrese ahora”, dice Rachel Vizcarra, asistente de programa de la UFW Foundation en Bakersfield, que está ayudando a familias a pre registrarse. “Si lo hace, sus niños serán registrados automáticamente en el programa”.\u003c/p>\n\u003cp>Oficiales del estado esperan que la cobertura comience el 16 de mayo. Pero como el cambio de política requiere de ajustes de programación complejos en los sistemas informáticos de los condados y del estado, puede ocurrir que la implementación se atrase, dice Tony Cava, del Departamento de Servicios de Salud estatal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No importa cuándo ocurra, los niños elegibles tendrán cobertura retroactiva al primer día de ese mes, dice. Por ejemplo, si el cambio entra en vigencia el 16 de mayo, la cobertura estará vigente desde el 1 de mayo.\u003c/p>\n\u003cp>Carolina Moran, de Canoga Park, espera con ansiedad para llevar a Lizeth, su hija de 14 años, al médico una vez que ella se convierta en elegible para los beneficios completos de Medi-Cal.\u003c/p>\n\u003cp>Lizeth tuvo que ir a una sala de emergencias en enero, a causa de un fuerte golpe en la cabeza en una cancha de fútbol, pero no pudo ver al doctor para una cita de seguimiento porque “no podemos pagarla. Deberíamos haber pagado de nuestro bolsillo”, dice Moran.\u003c/p>\n\u003cp>Lo primero que hará Moran será llevar a Lizeth para un examen físico “y estar segura que sus vacunas están al día”, dice. “También necesita el relleno para cinco caries”.\u003c/p>\n\u003cp>La elegibilidad para el Medi-Cal se basa en el ingreso familiar, y niños menores de 19 años califican a un nivel de ingresos más alto que los adultos. Son elegibles para Medi-Cal si el ingreso de la familia es menos del 266 por ciento del Nivel Federal de Pobreza, o alrededor de $53.600 para una familia de tres y $75.650 para una familia de cinco.\u003c/p>\n\u003cp>Actualmente, los niños y adultos que están en el país indocumentados califican para una cobertura de Medi-Cal limitada, llamada de alcance restringido, que cubre emergencias y servicios relacionados con el embarazo.\u003c/p>\n\u003cp>Aunque esto pueda parecer contrario a la intuición, defensores del cuidado de salud y el estado quieren que usted registre a sus niños para el Medi-Cal restringido ahora, en preparación para la disponibilidad de los beneficios completos del Medi-Cal.\u003c/p>\n\u003cp>La idea es que, cuando ocurra el cambio, los niños que califican serán automáticamente transferidos a la cobertura completa del Medi-Cal “en pocos días” y sin una aplicación adicional, dice Cava.\u003c/p>\n\u003cp>El estado estima que hay alrededor de 115.000 niños inmigrantes sin papeles que ya tienen Medi-Cal restringido.\u003c/p>\n\u003cp>Si su niño no tiene seguro, regístrelo en el Medi-Cal restringido ahora. Incluso si su hijo tiene cobertura a través de otro programa existente —como el Programa de Salud Infantil de Kaiser Permanente o cobertura de salud del condado— todavía debería registrarlo para el Medi-Cal restringido ahora, dice Mark Diel, CEO de California Coverage & Health Initiatives (CCHI), una red de inscripción y difusión en todo el estado.\u003c/p>\n\u003cp>Esto se debe a que esos niños eventualmente se convertirán en no elegibles para esos programas después de que sean elegibles para el Medi-Cal completo. (No saque a su niño de otro programa hasta que no confirme si es elegible para el Medi-Cal de alcance completo, y que haya sido aprobado, dice Cava).\u003c/p>\n\u003cp>Pero advierte: la aplicación del Medi-Cal es larga y complicada. Para completarla, necesitará proveer un certificado de nacimiento, prueba de una dirección local, prueba de identidad e información sobre ingresos, dice Vizcarra. Se pueden usar pasaportes y partidas de nacimiento de otros países.\u003c/p>\n\u003cp>“Hágalo con un reclutador local en vez de tratar de hacerlo por su cuenta,” dice Diel. “Es mucho más probable que aprueben su aplicación”.\u003c/p>\n\u003cp>La ayuda de clínicas locales de salud y grupos comunitarios es gratis. En internet, visite www.cchi4families.org/find-help para recursos locales.\u003c/p>\n\u003cp>Defensores y oficiales del estado también quieren que usted sepa que inscribir a sus hijos no debería dar lugar a consecuencias negativas de inmigración para usted —o para otros miembros de su familia— que pueden no tener un estatus legal.\u003c/p>\n\u003cp>“Nada de la información que se recoge es compartida con autoridades de inmigración”, dice María Romero-Mora, de CCHI.\u003c/p>\n\u003cp>Una vez que sus niños están en el Medi-Cal de alcance restringido, y eventualmente dentro del Medi-Cal completo, necesitará actuar. Revise las cartas que lleguen por correo antes y después de la transición, explicando sus opciones.\u003c/p>\n\u003cp>\u003cstrong>ELIJA UN PLAN\u003c/strong>: una vez que ocurra la transición al Medi-Cal completo, tendrá 60 días para elegir un plan de cuidado de salud gerenciado para niños que ya están inscriptos en el Medi-Cal restringido. Si no elige un plan, el estado le asignará uno, dice Cava.\u003c/p>\n\u003cp>Los padres de niños que no están en el Medi-Cal restringido al momento del cambio, y que los inscribieron después, tendrán 30 días para elegir un plan, agrega.\u003c/p>\n\u003cp>Si vive en uno de los 22 condados en donde el cuidado de Medi-Cal es operado por un único County Organized Health System, los niños serán registrados automáticamente en ese plan, dice Cava.\u003c/p>\n\u003cp>En todos los casos, hasta que se elige un plan —o se asigna uno— los niños recibirán cobertura a través del programa de pago por servicio (fee-for-service) del Medi-Cal.\u003c/p>\n\u003cp>\u003cstrong>PAGUE LAS PRIMAS\u003c/strong>: Medi-Cal es gratuito (libre de prima, es decir de una cuota mensual) para los niños hasta 160 por ciento del Nivel Federal de Pobreza, pero deberá pagar una prima si el ingreso familiar se encuentra entre 160 por ciento y 266 por ciento. La prima es de $13 por mes por cada niño, con un máximo de $39 por familia.\u003c/p>\n\u003cp>Los niños en los planes del Medi-Cal no tienen co pagos por cuidado médico.\u003c/p>\n\u003cp>\u003cstrong>RENUEVE\u003c/strong>: usted tendrá que participar en el proceso de renovación anual de Medi-Cal para asegurar que sus hijos sigan siendo elegibles y se mantengan inscriptos.\u003c/p>\n\u003cp>Finalmente, si usted no inscribe a su hijo en el Medi-Cal restringido antes del cambio, puede aplicar para beneficios completos después —en cualquier momento del año— en la oficina de servicios humanos de su condado, a través de una organización comunitaria o en el sitio de internet de Covered California, \u003ca href=\"http://www.CoveredCa.com\">www.CoveredCa.com\u003c/a>\u003c/p>\n\u003cp>En Canoga Park, Moran dice que tener a Lizeth en el Medi-Cal le dará a la familia una gran seguridad financiera. Lizeth está de acuerdo.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Me preocupa si tengo que ir a un chequeo, porque le va a costar dinero a mis padres, y a veces no tienen el dinero para pagarlo\", dice la estudiante de noveno grado.\u003c/p>\n\n",
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"excerpt": "Entrará en vigencia una nueva ley del programa estatal de cuidado de salud de bajos ingresos para los niños en EE.UU. sin papeles. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Read this story in English: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/09/medi-cal-expands-to-undocumented-children-heres-how-it-works/\" target=\"_blank\">Medi-Cal Expands to Undocumented Children. Here's How It Works\u003c/a>\u003c/em>\u003c/p>\n\u003cp>En poco tiempo, California comenzará a proveer cobertura completa de Medi-Cal para los niños de familias de bajos ingresos, independientemente de su status migratorio.\u003c/p>\n\u003cp>Dependiendo de a quien le pregunte, un número de entre 170.000 y 250.000 niños que viven en California, y están en el país indocumentados, calificarán.\u003c/p>\n\u003cp>Si piensa que su hijo calificará, o conoce a un padre cuyo hijo pueda ser elegible, oficiales de salud y defensores del cuidado de salud tienen un simple mensaje para usted: tome medidas ya. “Regístrese ahora”, dice Rachel Vizcarra, asistente de programa de la UFW Foundation en Bakersfield, que está ayudando a familias a pre registrarse. “Si lo hace, sus niños serán registrados automáticamente en el programa”.\u003c/p>\n\u003cp>Oficiales del estado esperan que la cobertura comience el 16 de mayo. Pero como el cambio de política requiere de ajustes de programación complejos en los sistemas informáticos de los condados y del estado, puede ocurrir que la implementación se atrase, dice Tony Cava, del Departamento de Servicios de Salud estatal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No importa cuándo ocurra, los niños elegibles tendrán cobertura retroactiva al primer día de ese mes, dice. Por ejemplo, si el cambio entra en vigencia el 16 de mayo, la cobertura estará vigente desde el 1 de mayo.\u003c/p>\n\u003cp>Carolina Moran, de Canoga Park, espera con ansiedad para llevar a Lizeth, su hija de 14 años, al médico una vez que ella se convierta en elegible para los beneficios completos de Medi-Cal.\u003c/p>\n\u003cp>Lizeth tuvo que ir a una sala de emergencias en enero, a causa de un fuerte golpe en la cabeza en una cancha de fútbol, pero no pudo ver al doctor para una cita de seguimiento porque “no podemos pagarla. Deberíamos haber pagado de nuestro bolsillo”, dice Moran.\u003c/p>\n\u003cp>Lo primero que hará Moran será llevar a Lizeth para un examen físico “y estar segura que sus vacunas están al día”, dice. “También necesita el relleno para cinco caries”.\u003c/p>\n\u003cp>La elegibilidad para el Medi-Cal se basa en el ingreso familiar, y niños menores de 19 años califican a un nivel de ingresos más alto que los adultos. Son elegibles para Medi-Cal si el ingreso de la familia es menos del 266 por ciento del Nivel Federal de Pobreza, o alrededor de $53.600 para una familia de tres y $75.650 para una familia de cinco.\u003c/p>\n\u003cp>Actualmente, los niños y adultos que están en el país indocumentados califican para una cobertura de Medi-Cal limitada, llamada de alcance restringido, que cubre emergencias y servicios relacionados con el embarazo.\u003c/p>\n\u003cp>Aunque esto pueda parecer contrario a la intuición, defensores del cuidado de salud y el estado quieren que usted registre a sus niños para el Medi-Cal restringido ahora, en preparación para la disponibilidad de los beneficios completos del Medi-Cal.\u003c/p>\n\u003cp>La idea es que, cuando ocurra el cambio, los niños que califican serán automáticamente transferidos a la cobertura completa del Medi-Cal “en pocos días” y sin una aplicación adicional, dice Cava.\u003c/p>\n\u003cp>El estado estima que hay alrededor de 115.000 niños inmigrantes sin papeles que ya tienen Medi-Cal restringido.\u003c/p>\n\u003cp>Si su niño no tiene seguro, regístrelo en el Medi-Cal restringido ahora. Incluso si su hijo tiene cobertura a través de otro programa existente —como el Programa de Salud Infantil de Kaiser Permanente o cobertura de salud del condado— todavía debería registrarlo para el Medi-Cal restringido ahora, dice Mark Diel, CEO de California Coverage & Health Initiatives (CCHI), una red de inscripción y difusión en todo el estado.\u003c/p>\n\u003cp>Esto se debe a que esos niños eventualmente se convertirán en no elegibles para esos programas después de que sean elegibles para el Medi-Cal completo. (No saque a su niño de otro programa hasta que no confirme si es elegible para el Medi-Cal de alcance completo, y que haya sido aprobado, dice Cava).\u003c/p>\n\u003cp>Pero advierte: la aplicación del Medi-Cal es larga y complicada. Para completarla, necesitará proveer un certificado de nacimiento, prueba de una dirección local, prueba de identidad e información sobre ingresos, dice Vizcarra. Se pueden usar pasaportes y partidas de nacimiento de otros países.\u003c/p>\n\u003cp>“Hágalo con un reclutador local en vez de tratar de hacerlo por su cuenta,” dice Diel. “Es mucho más probable que aprueben su aplicación”.\u003c/p>\n\u003cp>La ayuda de clínicas locales de salud y grupos comunitarios es gratis. En internet, visite www.cchi4families.org/find-help para recursos locales.\u003c/p>\n\u003cp>Defensores y oficiales del estado también quieren que usted sepa que inscribir a sus hijos no debería dar lugar a consecuencias negativas de inmigración para usted —o para otros miembros de su familia— que pueden no tener un estatus legal.\u003c/p>\n\u003cp>“Nada de la información que se recoge es compartida con autoridades de inmigración”, dice María Romero-Mora, de CCHI.\u003c/p>\n\u003cp>Una vez que sus niños están en el Medi-Cal de alcance restringido, y eventualmente dentro del Medi-Cal completo, necesitará actuar. Revise las cartas que lleguen por correo antes y después de la transición, explicando sus opciones.\u003c/p>\n\u003cp>\u003cstrong>ELIJA UN PLAN\u003c/strong>: una vez que ocurra la transición al Medi-Cal completo, tendrá 60 días para elegir un plan de cuidado de salud gerenciado para niños que ya están inscriptos en el Medi-Cal restringido. Si no elige un plan, el estado le asignará uno, dice Cava.\u003c/p>\n\u003cp>Los padres de niños que no están en el Medi-Cal restringido al momento del cambio, y que los inscribieron después, tendrán 30 días para elegir un plan, agrega.\u003c/p>\n\u003cp>Si vive en uno de los 22 condados en donde el cuidado de Medi-Cal es operado por un único County Organized Health System, los niños serán registrados automáticamente en ese plan, dice Cava.