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"content": "\u003cp>Did you recently have or adopt a baby, get married, or move to California from another state? Perhaps you lost your job – and your health insurance with it.\u003c/p>\n\u003cp>These are some of life’s common events that trigger special health insurance enrollment opportunities, which allow you to buy or switch plans outside of limited open enrollment periods.\u003c/p>\n\u003cp>But one common life event is missing from that list: Pregnancy.\u003c/p>\n\u003cp>Attempts to add it this year have failed. At the same time, recent changes have expanded coverage options for some uninsured, pregnant Californians.\u003c/p>\n\u003cp>\u003cstrong>Q: Do you know any solution to get health insurance now that \u003c/strong>\u003cstrong>my\u003c/strong>\u003cstrong> friend’s wife is pregnant and there are no health plans accepting applications? For some reason, they say it’s not a qualifying event.\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A: Jay of Rancho Cucamonga isn’t alone in wondering why pregnancy doesn’t trigger a special enrollment period for most commercial health insurance plans, whether purchased from the individual market or obtained from your employer.\u003c/p>\n\u003cp>In March, 37 Democratic U.S. Senators urged the secretary of the U.S. Department of Health and Human Services (HHS) to include pregnancy as a qualifying life event. Within days, California’s two Democratic U.S. Senators, Barbara Boxer and Dianne Feinstein, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/11/feinstein-and-boxer-say-pregnant-women-should-get-special-obamacare-enrollment/\" target=\"_blank\">asked California’s health insurance exchange, Covered California,\u003c/a> to do the same. In their letter, they said that doing so could save lives and reduce health costs.\u003c/p>\n\u003cp>“Especially since having a child is a qualifying life event, it makes sense to ensure that access to care is granted prior to birth,” they wrote.\u003c/p>\n\u003cp>HHS Secretary Sylvia Burwell responded in April that the department can’t make pregnancy a qualifying life event because “we do not have the legal authority to” do so.\u003c/p>\n\u003cp>(Which of course raises the question of who does have the authority. I asked HHS, but the agency declined to comment further.)\u003c/p>\n\u003cp>As a result of Burwell’s response, Covered California, too, said it couldn’t make pregnancy a qualifying event.\u003c/p>\n\u003cp>So what options are available for women who get pregnant while uninsured?\u003c/p>\n\u003cp>[contextly_sidebar id=\"98MRboitTJQrj3cwlOCCOBJ5XuRbYCsF\"]After all, nearly half of pregnancies are unintended, says Alina Salganicoff, director of Women’s Health Policy at the Kaiser Family Foundation.\u003c/p>\n\u003cp>In California, \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/documents/pregnancy_fact_sheet_chart.pdf\" target=\"_blank\">you may qualify \u003c/a>for a publicly-funded health program depending on your income. The thresholds can be relatively generous and include middle-income families.\u003c/p>\n\u003cp>And as long as you’re eligible, you can sign up anytime of year.\u003c/p>\n\u003cp>The first is \u003ca href=\"http://mcap.dhcs.ca.gov/my_mcap/important_information_applicants.aspx\" target=\"_blank\">Medi-Cal\u003c/a>, which is the state’s version of the federal Medicaid program for low-income residents. On Aug. 1, it increased the income limit for pregnant women to qualify for full-scope benefits to \u003ca href=\"http://aspe.hhs.gov/2015-poverty-guidelines#threshholds\" target=\"_blank\">138 percent of the Federal Poverty Level\u003c/a> (FPL).\u003c/p>\n\u003cp>This year, that’s up to roughly $22,000 for a family of two. (There’s a twist here. I’ll explain more below.)\u003c/p>\n\u003cp>The higher income threshold means that more pregnant women will qualify for comprehensive coverage, says Lucy Quacinella, a San Francisco attorney who advocates for health coverage options for working families.\u003c/p>\n\u003cp>“They won’t have to worry about whether something outside of a routine prenatal visit, like a referral to a specialist, will be covered,” she says.\u003c/p>\n\u003cp>Pregnant women who make between 138 percent and 213 percent of FPL may qualify for Pregnancy-Related Medi-Cal. This coverage includes “all medically necessary Medi-Cal services related to pregnancy and/or any complications that may pose a risk to the woman or her unborn child,” says Tony Cava of the state Department of Health Care Services.\u003c/p>\n\u003cp>(No matter how much their income is, pregnant women who are not in the country legally are not eligible for full Medi-Cal benefits. However, they are eligible for Pregnancy-Related Medi-Cal up to 213 percent of FPL, Quacinella says.)