\u003c/p>\n\u003cp>En todos los casos, hasta que se elige un plan —o se asigna uno— los niños recibirán cobertura a través del programa de pago por servicio (fee-for-service) del Medi-Cal.\u003c/p>\n\u003cp>\u003cstrong>PAGUE LAS PRIMAS\u003c/strong>: Medi-Cal es gratuito (libre de prima, es decir de una cuota mensual) para los niños hasta 160 por ciento del Nivel Federal de Pobreza, pero deberá pagar una prima si el ingreso familiar se encuentra entre 160 por ciento y 266 por ciento. 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"content": "\u003cp>Combine years of delay, ever-changing rules and requirements, state and federal red tape, and a once mighty company now in deep financial trouble, and what do you get?\u003c/p>\n\u003cp>In California’s case, the junking of a $179 million computer modernization project to process claims for Medi-Cal, the state’s health-payment program for low-income residents.\u003c/p>\n\u003cp>The project, put out to bid in 2007 and still far from completion, was finally put to rest on Monday when the state Department of Health Care Services announced a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Settlement%20Agreement%2003212016%201930%20FINAL%20web.pdf\" target=\"_blank\">legal settlement\u003c/a> with Xerox Corp., the project contractor, under which Xerox will pay the state approximately $120 million.\u003c/p>\n\u003cp>That means Medi-Cal’s existing computer system – creaky, patched-together, and decades old - will continue to operate for however long it takes the state to contract out and build a replacement.\u003c/p>\n\u003cp>According to the settlement, Xerox will continue to run the existing system until 2019.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The DHCS is putting a bright face on the project’s demise, calling it, in a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/Xerox_Settlement.aspx\" target=\"_blank\">press release\u003c/a> issued Monday, an “opportunity” to reevaluate current needs. A fresh start, it went on, will ensure “modern, robust and sustainable system.”\u003c/p>\n\u003cp>DHCS noted it's not the only state with such problems: “Many other states … have adjusted their strategies” toward their Medicaid computer systems, the release said. (Medi-Cal is California’s version of Medicaid.)\u003c/p>\n\u003cp>Indeed, several parties in Texas and Alaska, both public and private, have sued the Xerox subsidiary Xerox State Healthcare over contract problems.\u003c/p>\n\u003cp>The department declined to comment beyond the press release. The settlement requires that DHCS and Xerox both approve in advance any public statement for the next 30 days.\u003c/p>\n\u003cp>In a statement, Xerox said the settlement agreement finalizes the announcement it made last fall \"that it did not expect to complete implementation of the Health Enterprise Platform in California.\" Xerox added that it is \"pleased to work with DHCS to continue processing Medi-Cal claims through September 2019.\"\u003c/p>\n\u003cp>California’s drawn-out competition for the project began in 2007. Xerox won the contract in 2010. By 2012, the project was already in trouble. Delays caused the state to impose on Xerox a “\u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/Documents/Legislative%20Reports/CAMMIS_Quarterly_July-2012.pdf\" target=\"_blank\">corrective action plan\u003c/a>.”\u003c/p>\n\u003cp>Originally scheduled for completion by the end of this year, the project isn’t close to done, the settlement indicates.\u003c/p>\n\u003cp>Whenever government computer systems fall behind schedule, which is common, critics blame red tape. In this case, the massive Medi-Cal replacement contract with Xerox was inked just five days before President Obama signed the Affordable Care Act into law. As new regulations under the law worked their way through the health care system, requirements for the Medi-Cal project continued to change.\u003c/p>\n\u003cp>Compounding matters, Xerox fell into deep trouble. Its stock has lagged far behind the market in general. The company is under pressure from investor activist Carl Icahn. Late last year, Xerox said it would wind down its Medicaid computer systems business in California and Montana, take a $385 million charge against earnings, and “focus on profitable market segments.” That meant the end of the California project.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/downloads/mmisfacsr.pdf\" target=\"_blank\">Several companies \u003c/a>compete in the Medicaid system market. As of February, Xerox was the number-two provider, covering 11 states. The leader, HP Enterprise Systems, covers 18.\u003c/p>\n\u003cp>Xerox will pay about $103 million in cash, provide computer hardware and software worth $15 million, and abandon payment claims worth roughly $5 million more.\u003c/p>\n\u003cp>DHCS has reported it had paid Xerox $9 million for the replacement system, $8.1 million of that with federal funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Combine years of delay, ever-changing rules and requirements, state and federal red tape, and a once mighty company now in deep financial trouble, and what do you get?\u003c/p>\n\u003cp>In California’s case, the junking of a $179 million computer modernization project to process claims for Medi-Cal, the state’s health-payment program for low-income residents.\u003c/p>\n\u003cp>The project, put out to bid in 2007 and still far from completion, was finally put to rest on Monday when the state Department of Health Care Services announced a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Settlement%20Agreement%2003212016%201930%20FINAL%20web.pdf\" target=\"_blank\">legal settlement\u003c/a> with Xerox Corp., the project contractor, under which Xerox will pay the state approximately $120 million.\u003c/p>\n\u003cp>That means Medi-Cal’s existing computer system – creaky, patched-together, and decades old - will continue to operate for however long it takes the state to contract out and build a replacement.\u003c/p>\n\u003cp>According to the settlement, Xerox will continue to run the existing system until 2019.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The DHCS is putting a bright face on the project’s demise, calling it, in a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/Xerox_Settlement.aspx\" target=\"_blank\">press release\u003c/a> issued Monday, an “opportunity” to reevaluate current needs. A fresh start, it went on, will ensure “modern, robust and sustainable system.”\u003c/p>\n\u003cp>DHCS noted it's not the only state with such problems: “Many other states … have adjusted their strategies” toward their Medicaid computer systems, the release said. (Medi-Cal is California’s version of Medicaid.)\u003c/p>\n\u003cp>Indeed, several parties in Texas and Alaska, both public and private, have sued the Xerox subsidiary Xerox State Healthcare over contract problems.\u003c/p>\n\u003cp>The department declined to comment beyond the press release. The settlement requires that DHCS and Xerox both approve in advance any public statement for the next 30 days.\u003c/p>\n\u003cp>In a statement, Xerox said the settlement agreement finalizes the announcement it made last fall \"that it did not expect to complete implementation of the Health Enterprise Platform in California.\" Xerox added that it is \"pleased to work with DHCS to continue processing Medi-Cal claims through September 2019.\"\u003c/p>\n\u003cp>California’s drawn-out competition for the project began in 2007. Xerox won the contract in 2010. By 2012, the project was already in trouble. Delays caused the state to impose on Xerox a “\u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/Documents/Legislative%20Reports/CAMMIS_Quarterly_July-2012.pdf\" target=\"_blank\">corrective action plan\u003c/a>.”\u003c/p>\n\u003cp>Originally scheduled for completion by the end of this year, the project isn’t close to done, the settlement indicates.\u003c/p>\n\u003cp>Whenever government computer systems fall behind schedule, which is common, critics blame red tape. In this case, the massive Medi-Cal replacement contract with Xerox was inked just five days before President Obama signed the Affordable Care Act into law. As new regulations under the law worked their way through the health care system, requirements for the Medi-Cal project continued to change.\u003c/p>\n\u003cp>Compounding matters, Xerox fell into deep trouble. Its stock has lagged far behind the market in general. The company is under pressure from investor activist Carl Icahn. Late last year, Xerox said it would wind down its Medicaid computer systems business in California and Montana, take a $385 million charge against earnings, and “focus on profitable market segments.” That meant the end of the California project.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/downloads/mmisfacsr.pdf\" target=\"_blank\">Several companies \u003c/a>compete in the Medicaid system market. As of February, Xerox was the number-two provider, covering 11 states. The leader, HP Enterprise Systems, covers 18.\u003c/p>\n\u003cp>Xerox will pay about $103 million in cash, provide computer hardware and software worth $15 million, and abandon payment claims worth roughly $5 million more.\u003c/p>\n\u003cp>DHCS has reported it had paid Xerox $9 million for the replacement system, $8.1 million of that with federal funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Medi-Cal Expands to Undocumented Children. Here's How It Works",
"title": "Medi-Cal Expands to Undocumented Children. Here's How It Works",
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"content": "\u003cp>\u003cem>Lea este artículo en español : \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/22/medi-cal-se-expande-para-los-ninos-inmigrantes-asi-es-como-funciona/\" target=\"_blank\">“Medi-Cal se expande para los niños inmigrantes. Así es como funciona”\u003c/a>\u003c/em>\u003c/p>\n\u003cp>In a few months, California will begin providing full Medi-Cal coverage to all low-income children — regardless of their immigration status.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/02/09/states-medi-cal-bill-for-undocumented-children-could-go-up/\" target=\"_blank\">Depending on whom you ask\u003c/a>, anywhere from 170,000 to \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/covers/undocumented%20children%20transition%20memo%20final%20101615.pdf\" target=\"_blank\">250,000\u003c/a> children who live in California and are in the country illegally will qualify.\u003c/p>\n\u003caside class=\"pullquote alignright\">Take action now, sign up today, say health advocates\u003c/aside>\n\u003cp>If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. “Sign up today,” says Rachel Vizcarra, a program assistant with the \u003ca href=\"http://www.ufwfoundation.org/\" target=\"_blank\">UFW Foundation\u003c/a> in Bakersfield, which is helping families pre-enroll. “If you do, your kids will be automatically enrolled into the program.”\u003c/p>\n\u003cp>State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says Tony Cava of the \u003ca href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">state Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.\u003c/p>\n\u003cp>Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.\u003c/p>\n\u003cp>A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn’t see a doctor for a follow-up visit because “we couldn’t afford it. We would have to pay out of pocket,” Moran says.\u003c/p>\n\u003cp>The first thing Moran will do is take Lizeth for a physical “and make sure her vaccinations are up to date,” she says. “She also needs fillings for five cavities.”\u003c/p>\n\u003cp>Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They’re eligible for Medi-Cal if the family’s household income is less than 266 percent of the \u003ca href=\"https://aspe.hhs.gov/poverty-guidelines\" target=\"_blank\">Federal Poverty Level\u003c/a>, or about $53,600 for a family of three and $75,650 for a family of five.\u003c/p>\n\u003cp>Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.\u003c/p>\n\u003cp>Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.\u003c/p>\n\u003caside class=\"pullquote alignright\">Be warned: the Medi-Cal application is long and complicated, but free help is available to help with enrollment\u003c/aside>\n\u003cp>The idea is that when the change occurs, qualified children \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SB75/SB75_EE_Plan_032116_Final.PDF\" target=\"_blank\">will automatically transition\u003c/a> into full-scope Medi-Cal “within a few days” and without an additional application, Cava says.\u003c/p>\n\u003cp>The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.\u003c/p>\n\u003cp>If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program — such as Kaiser Permanente’s \u003ca href=\"http://info.kaiserpermanente.org/html/child_health_plan/index.html\" target=\"_blank\">Child Health Program\u003c/a> or county-based health coverage — you should still sign your child up for restricted Medi-Cal now, says Mark Diel, CEO of \u003ca href=\"http://cchi4families.org/\" target=\"_blank\">California Coverage & Health Initiatives\u003c/a> (CCHI), a statewide outreach and enrollment network.\u003c/p>\n\u003cp>That’s because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don’t drop out of another program until you confirm that your child’s full-scope Medi-Cal has been approved, he says.)\u003c/p>\n\u003cp>But be warned: The Medi-Cal application is long and complicated. To complete it, you’ll need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.\u003c/p>\n\u003cp>“Work with a local enroller instead of trying to do it on your own,” Diel says. “You’re much more likely to get the application approved.”\u003c/p>\n\u003cp>Help from local health clinics and community groups is free. Online, visit \u003ca href=\"http://www.cchi4families.org/find-help\" target=\"_blank\">www.cchi4families.org/find-help\u003c/a> for local resources.\u003c/p>\n\u003cp>Advocates and state officials also want you to know that enrolling your kids shouldn’t lead to negative immigration consequences for you — or other members of your family — who may not have legal status.\u003c/p>\n\u003cp>“None of the information being collected is shared with immigration authorities,” says Maria Romero-Mora of CCHI.\u003c/p>\n\u003cp>Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you’ll need to take action.\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75_FAQ_1.aspx\" target=\"_blank\"> Look for letters in the mail\u003c/a> before and after the transition explaining your options.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE A PLAN\u003c/strong>: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don’t choose a plan, the state will assign one, Cava says.\u003c/p>\n\u003cp>Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.\u003c/p>\n\u003cp>If you live in one of 22 counties where Medi-Cal managed care is operated by a single \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System\u003c/a>, children will be automatically enrolled in that plan, Cava says.\u003c/p>\n\u003cp>In all cases, until a plan is chosen — or assigned — children will receive coverage through Medi-Cal’s fee-for-service program.\u003c/p>\n\u003cp>\u003cstrong>PAY PREMIUMS\u003c/strong>: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.\u003c/p>\n\u003cp>Children in Medi-Cal plans don’t have co-payments for medical care.\u003c/p>\n\u003cp>\u003cstrong>RENEW\u003c/strong>: You will need to participate in Medi-Cal’s annual renewal process to ensure your children remain eligible and enrolled.\u003c/p>\n\u003cp>Finally, if you don’t sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward — anytime of year — at your county human services office, through a community organization or via the \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> website, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.\u003c/p>\n\u003cp>“I worry that if I have to go to a checkup, it’s going to cost my parents money, and sometimes they don’t have the money to pay for it,” the ninth-grader says.\u003c/p>\n\u003cp>\u003cem>This story is part of California Healthline's \u003ca href=\"http://californiahealthline.org/news/author/emily-bazar/\" target=\"_blank\">Ask Emily\u003c/a>, a series of Q&A columns answering consumers’ questions about California’s new medical world. It was produced by Kaiser Health News which publishes California Healthline, a service of the California Health Care Foundation.”\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Send questions for Emily to AskEmily@kff.org\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en español : \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/22/medi-cal-se-expande-para-los-ninos-inmigrantes-asi-es-como-funciona/\" target=\"_blank\">“Medi-Cal se expande para los niños inmigrantes. Así es como funciona”\u003c/a>\u003c/em>\u003c/p>\n\u003cp>In a few months, California will begin providing full Medi-Cal coverage to all low-income children — regardless of their immigration status.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/02/09/states-medi-cal-bill-for-undocumented-children-could-go-up/\" target=\"_blank\">Depending on whom you ask\u003c/a>, anywhere from 170,000 to \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/covers/undocumented%20children%20transition%20memo%20final%20101615.pdf\" target=\"_blank\">250,000\u003c/a> children who live in California and are in the country illegally will qualify.\u003c/p>\n\u003caside class=\"pullquote alignright\">Take action now, sign up today, say health advocates\u003c/aside>\n\u003cp>If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. “Sign up today,” says Rachel Vizcarra, a program assistant with the \u003ca href=\"http://www.ufwfoundation.org/\" target=\"_blank\">UFW Foundation\u003c/a> in Bakersfield, which is helping families pre-enroll. “If you do, your kids will be automatically enrolled into the program.”\u003c/p>\n\u003cp>State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says Tony Cava of the \u003ca href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">state Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.\u003c/p>\n\u003cp>Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.\u003c/p>\n\u003cp>A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn’t see a doctor for a follow-up visit because “we couldn’t afford it. We would have to pay out of pocket,” Moran says.\u003c/p>\n\u003cp>The first thing Moran will do is take Lizeth for a physical “and make sure her vaccinations are up to date,” she says. “She also needs fillings for five cavities.”\u003c/p>\n\u003cp>Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They’re eligible for Medi-Cal if the family’s household income is less than 266 percent of the \u003ca href=\"https://aspe.hhs.gov/poverty-guidelines\" target=\"_blank\">Federal Poverty Level\u003c/a>, or about $53,600 for a family of three and $75,650 for a family of five.\u003c/p>\n\u003cp>Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.\u003c/p>\n\u003cp>Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.\u003c/p>\n\u003caside class=\"pullquote alignright\">Be warned: the Medi-Cal application is long and complicated, but free help is available to help with enrollment\u003c/aside>\n\u003cp>The idea is that when the change occurs, qualified children \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SB75/SB75_EE_Plan_032116_Final.PDF\" target=\"_blank\">will automatically transition\u003c/a> into full-scope Medi-Cal “within a few days” and without an additional application, Cava says.\u003c/p>\n\u003cp>The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.\u003c/p>\n\u003cp>If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program — such as Kaiser Permanente’s \u003ca href=\"http://info.kaiserpermanente.org/html/child_health_plan/index.html\" target=\"_blank\">Child Health Program\u003c/a> or county-based health coverage — you should still sign your child up for restricted Medi-Cal now, says Mark Diel, CEO of \u003ca href=\"http://cchi4families.org/\" target=\"_blank\">California Coverage & Health Initiatives\u003c/a> (CCHI), a statewide outreach and enrollment network.\u003c/p>\n\u003cp>That’s because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don’t drop out of another program until you confirm that your child’s full-scope Medi-Cal has been approved, he says.)\u003c/p>\n\u003cp>But be warned: The Medi-Cal application is long and complicated. To complete it, you’ll need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.\u003c/p>\n\u003cp>“Work with a local enroller instead of trying to do it on your own,” Diel says. “You’re much more likely to get the application approved.”\u003c/p>\n\u003cp>Help from local health clinics and community groups is free. Online, visit \u003ca href=\"http://www.cchi4families.org/find-help\" target=\"_blank\">www.cchi4families.org/find-help\u003c/a> for local resources.\u003c/p>\n\u003cp>Advocates and state officials also want you to know that enrolling your kids shouldn’t lead to negative immigration consequences for you — or other members of your family — who may not have legal status.\u003c/p>\n\u003cp>“None of the information being collected is shared with immigration authorities,” says Maria Romero-Mora of CCHI.\u003c/p>\n\u003cp>Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you’ll need to take action.\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75_FAQ_1.aspx\" target=\"_blank\"> Look for letters in the mail\u003c/a> before and after the transition explaining your options.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE A PLAN\u003c/strong>: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don’t choose a plan, the state will assign one, Cava says.\u003c/p>\n\u003cp>Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.\u003c/p>\n\u003cp>If you live in one of 22 counties where Medi-Cal managed care is operated by a single \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System\u003c/a>, children will be automatically enrolled in that plan, Cava says.\u003c/p>\n\u003cp>In all cases, until a plan is chosen — or assigned — children will receive coverage through Medi-Cal’s fee-for-service program.\u003c/p>\n\u003cp>\u003cstrong>PAY PREMIUMS\u003c/strong>: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.\u003c/p>\n\u003cp>Children in Medi-Cal plans don’t have co-payments for medical care.\u003c/p>\n\u003cp>\u003cstrong>RENEW\u003c/strong>: You will need to participate in Medi-Cal’s annual renewal process to ensure your children remain eligible and enrolled.\u003c/p>\n\u003cp>Finally, if you don’t sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward — anytime of year — at your county human services office, through a community organization or via the \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> website, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.\u003c/p>\n\u003cp>“I worry that if I have to go to a checkup, it’s going to cost my parents money, and sometimes they don’t have the money to pay for it,” the ninth-grader says.\u003c/p>\n\u003cp>\u003cem>This story is part of California Healthline's \u003ca href=\"http://californiahealthline.org/news/author/emily-bazar/\" target=\"_blank\">Ask Emily\u003c/a>, a series of Q&A columns answering consumers’ questions about California’s new medical world. It was produced by Kaiser Health News which publishes California Healthline, a service of the California Health Care Foundation.”\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Send questions for Emily to AskEmily@kff.org\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Firms Take On Health Giant Sutter Over Contract Demand",
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"content": "\u003cp>Sutter Health, a large network of doctors and hospitals in Northern California that has long been accused of abusing its market power, is now squaring off against major U.S. corporations in a closely watched legal fight.\u003c/p>\n\u003cp>The battle is over Sutter's demand that companies sign an arbitration agreement to resolve any legal disputes with the health system. If firms don't sign the agreement, Sutter says, the companies will have to pay sharply higher rates for medical treatment of their employees at Sutter's hospitals, surgery centers and clinics – 95 percent of Sutter's full charge.\u003c/p>\n\u003cp>Sutter's nonprofit system, based in Sacramento, includes 24 hospitals, 34 surgery centers and more than 5,000 physicians. It reported $11 billion in revenue last year and an operating profit of $287 million.\u003c/p>\n\u003cp>Some companies and labor unions say Sutter's ultimatum is aimed at preventing them from joining an ongoing class-action lawsuit that accuses the giant health system of imposing anticompetitive terms and \"illegally inflated prices\" for health care. Sutter disputes the allegations, and says its charges are in line with those of its peers.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Y2d5hBl1KuDN1DpSTprRzxb3vXMiE6Wd\"]In a March 16 \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/pbgh-sutter-filing.pdf\" target=\"_blank\">court filing\u003c/a>, \u003ca href=\"http://staging.pbgh.org/about/pbgh-staff\">David Lansky\u003c/a>, chief executive of the Pacific Business Group on Health, said it isn't feasible for large companies employing people in Northern California to exclude Sutter from their workers' insurance networks, given the network's size and reach. Lansky's organization represents big companies like Wells Fargo Bank, Intel and Chevron, as well as government agencies like the California Public Employees' Retirement System.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Their choice is between two unacceptable alternatives,\" Lansky said in his filing. \"Pay 95 percent out-of-network pricing for enrollees that access Sutter services, or agree to give up their claims in this litigation.\"\u003c/p>\n\u003cp>Major insurers are split in their reaction to Sutter's move. Industry giants Anthem and Aetna are urging customers to accept arbitration in order to remain in the network, while rival Blue Shield of California says it opposes Sutter's request. Blue Shield has clashed publicly with Sutter before over contract terms and prices.\u003c/p>\n\u003cp>All this comes amid growing concern nationwide about the financial toll from industry consolidation, as big health systems amass market clout by acquiring more hospitals, outpatient facilities and physician offices.\u003c/p>\n\u003cp>\"This is an important legal case because it could have national repercussions,\" said \u003ca href=\"https://priceschool.usc.edu/glenn-melnick/\">Glenn Melnick\u003c/a>, a health-care economist at the University of Southern California. \"Sutter is the model for the rest of the country, and there are so many other health systems doing similar things so they can raise prices.