\u003c/p>\n\u003cp>Coverage in full-scope Medi-Cal and Pregnancy-Related Medi-Cal is free for those who qualify.\u003c/p>\n\u003cp>Plus, while you’re waiting for your Medi-Cal application to be processed, there’s a program called \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/pages/pe.aspx\" target=\"_blank\">Presumptive Eligibility for Pregnant Women\u003c/a>, which allows you to access temporary prenatal care. Call 800-824-0088 for more information.\u003c/p>\n\u003cp>Pregnant women who make between 213 percent and 322 percent of FPL (up to roughly $51,300 for a family of two), may qualify for different coverage called the \u003ca href=\"http://mcap.dhcs.ca.gov/home/default.aspx\">Medi-Cal Access Program\u003c/a>, formerly known as AIM.\u003c/p>\n\u003cp>Earlier this year, the state removed the requirement that women sign up by their 30\u003csup>th\u003c/sup> week of gestation, allowing them to apply anytime during pregnancy, says Lynn Kersey, executive director of Maternal and Child Health Access.\u003c/p>\n\u003cp>This program costs 1.5 percent of annual household income (after some adjustments) but does not have deductibles or copayments.\u003c/p>\n\u003cp>You can apply for Medi-Cal or the Medi-Cal Access Program by visiting \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com \u003c/a>or by calling 800-300-1506. You can apply in person at your \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/countyoffices.aspx\" target=\"_blank\">county human services office.\u003c/a>\u003c/p>\n\u003cp>Now, here’s the twist: For Medi-Cal and the Medi-Cal Access Program, a pregnant woman counts not just as one person when calculating income, but one person plus the number of fetuses she’s carrying.\u003c/p>\n\u003cp>“That means you can make more money and still qualify for these programs,” Kersey says.\u003c/p>\n\u003cp>For instance, a single mom who has one child and is expecting another would have a family size of three instead of two, which means she would be eligible for the Medi-Cal Access Program up to an annual income of nearly $65,000 instead of $51,300.\u003c/p>\n\u003cp>If you make too much money to qualify for these programs, you still have options.\u003c/p>\n\u003cul>\n\u003cli>Community health clinics won’t turn you away and offer care on a sliding-scale based on your income, Salganicoff says.\u003c/li>\n\u003cli>Talk to your doctor and hospital (ask to speak with a medical social worker) to see if you can receive reduced-cost care or work out a payment plan, she adds.\u003c/li>\n\u003cli>Check with your county health agency to see what programs, if any, might be available to you, Kersey says. For instance, she says \u003ca href=\"https://dhs.lacounty.gov/wps/portal/dhs/healthcoverageoptions/lacountynocost/prepayment\" target=\"_blank\">Los Angeles County offers some services.\u003c/a>\u003c/li>\n\u003cli>Open-enrollment season is upon us. For Covered California and the open market, it starts Nov. 1 and ends Jan. 31, 2016. If you’re pregnant and uninsured –- or you’re planning to get pregnant –- now’s the time to sign up.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>Questions for Emily: \u003c/em>\u003cem>\u003ca href=\"http://AskEmily@usc.edu\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>\u003c/em>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Did you recently have or adopt a baby, get married, or move to California from another state? Perhaps you lost your job – and your health insurance with it.\u003c/p>\n\u003cp>These are some of life’s common events that trigger special health insurance enrollment opportunities, which allow you to buy or switch plans outside of limited open enrollment periods.\u003c/p>\n\u003cp>But one common life event is missing from that list: Pregnancy.\u003c/p>\n\u003cp>Attempts to add it this year have failed. At the same time, recent changes have expanded coverage options for some uninsured, pregnant Californians.\u003c/p>\n\u003cp>\u003cstrong>Q: Do you know any solution to get health insurance now that \u003c/strong>\u003cstrong>my\u003c/strong>\u003cstrong> friend’s wife is pregnant and there are no health plans accepting applications? For some reason, they say it’s not a qualifying event.\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A: Jay of Rancho Cucamonga isn’t alone in wondering why pregnancy doesn’t trigger a special enrollment period for most commercial health insurance plans, whether purchased from the individual market or obtained from your employer.\u003c/p>\n\u003cp>In March, 37 Democratic U.S. Senators urged the secretary of the U.S. Department of Health and Human Services (HHS) to include pregnancy as a qualifying life event. Within days, California’s two Democratic U.S. Senators, Barbara Boxer and Dianne Feinstein, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/11/feinstein-and-boxer-say-pregnant-women-should-get-special-obamacare-enrollment/\" target=\"_blank\">asked California’s health insurance exchange, Covered California,\u003c/a> to do the same. In their letter, they said that doing so could save lives and reduce health costs.