\"\u003c/p>\n\u003cp>The current fight centers on large employers that tend to self-insure because they have the financial resources to pay their own medical claims. These firms often hire an insurer to negotiate with hospitals and other health care providers to get discounted rates for employees.\u003c/p>\n\u003cp>Sutter insists it won't use the arbitration agreements to prevent employers from participating in the class-action lawsuit brought by a grocery workers' health plan in San Francisco County Superior Court.\u003c/p>\n\u003cp>[contextly_sidebar id=\"kkWEu5RBmPnXoSZHYWYjolhcRwWQy64j\"]The health system says it only sought the new arbitration requirement after a state appellate court ruling last year. The court ruled that the plaintiff suing Sutter — the \u003ca href=\"http://www.ufcw.org/\" target=\"_blank\">United Food and Commercial Workers\u003c/a> and its \u003ca href=\"https://www.ufcwtrust.com/memberservicesinformation.aspx\" target=\"_blank\">Employers Benefit Trust\u003c/a> — wasn't bound by the arbitration provisions in the contract that Blue Shield signed with Sutter as the health plan administrator.\u003c/p>\n\u003cp>Sutter says it is asking employers and labor groups to review and agree to its contract terms so there's consistency among all parties involved. Arbitration is widely used by companies of all types to avoid costly litigation in resolving disputes.\u003c/p>\n\u003cp>\"If self-funded payers wish to access the discounted rates that Sutter Health makes available under these contracts, it is reasonable to ask that they abide by the package of terms that make those rates financially feasible,\" Sutter spokesman \u003ca href=\"https://www.linkedin.com/in/bill-gleeson-5b8b908\">Bill Gleeson\u003c/a> says. \"They should not be able to cherry pick which provisions apply to them and which do not.\"\u003c/p>\n\u003cp>But attorneys for the grocery workers' health plan are asking the court to stop Sutter from seeking arbitration agreements, alleging that the health giant's move is an attempt to hinder the litigation. A hearing on the matter is slated for Thursday.\u003c/p>\n\u003cp>\"We do not want potential class members precluded from this lawsuit at the point of a gun,\" said \u003ca href=\"http://www.pillsburycoleman.com/Attorneys/Richard-L-Grossman.shtml\">Richard Grossman\u003c/a>, lead counsel for the joint employer-union health plan, which represents more than 60,000 employees, dependents and retirees. \"The fact they are even willing to make this threat to obtain the arbitration clause has shocked the payer community.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.pbgh.org/about/pbgh-staff/52-bill-kramer-mba\">Bill Kramer\u003c/a>, executive director for national health policy at the Pacific Business Group on Health, agreed that Sutter's threat to pull all of its facilities from an insurance network took employers by surprise.\u003c/p>\n\u003cp>\"This can appear to be an arcane legal battle between corporations, but it has real-world consequences for the affordability of health care for employees and their families,\" Kramer says. \"The in-network rates at Sutter are already too high, and out-of-network prices are even higher.\"\u003c/p>\n\u003cp>The lawsuit over antitrust violations and unfair competition alleges that Sutter's hospital prices in San Francisco have exceeded those of competitors by as much as 56 percent. It also says an overnight hospital stay at Sutter hospitals in San Francisco or Sacramento costs at least 38 percent more than a comparable stay in the more competitive Los Angeles market.\u003c/p>\n\u003cp>Employers began expressing concerns about Sutter's move in recent weeks after insurers raised the issue.\u003c/p>\n\u003cp>In a \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/anthem-sutter-documents.pdf\" target=\"_blank\">Feb. 22 memo\u003c/a> to customers, Anthem said it \"must now obtain a signed attestation from all California-based self-funded customers and all Anthem national accounts with 50-plus members in Sutter's Northern California service area.\" Many customers face a May 16 deadline to sign, according to Anthem.\u003c/p>\n\u003cp>The insurer noted that state and federal investigations of Sutter's conduct haven't yielded any results so far.\u003c/p>\n\u003cp>California Attorney General \u003ca href=\"https://oag.ca.gov/about\">Kamala Harris\u003c/a> has been investigating Sutter and other big medical providers for several years over potential harm to consumers. A spokeswoman for her office says the attorney general can't comment on any ongoing investigations.\u003c/p>\n\u003cp>Meanwhile, Sutter accounts for 28 percent of Anthem's medical spending in a 21-county area of Northern California, according to the insurer.\u003c/p>\n\u003cp>\"Sutter's market share is over 35 percent in eight counties and over 45 percent in six counties,\" Perry Pogany, Anthem's vice president for account management, wrote to customers in February. \"Sutter is able to secure significant and unique concessions in its carrier contracts due to its position in northern California.\"\u003c/p>\n\u003cp>Anthem and Blue Shield both declined to comment further on the Sutter matter. The grocery workers' self-funded plan that is suing Sutter is a customer of Blue Shield.\u003c/p>\n\u003cp>Melnick and other economists say the lack of competition among health care providers in Northern California helps explain why the premiums there for health insurance are about 25 percent higher, on average, than premiums in the southern part of the state.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> has reported a similar pattern, with an average rate increase of 7 percent for policyholders in Northern California this year, compared to 1.8 percent for plans in southern California.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Big+California+Firms+Take+On+Health+Care+Giant+Over+Cost+of+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sutter Health, a large network of doctors and hospitals in Northern California that has long been accused of abusing its market power, is now squaring off against major U.S. corporations in a closely watched legal fight.\u003c/p>\n\u003cp>The battle is over Sutter's demand that companies sign an arbitration agreement to resolve any legal disputes with the health system. If firms don't sign the agreement, Sutter says, the companies will have to pay sharply higher rates for medical treatment of their employees at Sutter's hospitals, surgery centers and clinics – 95 percent of Sutter's full charge.\u003c/p>\n\u003cp>Sutter's nonprofit system, based in Sacramento, includes 24 hospitals, 34 surgery centers and more than 5,000 physicians. It reported $11 billion in revenue last year and an operating profit of $287 million.\u003c/p>\n\u003cp>Some companies and labor unions say Sutter's ultimatum is aimed at preventing them from joining an ongoing class-action lawsuit that accuses the giant health system of imposing anticompetitive terms and \"illegally inflated prices\" for health care. Sutter disputes the allegations, and says its charges are in line with those of its peers.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In a March 16 \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/pbgh-sutter-filing.pdf\" target=\"_blank\">court filing\u003c/a>, \u003ca href=\"http://staging.pbgh.org/about/pbgh-staff\">David Lansky\u003c/a>, chief executive of the Pacific Business Group on Health, said it isn't feasible for large companies employing people in Northern California to exclude Sutter from their workers' insurance networks, given the network's size and reach. Lansky's organization represents big companies like Wells Fargo Bank, Intel and Chevron, as well as government agencies like the California Public Employees' Retirement System.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Their choice is between two unacceptable alternatives,\" Lansky said in his filing. \"Pay 95 percent out-of-network pricing for enrollees that access Sutter services, or agree to give up their claims in this litigation.\"\u003c/p>\n\u003cp>Major insurers are split in their reaction to Sutter's move. Industry giants Anthem and Aetna are urging customers to accept arbitration in order to remain in the network, while rival Blue Shield of California says it opposes Sutter's request. Blue Shield has clashed publicly with Sutter before over contract terms and prices.\u003c/p>\n\u003cp>All this comes amid growing concern nationwide about the financial toll from industry consolidation, as big health systems amass market clout by acquiring more hospitals, outpatient facilities and physician offices.\u003c/p>\n\u003cp>\"This is an important legal case because it could have national repercussions,\" said \u003ca href=\"https://priceschool.usc.edu/glenn-melnick/\">Glenn Melnick\u003c/a>, a health-care economist at the University of Southern California. \"Sutter is the model for the rest of the country, and there are so many other health systems doing similar things so they can raise prices.\"\u003c/p>\n\u003cp>The current fight centers on large employers that tend to self-insure because they have the financial resources to pay their own medical claims. These firms often hire an insurer to negotiate with hospitals and other health care providers to get discounted rates for employees.\u003c/p>\n\u003cp>Sutter insists it won't use the arbitration agreements to prevent employers from participating in the class-action lawsuit brought by a grocery workers' health plan in San Francisco County Superior Court.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The health system says it only sought the new arbitration requirement after a state appellate court ruling last year. The court ruled that the plaintiff suing Sutter — the \u003ca href=\"http://www.ufcw.org/\" target=\"_blank\">United Food and Commercial Workers\u003c/a> and its \u003ca href=\"https://www.ufcwtrust.com/memberservicesinformation.aspx\" target=\"_blank\">Employers Benefit Trust\u003c/a> — wasn't bound by the arbitration provisions in the contract that Blue Shield signed with Sutter as the health plan administrator.\u003c/p>\n\u003cp>Sutter says it is asking employers and labor groups to review and agree to its contract terms so there's consistency among all parties involved. Arbitration is widely used by companies of all types to avoid costly litigation in resolving disputes.\u003c/p>\n\u003cp>\"If self-funded payers wish to access the discounted rates that Sutter Health makes available under these contracts, it is reasonable to ask that they abide by the package of terms that make those rates financially feasible,\" Sutter spokesman \u003ca href=\"https://www.linkedin.com/in/bill-gleeson-5b8b908\">Bill Gleeson\u003c/a> says. \"They should not be able to cherry pick which provisions apply to them and which do not.\"\u003c/p>\n\u003cp>But attorneys for the grocery workers' health plan are asking the court to stop Sutter from seeking arbitration agreements, alleging that the health giant's move is an attempt to hinder the litigation. A hearing on the matter is slated for Thursday.\u003c/p>\n\u003cp>\"We do not want potential class members precluded from this lawsuit at the point of a gun,\" said \u003ca href=\"http://www.pillsburycoleman.com/Attorneys/Richard-L-Grossman.shtml\">Richard Grossman\u003c/a>, lead counsel for the joint employer-union health plan, which represents more than 60,000 employees, dependents and retirees. \"The fact they are even willing to make this threat to obtain the arbitration clause has shocked the payer community.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.pbgh.org/about/pbgh-staff/52-bill-kramer-mba\">Bill Kramer\u003c/a>, executive director for national health policy at the Pacific Business Group on Health, agreed that Sutter's threat to pull all of its facilities from an insurance network took employers by surprise.\u003c/p>\n\u003cp>\"This can appear to be an arcane legal battle between corporations, but it has real-world consequences for the affordability of health care for employees and their families,\" Kramer says. \"The in-network rates at Sutter are already too high, and out-of-network prices are even higher.\"\u003c/p>\n\u003cp>The lawsuit over antitrust violations and unfair competition alleges that Sutter's hospital prices in San Francisco have exceeded those of competitors by as much as 56 percent. It also says an overnight hospital stay at Sutter hospitals in San Francisco or Sacramento costs at least 38 percent more than a comparable stay in the more competitive Los Angeles market.\u003c/p>\n\u003cp>Employers began expressing concerns about Sutter's move in recent weeks after insurers raised the issue.\u003c/p>\n\u003cp>In a \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/anthem-sutter-documents.pdf\" target=\"_blank\">Feb. 22 memo\u003c/a> to customers, Anthem said it \"must now obtain a signed attestation from all California-based self-funded customers and all Anthem national accounts with 50-plus members in Sutter's Northern California service area.\" Many customers face a May 16 deadline to sign, according to Anthem.\u003c/p>\n\u003cp>The insurer noted that state and federal investigations of Sutter's conduct haven't yielded any results so far.