\u003c/p>\n\u003cp>“Especially since having a child is a qualifying life event, it makes sense to ensure that access to care is granted prior to birth,” they wrote.\u003c/p>\n\u003cp>HHS Secretary Sylvia Burwell responded in April that the department can’t make pregnancy a qualifying life event because “we do not have the legal authority to” do so.\u003c/p>\n\u003cp>(Which of course raises the question of who does have the authority. I asked HHS, but the agency declined to comment further.)\u003c/p>\n\u003cp>As a result of Burwell’s response, Covered California, too, said it couldn’t make pregnancy a qualifying event.\u003c/p>\n\u003cp>So what options are available for women who get pregnant while uninsured?\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>After all, nearly half of pregnancies are unintended, says Alina Salganicoff, director of Women’s Health Policy at the Kaiser Family Foundation.\u003c/p>\n\u003cp>In California, \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/documents/pregnancy_fact_sheet_chart.pdf\" target=\"_blank\">you may qualify \u003c/a>for a publicly-funded health program depending on your income. The thresholds can be relatively generous and include middle-income families.\u003c/p>\n\u003cp>And as long as you’re eligible, you can sign up anytime of year.\u003c/p>\n\u003cp>The first is \u003ca href=\"http://mcap.dhcs.ca.gov/my_mcap/important_information_applicants.aspx\" target=\"_blank\">Medi-Cal\u003c/a>, which is the state’s version of the federal Medicaid program for low-income residents. On Aug. 1, it increased the income limit for pregnant women to qualify for full-scope benefits to \u003ca href=\"http://aspe.hhs.gov/2015-poverty-guidelines#threshholds\" target=\"_blank\">138 percent of the Federal Poverty Level\u003c/a> (FPL).\u003c/p>\n\u003cp>This year, that’s up to roughly $22,000 for a family of two. (There’s a twist here. I’ll explain more below.)\u003c/p>\n\u003cp>The higher income threshold means that more pregnant women will qualify for comprehensive coverage, says Lucy Quacinella, a San Francisco attorney who advocates for health coverage options for working families.\u003c/p>\n\u003cp>“They won’t have to worry about whether something outside of a routine prenatal visit, like a referral to a specialist, will be covered,” she says.\u003c/p>\n\u003cp>Pregnant women who make between 138 percent and 213 percent of FPL may qualify for Pregnancy-Related Medi-Cal. This coverage includes “all medically necessary Medi-Cal services related to pregnancy and/or any complications that may pose a risk to the woman or her unborn child,” says Tony Cava of the state Department of Health Care Services.\u003c/p>\n\u003cp>(No matter how much their income is, pregnant women who are not in the country legally are not eligible for full Medi-Cal benefits. However, they are eligible for Pregnancy-Related Medi-Cal up to 213 percent of FPL, Quacinella says.)\u003c/p>\n\u003cp>Coverage in full-scope Medi-Cal and Pregnancy-Related Medi-Cal is free for those who qualify.\u003c/p>\n\u003cp>Plus, while you’re waiting for your Medi-Cal application to be processed, there’s a program called \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/pages/pe.aspx\" target=\"_blank\">Presumptive Eligibility for Pregnant Women\u003c/a>, which allows you to access temporary prenatal care. Call 800-824-0088 for more information.\u003c/p>\n\u003cp>Pregnant women who make between 213 percent and 322 percent of FPL (up to roughly $51,300 for a family of two), may qualify for different coverage called the \u003ca href=\"http://mcap.dhcs.ca.gov/home/default.aspx\">Medi-Cal Access Program\u003c/a>, formerly known as AIM.\u003c/p>\n\u003cp>Earlier this year, the state removed the requirement that women sign up by their 30\u003csup>th\u003c/sup> week of gestation, allowing them to apply anytime during pregnancy, says Lynn Kersey, executive director of Maternal and Child Health Access.\u003c/p>\n\u003cp>This program costs 1.5 percent of annual household income (after some adjustments) but does not have deductibles or copayments.\u003c/p>\n\u003cp>You can apply for Medi-Cal or the Medi-Cal Access Program by visiting \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com \u003c/a>or by calling 800-300-1506. You can apply in person at your \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/countyoffices.aspx\" target=\"_blank\">county human services office.\u003c/a>\u003c/p>\n\u003cp>Now, here’s the twist: For Medi-Cal and the Medi-Cal Access Program, a pregnant woman counts not just as one person when calculating income, but one person plus the number of fetuses she’s carrying.