\u003c/p>\n\u003cp>California Attorney General \u003ca href=\"https://oag.ca.gov/about\">Kamala Harris\u003c/a> has been investigating Sutter and other big medical providers for several years over potential harm to consumers. A spokeswoman for her office says the attorney general can't comment on any ongoing investigations.\u003c/p>\n\u003cp>Meanwhile, Sutter accounts for 28 percent of Anthem's medical spending in a 21-county area of Northern California, according to the insurer.\u003c/p>\n\u003cp>\"Sutter's market share is over 35 percent in eight counties and over 45 percent in six counties,\" Perry Pogany, Anthem's vice president for account management, wrote to customers in February. \"Sutter is able to secure significant and unique concessions in its carrier contracts due to its position in northern California.\"\u003c/p>\n\u003cp>Anthem and Blue Shield both declined to comment further on the Sutter matter. The grocery workers' self-funded plan that is suing Sutter is a customer of Blue Shield.\u003c/p>\n\u003cp>Melnick and other economists say the lack of competition among health care providers in Northern California helps explain why the premiums there for health insurance are about 25 percent higher, on average, than premiums in the southern part of the state.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> has reported a similar pattern, with an average rate increase of 7 percent for policyholders in Northern California this year, compared to 1.8 percent for plans in southern California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Big+California+Firms+Take+On+Health+Care+Giant+Over+Cost+of+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Tucked in \u003ca href=\"http://www.11alive.com/news/full-transcript-president-obama-at-atlanta-heroin-summit/108944462\" target=\"_blank\">remarks\u003c/a> the president made Tuesday on the opioid epidemic was his announcement of a new \u003ca href=\"https://www.whitehouse.gov/the-press-office/2016/03/29/presidential-memorandum-mental-health-and-substance-use-disorder-parity\" target=\"_blank\">task force on mental health parity\u003c/a> — aimed at ensuring that people with mental illnesses and substance abuse problems don’t face discrimination in the health care system.\u003c/p>\n\u003caside class=\"pullquote alignright\">Advocates say parity has long been an 'empty phrase' and it has taken the administration far too long to address the problem.\u003c/aside>\n\u003cp>Despite a landmark \u003ca href=\"https://www.cms.gov/Regulations-and-Guidance/Health-Insurance-Reform/HealthInsReformforConsume/downloads/MHPAEA.pdf\" target=\"_blank\">2008 law\u003c/a> intended to do just that, enforcement has been paltry, and advocates say discrimination has continued.\u003c/p>\n\u003cp>“The goal of the task force is to essentially develop a set of tools, guidelines, mechanisms so that it’s actually enforced, that the concept is not just a phrase — an empty phrase,” President Obama said during a panel discussion at the National Prescription Drug Abuse and Heroin Summit in Atlanta, Georgia. “We’ve got to let the insurance carriers know that we’re serious about this.”\u003c/p>\n\u003cp>Advocates say parity has long been an “empty phrase” and it has taken the administration far too long to address the problem. They say insurers have been subverting the law in subtle ways, and the government has not aggressively acted to stop them.\u003c/p>\n\u003cp>“It’s better late than never, and you can’t not be grateful for the fact that we’re finally implementing a law that was passed nearly a decade ago,” said former congressman Patrick Kennedy, one of the authors of the parity law. “But it’s troubling that it’s occurring in the last year of the presidency, and that it took the administration this long to address a problem that’s been with us for many years.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In \u003ca href=\"http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/A-Long-Road-Ahead/2015-ALongRoadAhead.pdf\" target=\"_blank\">a 2015 survey\u003c/a> by the National Alliance on Mental Illness, an advocacy group for people with mental illness and their families, many patients said they were denied payment because treatment was deemed “not medically necessary” twice as often for mental health as for other medical conditions. Only \u003ca href=\"http://khn.org/news/achieving-mental-health-parity-slow-going-even-in-pace-car-state/\" target=\"_blank\">a handful of states, including California\u003c/a> and New York, have been investigating whether insurers are complying with the parity law. Meanwhile, the federal government has taken few if any public enforcement actions, as \u003ca href=\"http://khn.org/news/advocates-say-mental-health-parity-law-is-not-fulfilling-its-promise/\" target=\"_blank\">Kaiser Health News reported\u003c/a> last year.\u003c/p>\n\u003cp>For years, Kennedy has been traveling the country speaking about the lack of enforcement of the federal mental health parity law he helped create. One problem, he has said repeatedly, is that the administration has been hesitant to enforce a law against insurers, who were a key partner in implementing the Affordable Care Act.\u003c/p>\n\u003cp>“Even this administration, which is pro-consumer and liberal, has a tough time doing anything but dancing around issues of enforcing the law because they’re afraid to step on the insurers’ toes,” Kennedy said.\u003c/p>\n\u003cp>Tuesday’s announcement, he said, was also meager. “If the administration really wanted to be front and center on this they could have done it at the White House at a summit that would have gotten all kind of attention.”\u003c/p>\n\u003cp>Instead, he said, it was buried in an announcement of new programs and funding for opioid addiction. Also announced Tuesday were \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-03-29.html\" target=\"_blank\">the final parity rules\u003c/a> for patients with coverage under Medicaid and the Children’s Health Insurance Program (CHIP).\u003c/p>\n\u003cp>Despite the complaints of advocates and patients, insurers argue they have long been complying with parity.\u003c/p>\n\u003cp>“Our industry has long supported mental health parity and implementation of those requirements so that consumers have access to care when they need it,” Clare Krusing, a spokesperson for America’s Health Insurance Plans, the industry’s main trade group, said in a written statement. “Suggesting that coverage decisions drive the mental health challenges we face does a disservice to the ongoing efforts to improve the country’s health system for those who need behavioral health care.”\u003c/p>\n\u003cp>The interagency task force, which will be chaired by the White House’s \u003ca href=\"https://www.whitehouse.gov/administration/eop/dpc\" target=\"_blank\">Domestic Policy Council\u003c/a>, will aim to identify and promote best practices for state and federal agencies to ensure that insurers are complying with the parity law. It will consist of heads of the departments of Treasury, Justice, Labor and Health and Human Services, among others, and will be responsible for delivering a report to the President by October 31, 2016.\u003c/p>\n\u003cp>“I think anything the White House does to acknowledge the obstacles to treatment of mental illness is a step in the right direction. But frankly, another task force is a far cry from much-needed enforcement,” said Meiram Bendat, a Los Angeles-based lawyer who has filed several lawsuits against insurers alleging violations of the parity law.\u003c/p>\n\u003cp>People with mental illness and their advocates have long been aware of exactly what the problems are, he said. But rooting them out will require the task force to be “keenly attuned to social and institutional bias against patients with behavioral health problems. And that bias frequently takes the form of insurance companies effectively limiting care only to crisis and refusing to acknowledge the pervasive and long-term nature of these disorders.”\u003c/p>\n\u003cp>Provider groups widely applauded the creation of the task force.\u003c/p>\n\u003cp>“What we’re hoping is that the task force will increase the visibility of the issue and highlight its significance,” said Dr. Renée Binder, president of the American Psychiatric Association, which has identified wide variation in how well insurers are complying with the law.\u003c/p>\n\u003cp>“We would welcome the opportunity to meet with the task force as part of its outreach charge,” she said.\u003c/p>\n\u003cp>But even if parity is successfully implemented, Benjamin Miller, director of the health policy center at the University of Colorado School of Medicine, said it may be “too little, too late.”\u003c/p>\n\u003cp>“It’s simply not enough to have mental health parity – even with this change in law, there will still be access issues for patients.”\u003c/p>\n\u003cp>That’s because mental health providers often don’t have appointments readily available or won’t accept these patients’ insurance coverage, he said.\u003c/p>\n\u003cp>“While mental health parity rights a wrong, it does not change the fundamental delivery of care, which is sorely needed for increasing access to mental health,” Miller said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent project of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tucked in \u003ca href=\"http://www.11alive.com/news/full-transcript-president-obama-at-atlanta-heroin-summit/108944462\" target=\"_blank\">remarks\u003c/a> the president made Tuesday on the opioid epidemic was his announcement of a new \u003ca href=\"https://www.whitehouse.gov/the-press-office/2016/03/29/presidential-memorandum-mental-health-and-substance-use-disorder-parity\" target=\"_blank\">task force on mental health parity\u003c/a> — aimed at ensuring that people with mental illnesses and substance abuse problems don’t face discrimination in the health care system.\u003c/p>\n\u003caside class=\"pullquote alignright\">Advocates say parity has long been an 'empty phrase' and it has taken the administration far too long to address the problem.\u003c/aside>\n\u003cp>Despite a landmark \u003ca href=\"https://www.cms.gov/Regulations-and-Guidance/Health-Insurance-Reform/HealthInsReformforConsume/downloads/MHPAEA.pdf\" target=\"_blank\">2008 law\u003c/a> intended to do just that, enforcement has been paltry, and advocates say discrimination has continued.\u003c/p>\n\u003cp>“The goal of the task force is to essentially develop a set of tools, guidelines, mechanisms so that it’s actually enforced, that the concept is not just a phrase — an empty phrase,” President Obama said during a panel discussion at the National Prescription Drug Abuse and Heroin Summit in Atlanta, Georgia. “We’ve got to let the insurance carriers know that we’re serious about this.”\u003c/p>\n\u003cp>Advocates say parity has long been an “empty phrase” and it has taken the administration far too long to address the problem. They say insurers have been subverting the law in subtle ways, and the government has not aggressively acted to stop them.\u003c/p>\n\u003cp>“It’s better late than never, and you can’t not be grateful for the fact that we’re finally implementing a law that was passed nearly a decade ago,” said former congressman Patrick Kennedy, one of the authors of the parity law. “But it’s troubling that it’s occurring in the last year of the presidency, and that it took the administration this long to address a problem that’s been with us for many years.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In \u003ca href=\"http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/A-Long-Road-Ahead/2015-ALongRoadAhead.pdf\" target=\"_blank\">a 2015 survey\u003c/a> by the National Alliance on Mental Illness, an advocacy group for people with mental illness and their families, many patients said they were denied payment because treatment was deemed “not medically necessary” twice as often for mental health as for other medical conditions. Only \u003ca href=\"http://khn.org/news/achieving-mental-health-parity-slow-going-even-in-pace-car-state/\" target=\"_blank\">a handful of states, including California\u003c/a> and New York, have been investigating whether insurers are complying with the parity law. Meanwhile, the federal government has taken few if any public enforcement actions, as \u003ca href=\"http://khn.org/news/advocates-say-mental-health-parity-law-is-not-fulfilling-its-promise/\" target=\"_blank\">Kaiser Health News reported\u003c/a> last year.\u003c/p>\n\u003cp>For years, Kennedy has been traveling the country speaking about the lack of enforcement of the federal mental health parity law he helped create. One problem, he has said repeatedly, is that the administration has been hesitant to enforce a law against insurers, who were a key partner in implementing the Affordable Care Act.\u003c/p>\n\u003cp>“Even this administration, which is pro-consumer and liberal, has a tough time doing anything but dancing around issues of enforcing the law because they’re afraid to step on the insurers’ toes,” Kennedy said.\u003c/p>\n\u003cp>Tuesday’s announcement, he said, was also meager. “If the administration really wanted to be front and center on this they could have done it at the White House at a summit that would have gotten all kind of attention.”\u003c/p>\n\u003cp>Instead, he said, it was buried in an announcement of new programs and funding for opioid addiction. Also announced Tuesday were \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-03-29.html\" target=\"_blank\">the final parity rules\u003c/a> for patients with coverage under Medicaid and the Children’s Health Insurance Program (CHIP).\u003c/p>\n\u003cp>Despite the complaints of advocates and patients, insurers argue they have long been complying with parity.\u003c/p>\n\u003cp>“Our industry has long supported mental health parity and implementation of those requirements so that consumers have access to care when they need it,” Clare Krusing, a spokesperson for America’s Health Insurance Plans, the industry’s main trade group, said in a written statement. “Suggesting that coverage decisions drive the mental health challenges we face does a disservice to the ongoing efforts to improve the country’s health system for those who need behavioral health care.”\u003c/p>\n\u003cp>The interagency task force, which will be chaired by the White House’s \u003ca href=\"https://www.whitehouse.gov/administration/eop/dpc\" target=\"_blank\">Domestic Policy Council\u003c/a>, will aim to identify and promote best practices for state and federal agencies to ensure that insurers are complying with the parity law. It will consist of heads of the departments of Treasury, Justice, Labor and Health and Human Services, among others, and will be responsible for delivering a report to the President by October 31, 2016.\u003c/p>\n\u003cp>“I think anything the White House does to acknowledge the obstacles to treatment of mental illness is a step in the right direction. But frankly, another task force is a far cry from much-needed enforcement,” said Meiram Bendat, a Los Angeles-based lawyer who has filed several lawsuits against insurers alleging violations of the parity law.\u003c/p>\n\u003cp>People with mental illness and their advocates have long been aware of exactly what the problems are, he said. But rooting them out will require the task force to be “keenly attuned to social and institutional bias against patients with behavioral health problems. And that bias frequently takes the form of insurance companies effectively limiting care only to crisis and refusing to acknowledge the pervasive and long-term nature of these disorders.”\u003c/p>\n\u003cp>Provider groups widely applauded the creation of the task force.\u003c/p>\n\u003cp>“What we’re hoping is that the task force will increase the visibility of the issue and highlight its significance,” said Dr. Renée Binder, president of the American Psychiatric Association, which has identified wide variation in how well insurers are complying with the law.\u003c/p>\n\u003cp>“We would welcome the opportunity to meet with the task force as part of its outreach charge,” she said.\u003c/p>\n\u003cp>But even if parity is successfully implemented, Benjamin Miller, director of the health policy center at the University of Colorado School of Medicine, said it may be “too little, too late.”\u003c/p>\n\u003cp>“It’s simply not enough to have mental health parity – even with this change in law, there will still be access issues for patients.”\u003c/p>\n\u003cp>That’s because mental health providers often don’t have appointments readily available or won’t accept these patients’ insurance coverage, he said.\u003c/p>\n\u003cp>“While mental health parity rights a wrong, it does not change the fundamental delivery of care, which is sorely needed for increasing access to mental health,” Miller said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>State Insurance Commissioner Dave Jones continued to make his skepticism clear regarding Anthem Inc.’s proposed $54.2 billion acquisition of Cigna Corp. during a hearing in San Francisco on Tuesday.\u003c/p>\n\u003cp>Company executives faced Jones and a panel of physicians and consumer advocates who questioned the benefits the companies say the acquisition will bring.\u003c/p>\n\u003cp>The California Department of Insurance hearing took a more pressing tone than a related hearing held by the California Department of Managed Health Care earlier this month.\u003c/p>\n\u003cp>According to Anthem and Cigna, the merger will result in easier access to medical providers for patients and lead to more affordable health insurance policies.\u003c/p>\n\u003cp>Jay Wagner, Anthem’s vice president and counsel, and Tom Richards, Cigna’s global leader for strategy and business development, said the purchase would cut costs by $2 billion annually.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They told Jones they were “quite confident” in that estimate. But Wagner and Richards said they could not commit to guaranteeing savings for consumers because of factors out of their control, such as the rising prices of specialty drugs.\u003c/p>\n\u003cp>Brent Fulton, a professor of health economics and policy at UC Berkeley, presented an analysis on the Anthem and Cigna merger at the request of the Department of Insurance.\u003c/p>\n\u003cp>Theoretically, Fulton said, consolidation could lead to stronger negotiating leverage with hospitals, physician organizations and other providers of health care services that now hold market power, resulting in lower costs for health insurance customers.\u003c/p>\n\u003cp>“However, we are not aware of any peer-reviewed studies that have found that higher insurer market concentration has led to lower health insurance premiums,” Fulton said.\u003c/p>\n\u003cp>Consumer advocates said the acquisition would make existing problems with health insurance worse. Anthem, they claimed, has already struggled with inaccuracies in provider directories, low quality ratings and poor management of grievances.\u003c/p>\n\u003cp>“We don’t have any proof from Anthem on concrete benefits to consumers,” said Carmen Balber, executive director of Consumer Watchdog.\u003c/p>\n\u003cp>“Consumers are already hurting in cost,” she said, stating that about 20 percent of consumers can’t afford the prices even with insurance.\u003c/p>\n\u003cp>Anthem is part of the four insurance titans that dominate the health insurance market in California, along with Kaiser Permanente, Blue Shield and Health Net. If approved, the Anthem and Cigna merger would result in the largest insurer by enrollment in the state, with an approximate 8.2 million policyholders, surpassing current leader Kaiser. (Cigna now is in fifth place.)\u003c/p>\n\u003cp>Even without the merger, the top four insurance companies control more than 80 percent of the market. The Anthem-Cigna union is one of two pending mergers still under review by state regulators.\u003c/p>\n\u003cp>Last week, Centene’s $7 billion purchase of Health Net was approved. Regulators are also examining the planned $37 billion combination of Aetna Inc. and Humana Inc.\u003c/p>\n\u003cp>The Anthem-Cigna merger also needs the green light from 23 other states. Nationally, the combination would cover some 53 million policyholders, overtaking UnitedHealth Group Inc., which has close to 46 million members, according to 2013 estimates.\u003c/p>\n\u003cp>The California Department of Managed Health Care, which held a hearing on this same merger earlier this month, is expected to impose certain conditions on the Anthem-Cigna deal to address consumer worries about the potential impact of large-scale consolidation. Those conditions are not yet clear.\u003c/p>\n\u003cp>Jones said he’s asked the two companies for more information, and he expects to make a recommendation in the coming week.\u003c/p>\n\u003cp>“I am considering what is best for consumers and the overall marketplace,” Jones said in a prepared statement. “Anthem and Cigna bear the burden of demonstrating this proposed merger is in the best interest of the California consumers and health care marketplace.”\u003c/p>\n\u003cp>Jones said he plans to make a recommendation to the Federal Trade Commission and Department of Justice, who ultimately have the final say on the merger nationwide.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>State Insurance Commissioner Dave Jones continued to make his skepticism clear regarding Anthem Inc.’s proposed $54.2 billion acquisition of Cigna Corp. during a hearing in San Francisco on Tuesday.\u003c/p>\n\u003cp>Company executives faced Jones and a panel of physicians and consumer advocates who questioned the benefits the companies say the acquisition will bring.\u003c/p>\n\u003cp>The California Department of Insurance hearing took a more pressing tone than a related hearing held by the California Department of Managed Health Care earlier this month.\u003c/p>\n\u003cp>According to Anthem and Cigna, the merger will result in easier access to medical providers for patients and lead to more affordable health insurance policies.\u003c/p>\n\u003cp>Jay Wagner, Anthem’s vice president and counsel, and Tom Richards, Cigna’s global leader for strategy and business development, said the purchase would cut costs by $2 billion annually.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They told Jones they were “quite confident” in that estimate. But Wagner and Richards said they could not commit to guaranteeing savings for consumers because of factors out of their control, such as the rising prices of specialty drugs.\u003c/p>\n\u003cp>Brent Fulton, a professor of health economics and policy at UC Berkeley, presented an analysis on the Anthem and Cigna merger at the request of the Department of Insurance.\u003c/p>\n\u003cp>Theoretically, Fulton said, consolidation could lead to stronger negotiating leverage with hospitals, physician organizations and other providers of health care services that now hold market power, resulting in lower costs for health insurance customers.\u003c/p>\n\u003cp>“However, we are not aware of any peer-reviewed studies that have found that higher insurer market concentration has led to lower health insurance premiums,” Fulton said.\u003c/p>\n\u003cp>Consumer advocates said the acquisition would make existing problems with health insurance worse. Anthem, they claimed, has already struggled with inaccuracies in provider directories, low quality ratings and poor management of grievances.\u003c/p>\n\u003cp>“We don’t have any proof from Anthem on concrete benefits to consumers,” said Carmen Balber, executive director of Consumer Watchdog.\u003c/p>\n\u003cp>“Consumers are already hurting in cost,” she said, stating that about 20 percent of consumers can’t afford the prices even with insurance.\u003c/p>\n\u003cp>Anthem is part of the four insurance titans that dominate the health insurance market in California, along with Kaiser Permanente, Blue Shield and Health Net. If approved, the Anthem and Cigna merger would result in the largest insurer by enrollment in the state, with an approximate 8.2 million policyholders, surpassing current leader Kaiser. (Cigna now is in fifth place.)\u003c/p>\n\u003cp>Even without the merger, the top four insurance companies control more than 80 percent of the market. The Anthem-Cigna union is one of two pending mergers still under review by state regulators.\u003c/p>\n\u003cp>Last week, Centene’s $7 billion purchase of Health Net was approved. Regulators are also examining the planned $37 billion combination of Aetna Inc. and Humana Inc.\u003c/p>\n\u003cp>The Anthem-Cigna merger also needs the green light from 23 other states. Nationally, the combination would cover some 53 million policyholders, overtaking UnitedHealth Group Inc., which has close to 46 million members, according to 2013 estimates.\u003c/p>\n\u003cp>The California Department of Managed Health Care, which held a hearing on this same merger earlier this month, is expected to impose certain conditions on the Anthem-Cigna deal to address consumer worries about the potential impact of large-scale consolidation. Those conditions are not yet clear.\u003c/p>\n\u003cp>Jones said he’s asked the two companies for more information, and he expects to make a recommendation in the coming week.\u003c/p>\n\u003cp>“I am considering what is best for consumers and the overall marketplace,” Jones said in a prepared statement. “Anthem and Cigna bear the burden of demonstrating this proposed merger is in the best interest of the California consumers and health care marketplace.”\u003c/p>\n\u003cp>Jones said he plans to make a recommendation to the Federal Trade Commission and Department of Justice, who ultimately have the final say on the merger nationwide.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Can't Afford Your Life-Saving Prescription Drugs? Get a Mortgage, Some Experts Propose",
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"content": "\u003cp>Californians are used to big mortgages. Now, how about prescription drug loans?\u003c/p>\n\u003cp>That’s one idea for coping with prohibitively expensive drug prices. The unusual proposal is being pitched by academics at the Massachusetts Institute of Technology and Harvard University.\u003c/p>\n\u003cp>Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.\u003c/p>\n\u003cp>Some consumer advocates and health insurance experts see it differently.\u003c/p>\n\u003cp>“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.\u003c/p>\n\u003cp>“This is a private sector stopgap way to deal with something right now,” said Lo.\u003c/p>\n\u003cp>Their proposal calls for the loans to be financed by a pool of investors who would buy bonds and equities issued by an organization that makes the loans to consumers.\u003c/p>\n\u003cp>While it’s “distasteful” to talk about patients mortgaging their lives for treatment, Lo said, they hope the proposal will spur change.\u003c/p>\n\u003cp>The health care installment loans that Lo, Weinstock and their co-author Vahid Montazerhodjat, a former MIT doctoral student who was working with Lo, propose would be aimed at helping people afford “transformative” therapies that cure potentially lethal conditions such as cancer or hepatitis C. They’re not designed to pay for maintenance drugs that help people deal with chronic illness. It’s easier for insurers to cover maintenance drugs because they’re purchased over an extended period of time, they said.\u003c/p>\n\u003cp>In contrast, breakthrough hepatitis C drugs Sovaldi and Harvoni, for example, can cure people of the liver-destroying disease in a few months, but the price tag of $84,000 or more has led many insurers to limit coverage to people whose disease has significantly progressed to show signs of liver damage.\u003c/p>\n\u003cp>“There are miraculous treatments like Harvoni, but they’re out of reach” for many people, said Lo.\u003c/p>\n\u003cp>Someone who wanted that Harvoni treatment might take out a health care loan with a nine-year term at an annual interest rate of about 9 percent, the authors suggest. In a twist on conventional loans, if a therapy doesn’t work or the patient relapses or dies, the patient isn’t obligated to repay the loan.\u003c/p>\n\u003cp>Are sick patients good loan prospects? Lenders might want to assess not only loan applicants’ creditworthiness but also their health to determine whether the applicant is likely to live long enough to pay it off.\u003c/p>\n\u003cp>The study authors say that requiring repayment only if the treatment works will protect patients and provide an incentive for the development of more effective drugs.\u003c/p>\n\u003cp>That’s a wrongheaded approach, said A. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design.\u003c/p>\n\u003cp>Medical treatment isn’t always straightforward. Even highly “transformative” drugs such as Sovaldi aren’t guaranteed to work, Fendrick said, and other factors come into play. For example, about 10 percent of people who were prescribed Sovaldi for hepatitis C didn’t finish their course of treatment, Fendrick said, referring to an analysis by the CVS Health Research Institute.\u003c/p>\n\u003cp>“In this situation, the person who does the right thing and gets the good outcome is penalized and has to pay the money back,” he said. Instead, he argued, patients who follow their doctor’s recommendations and “do what you’re supposed to do” should not be held liable for the loans.\u003c/p>\n\u003cp>The proposal doesn’t address drug prices, except to say that the potential for increase due to higher demand for previously unaffordable therapies needs to be addressed.\u003c/p>\n\u003cp>Price increases are a real concern, said Paul Ginsburg, director of public policy at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The health law has made it easier for people to afford expensive drugs. It expanded Medicaid coverage to millions of lower income adults and capped at roughly $7,000 the amount consumers generally spend annually out-of-pocket for care.\u003c/p>\n\u003cp>“It’s helped people, but it’s also driven prices higher,” he said. From a drug company’s perspective, “It just means that more people can afford this drug, so we can charge more for it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lo said the MIT Laboratory for Financial Engineering and the Dana-Farber Cancer Institute will host a conference this winter to bring together drug manufacturers, insurers, patient advocates, financial engineers and others to discuss strategies to make expensive drug therapies more affordable. Health care loans will be on the agenda, he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Californians are used to big mortgages. Now, how about prescription drug loans?\u003c/p>\n\u003cp>That’s one idea for coping with prohibitively expensive drug prices. The unusual proposal is being pitched by academics at the Massachusetts Institute of Technology and Harvard University.\u003c/p>\n\u003cp>Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.\u003c/p>\n\u003cp>Some consumer advocates and health insurance experts see it differently.\u003c/p>\n\u003cp>“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.\u003c/p>\n\u003cp>“This is a private sector stopgap way to deal with something right now,” said Lo.\u003c/p>\n\u003cp>Their proposal calls for the loans to be financed by a pool of investors who would buy bonds and equities issued by an organization that makes the loans to consumers.\u003c/p>\n\u003cp>While it’s “distasteful” to talk about patients mortgaging their lives for treatment, Lo said, they hope the proposal will spur change.\u003c/p>\n\u003cp>The health care installment loans that Lo, Weinstock and their co-author Vahid Montazerhodjat, a former MIT doctoral student who was working with Lo, propose would be aimed at helping people afford “transformative” therapies that cure potentially lethal conditions such as cancer or hepatitis C. They’re not designed to pay for maintenance drugs that help people deal with chronic illness. It’s easier for insurers to cover maintenance drugs because they’re purchased over an extended period of time, they said.\u003c/p>\n\u003cp>In contrast, breakthrough hepatitis C drugs Sovaldi and Harvoni, for example, can cure people of the liver-destroying disease in a few months, but the price tag of $84,000 or more has led many insurers to limit coverage to people whose disease has significantly progressed to show signs of liver damage.\u003c/p>\n\u003cp>“There are miraculous treatments like Harvoni, but they’re out of reach” for many people, said Lo.\u003c/p>\n\u003cp>Someone who wanted that Harvoni treatment might take out a health care loan with a nine-year term at an annual interest rate of about 9 percent, the authors suggest. In a twist on conventional loans, if a therapy doesn’t work or the patient relapses or dies, the patient isn’t obligated to repay the loan.\u003c/p>\n\u003cp>Are sick patients good loan prospects? Lenders might want to assess not only loan applicants’ creditworthiness but also their health to determine whether the applicant is likely to live long enough to pay it off.\u003c/p>\n\u003cp>The study authors say that requiring repayment only if the treatment works will protect patients and provide an incentive for the development of more effective drugs.\u003c/p>\n\u003cp>That’s a wrongheaded approach, said A. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design.\u003c/p>\n\u003cp>Medical treatment isn’t always straightforward. Even highly “transformative” drugs such as Sovaldi aren’t guaranteed to work, Fendrick said, and other factors come into play. For example, about 10 percent of people who were prescribed Sovaldi for hepatitis C didn’t finish their course of treatment, Fendrick said, referring to an analysis by the CVS Health Research Institute.\u003c/p>\n\u003cp>“In this situation, the person who does the right thing and gets the good outcome is penalized and has to pay the money back,” he said. Instead, he argued, patients who follow their doctor’s recommendations and “do what you’re supposed to do” should not be held liable for the loans.\u003c/p>\n\u003cp>The proposal doesn’t address drug prices, except to say that the potential for increase due to higher demand for previously unaffordable therapies needs to be addressed.\u003c/p>\n\u003cp>Price increases are a real concern, said Paul Ginsburg, director of public policy at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The health law has made it easier for people to afford expensive drugs. It expanded Medicaid coverage to millions of lower income adults and capped at roughly $7,000 the amount consumers generally spend annually out-of-pocket for care.\u003c/p>\n\u003cp>“It’s helped people, but it’s also driven prices higher,” he said. From a drug company’s perspective, “It just means that more people can afford this drug, so we can charge more for it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lo said the MIT Laboratory for Financial Engineering and the Dana-Farber Cancer Institute will host a conference this winter to bring together drug manufacturers, insurers, patient advocates, financial engineers and others to discuss strategies to make expensive drug therapies more affordable. Health care loans will be on the agenda, he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Last week, state regulators signed off on Centene’s $7 billion purchase of fellow health insurer Health Net.\u003c/p>\n\u003cp>But that’s a dinky deal compared to Anthem’s proposed $54 billion acquisition of Cigna, which Tuesday undergoes public review by the California Department of Insurance and its politically ambitious commissioner, Dave Jones.\u003c/p>\n\u003cp>The stakes are high. A rejection by California — given the state’s huge market — could jeopardize the acquisition altogether.\u003c/p>\n\u003cp>Eyes are now on Jones, who plans to run for state attorney general in 2018. Last week he said the Centene-Health Net deal could enhance competition in California. Centene currently has almost no market share in California but does have financial stability from its out-of-state business, so it would bring an infusion of “new capital and new resources” to take over Health Net and take on market share leaders.\u003c/p>\n\u003cp>More than three-quarters of the private insurance market in California now belongs to Kaiser Permanente (42 percent), Anthem Blue Cross (20 percent) and Blue Shield of California (15 percent). Centene’s acquisition of Health Net, the fourth-largest insurer in the state (6 percent), could help it compete with the Big Three, Jones said. In the case of Anthem, though, that logic would work against it, because merger approval would mean one of the Big Three would just get more powerful, according to Shana Charles, health policy professor at California State University Fullerton.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“For the regulators, the big question is whether or not a merger would make the market more competitive,” she said. “Because Anthem is so big in California, that’s going to be a big concern.”\u003c/p>\n\u003cp>Jones has fashioned himself as a consumer advocate challenging the power of big insurers. “He has consistently played that role,” Charles said. “So really, this is a perfect opportunity for him.”\u003c/p>\n\u003cp>Several factors weigh against the Anthem/Cigna and Aetna/Humana deals, consumer advocates said.\u003c/p>\n\u003cp>“For the Anthem/Cigna deal, there is overlap in market share, and that wasn’t the case with Centene,” said Tam Ma, attorney for the Sacramento-based advocacy nonprofit Health Access California. Since Cigna and Anthem compete for subscribers, Ma said the Anthem deal would reduce health insurance competition in 31 counties in California.\u003c/p>\n\u003cp>And, Ma said, Anthem has a history of dramatically hiking premium rates, even after state regulators have deemed them unreasonable. Add in a high number of consumer complaints, a question about whether they contract with enough doctors, low quality ratings and Anthem’s major data breach last year, and you get a volatile mixture that defies merger approval, she said. “The big concern is, if they get bigger, are these problems going to get bigger?”\u003c/p>\n\u003cp>In a prepared statement, Anthem spokesman Darrel Ng said Anthem and Cigna have limited overlap and combined will be in a better position to improve consumer choice and quality as well as preserve affordability.\u003c/p>\n\u003cp>“Expanding access to affordable health coverage is the foundation of our combination with Cigna and will remain Anthem’s top priority,” Ng said.\u003c/p>\n\u003cp>“We are continuing to work with the Department of Justice and appropriate state regulators, and are confident that our proposed merger is being reviewed based on these facts.”\u003c/p>\n\u003cp>An outright rejection could sink the deal. That could send shockwaves through the stock market and raise questions about California’s attitude toward business. Health care systems around the country are combining, claiming financial necessity. Insurers say they need to combine, too, to maintain negotiating clout.\u003c/p>\n\u003cp>Instead of blocking the deal, regulators could approve it with conditions.\u003c/p>\n\u003cp>One of Jones’ predecessors, John Garamendi, did both. In 2004, he rejected Anthem’s proposed merger with competitor Wellpoint. Anthem sued him. Garamendi later approved the deal, but got the company to pay $265 million toward various health projects in California, double those in the original agreement.\u003c/p>\n\u003cp>Approval in California isn’t Anthem’s only worry. Federal antitrust officials have yet to weigh in. It’s unclear who will render judgment on the deal first, them or Jones.\u003c/p>\n\u003cp>The hearing Tuesday is in San Francisco. The insurance department said it will soon hold hearings on another huge health industry deal, Aetna’s proposed $37 million acquisition of Humana. The Department of Managed Health Care has already held its hearings on both mergers, but has not issued a timeframe for any decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“For the regulators, the big question is whether or not a merger would make the market more competitive,” she said. “Because Anthem is so big in California, that’s going to be a big concern.”\u003c/p>\n\u003cp>Jones has fashioned himself as a consumer advocate challenging the power of big insurers. “He has consistently played that role,” Charles said. “So really, this is a perfect opportunity for him.”\u003c/p>\n\u003cp>Several factors weigh against the Anthem/Cigna and Aetna/Humana deals, consumer advocates said.\u003c/p>\n\u003cp>“For the Anthem/Cigna deal, there is overlap in market share, and that wasn’t the case with Centene,” said Tam Ma, attorney for the Sacramento-based advocacy nonprofit Health Access California. Since Cigna and Anthem compete for subscribers, Ma said the Anthem deal would reduce health insurance competition in 31 counties in California.\u003c/p>\n\u003cp>And, Ma said, Anthem has a history of dramatically hiking premium rates, even after state regulators have deemed them unreasonable. Add in a high number of consumer complaints, a question about whether they contract with enough doctors, low quality ratings and Anthem’s major data breach last year, and you get a volatile mixture that defies merger approval, she said. “The big concern is, if they get bigger, are these problems going to get bigger?”\u003c/p>\n\u003cp>In a prepared statement, Anthem spokesman Darrel Ng said Anthem and Cigna have limited overlap and combined will be in a better position to improve consumer choice and quality as well as preserve affordability.\u003c/p>\n\u003cp>“Expanding access to affordable health coverage is the foundation of our combination with Cigna and will remain Anthem’s top priority,” Ng said.\u003c/p>\n\u003cp>“We are continuing to work with the Department of Justice and appropriate state regulators, and are confident that our proposed merger is being reviewed based on these facts.”\u003c/p>\n\u003cp>An outright rejection could sink the deal. That could send shockwaves through the stock market and raise questions about California’s attitude toward business. Health care systems around the country are combining, claiming financial necessity. Insurers say they need to combine, too, to maintain negotiating clout.\u003c/p>\n\u003cp>Instead of blocking the deal, regulators could approve it with conditions.\u003c/p>\n\u003cp>One of Jones’ predecessors, John Garamendi, did both. In 2004, he rejected Anthem’s proposed merger with competitor Wellpoint. Anthem sued him. Garamendi later approved the deal, but got the company to pay $265 million toward various health projects in California, double those in the original agreement.\u003c/p>\n\u003cp>Approval in California isn’t Anthem’s only worry. Federal antitrust officials have yet to weigh in. It’s unclear who will render judgment on the deal first, them or Jones.\u003c/p>\n\u003cp>The hearing Tuesday is in San Francisco. The insurance department said it will soon hold hearings on another huge health industry deal, Aetna’s proposed $37 million acquisition of Humana. The Department of Managed Health Care has already held its hearings on both mergers, but has not issued a timeframe for any decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Faces Challenges Enrolling Undocumented Children in Medi-Cal",
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"content": "\u003cp>Hundreds of thousands of low-income, undocumented children in California will be eligible to enroll in full-scope health coverage through Medi-Cal starting on May 1 under legislation approved last year.\u003c/p>\n\u003cp>As officials try to get the word out about California's decision to open the program to children from low-income families regardless of immigration status, these kids will still face significant barriers to obtaining the coverage, says the \u003ca href=\"http://www.sbsun.com/social-affairs/20160323/group-gets-the-word-out-undocumented-children-now-eligible-for-health-care\" target=\"_blank\">\u003cem>San Bernardino County Sun\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>Officials say they hope community clinics, religious groups and ethnic media outlets will help alert undocumented immigrants to enroll their children. Even so, state officials expect only about half of eligible kids to enroll in the program in its first year, the Sun writes.\u003c/p>\n\u003cp>Many undocumented families may be reluctant to participate out of fear that it would put at risk their chance to obtain a legal immigration status. Lack of empowerment and confusion over how and why to enroll may also make it difficult to reach the eligible families, experts say.\u003c/p>\n\u003cp>The expansion will extend Medi-Cal coverage to about 170,000 undocumented immigrant children under age 19. About 115,000 undocumented children are currently enrolled in restricted Medi-Cal programs and 55,000 eligible children aren’t receiving coverage, the Sun writes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Also, the process of moving eligible children into full scope Medi-Cal from their current more limited plans creates administrative hurdles that could cause disruptions in care or even lead to families dropping out of the system, the \u003ca href=\"http://www.chcf.org/articles/2015/11/medical-enrolls-undocumented-kids\" target=\"_blank\">California Health Care Foundation\u003c/a> writes.\u003c/p>\n\u003cp>The Medi-Cal expansion will help these undocumented children get preventive care, such as physicals and immunizations, mental health care, and vision care, Assemblywoman Cheryl Brown, D-San Bernardino, told the Sun.\u003c/p>\n\u003cp>How to provide health care to undocumented immigrants has been the subject of recent political debate. Under the Affordable Care Act, undocumented immigrants were excluded from purchasing coverage through Covered California.\u003c/p>\n\u003cp>After rejecting the idea of covering both undocumented adults and children, California lawmakers granted full-scope coverage to the children as long as they meet the income standards. The program will cost $40 million in this year's budget and an estimated $132 million each following year.\u003c/p>\n\u003cp>\"This is a major investment that California is doing, and it's completely the reverse of what we’re seeing at the national level,\" said state Sen. Ricardo Lara, D-Bell Gardens, who led the health care expansion effort, told the \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-california-immigrant-healthcare-20151009-story.html\" target=\"_blank\">\u003cem>Los Angeles Times\u003c/em>\u003c/a> in October.\u003c/p>\n\u003cp>Offering Medi-Cal coverage to undocumented children is a good long-term investment for the state, experts say. It will bring down health care costs by reducing trips to the emergency room for routine care and help ease stress on community health centers, which often treat undocumented patients without reimbursement, experts told \u003ca href=\"http://californiahealthline.org/morning-breakout/advocates-extending-medical-to-undocumented-kids-a-good-first-step/\" target=\"_blank\">\u003cem>California Healthline\u003c/em>\u003c/a> in July.\u003c/p>\n\u003cp>Eligible children can be enrolled in-person at \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx\" target=\"_blank\">county social services offices\u003c/a>, or online or by mail through \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, according to the \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75Children.aspx\" target=\"_blank\">California Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We have a big challenge ahead of us to dispel the perception that undocumented people are forever left out,\" Daniel Zingale, senior vice president at the California Endowment told \u003cem>California Healthline\u003c/em>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hundreds of thousands of low-income, undocumented children in California will be eligible to enroll in full-scope health coverage through Medi-Cal starting on May 1 under legislation approved last year.\u003c/p>\n\u003cp>As officials try to get the word out about California's decision to open the program to children from low-income families regardless of immigration status, these kids will still face significant barriers to obtaining the coverage, says the \u003ca href=\"http://www.sbsun.com/social-affairs/20160323/group-gets-the-word-out-undocumented-children-now-eligible-for-health-care\" target=\"_blank\">\u003cem>San Bernardino County Sun\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>Officials say they hope community clinics, religious groups and ethnic media outlets will help alert undocumented immigrants to enroll their children. Even so, state officials expect only about half of eligible kids to enroll in the program in its first year, the Sun writes.\u003c/p>\n\u003cp>Many undocumented families may be reluctant to participate out of fear that it would put at risk their chance to obtain a legal immigration status. Lack of empowerment and confusion over how and why to enroll may also make it difficult to reach the eligible families, experts say.\u003c/p>\n\u003cp>The expansion will extend Medi-Cal coverage to about 170,000 undocumented immigrant children under age 19. About 115,000 undocumented children are currently enrolled in restricted Medi-Cal programs and 55,000 eligible children aren’t receiving coverage, the Sun writes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Also, the process of moving eligible children into full scope Medi-Cal from their current more limited plans creates administrative hurdles that could cause disruptions in care or even lead to families dropping out of the system, the \u003ca href=\"http://www.chcf.org/articles/2015/11/medical-enrolls-undocumented-kids\" target=\"_blank\">California Health Care Foundation\u003c/a> writes.\u003c/p>\n\u003cp>The Medi-Cal expansion will help these undocumented children get preventive care, such as physicals and immunizations, mental health care, and vision care, Assemblywoman Cheryl Brown, D-San Bernardino, told the Sun.\u003c/p>\n\u003cp>How to provide health care to undocumented immigrants has been the subject of recent political debate. Under the Affordable Care Act, undocumented immigrants were excluded from purchasing coverage through Covered California.\u003c/p>\n\u003cp>After rejecting the idea of covering both undocumented adults and children, California lawmakers granted full-scope coverage to the children as long as they meet the income standards. The program will cost $40 million in this year's budget and an estimated $132 million each following year.\u003c/p>\n\u003cp>\"This is a major investment that California is doing, and it's completely the reverse of what we’re seeing at the national level,\" said state Sen. Ricardo Lara, D-Bell Gardens, who led the health care expansion effort, told the \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-california-immigrant-healthcare-20151009-story.html\" target=\"_blank\">\u003cem>Los Angeles Times\u003c/em>\u003c/a> in October.\u003c/p>\n\u003cp>Offering Medi-Cal coverage to undocumented children is a good long-term investment for the state, experts say. It will bring down health care costs by reducing trips to the emergency room for routine care and help ease stress on community health centers, which often treat undocumented patients without reimbursement, experts told \u003ca href=\"http://californiahealthline.org/morning-breakout/advocates-extending-medical-to-undocumented-kids-a-good-first-step/\" target=\"_blank\">\u003cem>California Healthline\u003c/em>\u003c/a> in July.\u003c/p>\n\u003cp>Eligible children can be enrolled in-person at \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx\" target=\"_blank\">county social services offices\u003c/a>, or online or by mail through \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, according to the \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75Children.aspx\" target=\"_blank\">California Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We have a big challenge ahead of us to dispel the perception that undocumented people are forever left out,\" Daniel Zingale, senior vice president at the California Endowment told \u003cem>California Healthline\u003c/em>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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},
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"officialWebsiteLink": "/californiareport",
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"order": 8
},
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"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
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},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"order": 9
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"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"id": "fresh-air",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"source": "NPR"
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"how-i-built-this": {
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"jerrybrown": {
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
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"id": "latino-usa",
"title": "Latino USA",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
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"link": "/radio/program/latino-usa",
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"source": "WaitWhat"
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/onourwatch",
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"source": "kqed",
"order": 11
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