\u003c/p>\n\u003cp>“That means you can make more money and still qualify for these programs,” Kersey says.\u003c/p>\n\u003cp>For instance, a single mom who has one child and is expecting another would have a family size of three instead of two, which means she would be eligible for the Medi-Cal Access Program up to an annual income of nearly $65,000 instead of $51,300.\u003c/p>\n\u003cp>If you make too much money to qualify for these programs, you still have options.\u003c/p>\n\u003cul>\n\u003cli>Community health clinics won’t turn you away and offer care on a sliding-scale based on your income, Salganicoff says.\u003c/li>\n\u003cli>Talk to your doctor and hospital (ask to speak with a medical social worker) to see if you can receive reduced-cost care or work out a payment plan, she adds.\u003c/li>\n\u003cli>Check with your county health agency to see what programs, if any, might be available to you, Kersey says. For instance, she says \u003ca href=\"https://dhs.lacounty.gov/wps/portal/dhs/healthcoverageoptions/lacountynocost/prepayment\" target=\"_blank\">Los Angeles County offers some services.\u003c/a>\u003c/li>\n\u003cli>Open-enrollment season is upon us. For Covered California and the open market, it starts Nov. 1 and ends Jan. 31, 2016. If you’re pregnant and uninsured –- or you’re planning to get pregnant –- now’s the time to sign up.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>Questions for Emily: \u003c/em>\u003cem>\u003ca href=\"http://AskEmily@usc.edu\">AskEmily@usc.edu\u003c/a>\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>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>\u003c/em>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Who's Responsible for Your Uber Driver's Health Coverage?",
"title": "Who's Responsible for Your Uber Driver's Health Coverage?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>For six months, Eliza Kinrose worked about ten hours a week delivering anything from cupcakes to art supplies to strangers’ homes.\u003c/p>\n\u003cp>Shortly after quitting her steady job as a recruiter, Kinrose, 29, signed up to work for a new San Francisco-based mobile delivery service called \u003ca href=\"https://postmates.com/\">Postmates\u003c/a>. She made about $15 an hour for six months, which was just enough to scrape by until she launched a yoga business.\u003c/p>\n\u003cp>Postmates is just one of an explosion of “gig economy” or “on-demand economy” companies that connect people seeking services with sellers of those services in a few minutes’ time. Those who work for the gig economy do not receive health insurance, or any of the other social protections extended to employees. Unless they are employed elsewhere, they need to find and pay for these protections on their own.\u003c/p>\n\u003cp>But one evening, Kinrose received an email from Postmates about an intriguing free \"perk\" to help her find health insurance called \u003ca href=\"https://www.stridehealth.com/\">Stride Health.\u003c/a>\u003c/p>\n\u003cp>Stride Health is a startup health insurance broker service, which makes recommendations about health plans that are tailored to people's needs. The company offers web and mobile services to assist customers once they've purchased a health plan, including premium payment reminders and guidance on whether they qualify for subsidies. Stride Health also shows customers how much scenarios, like asthma or heart disease, would affect their out of pocket costs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>San Francisco-based Stride Health is one of many startups taking advantage of new opportunities created by the \u003ca href=\"http://www.hhs.gov/healthcare/rights/\">Affordable Care Act\u003c/a> and the perceived failings of the federal and state marketplaces for individuals to buy health insurance. It is unique, however, in targeting gig economy workers like Kinrose. Uber, Postmates and Taskrabbit, three of the largest gig economy companies, market Stride Health's service to their workers.\u003c/p>\n\u003cfigure id=\"attachment_48816\" class=\"wp-caption alignright\" style=\"max-width: 307px\">\u003cimg class=\" wp-image-48816\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/10/uber-sidecar-400x600.jpg\" alt=\"Many workers, like Rick Warren, drive for multiple companies, including Sidecar and Lyft. \" width=\"307\" height=\"461\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-400x600.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-787x1180.jpg 787w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-1180x1770.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-960x1440.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar.jpg 1280w\" sizes=\"(max-width: 307px) 100vw, 307px\">\u003cfigcaption class=\"wp-caption-text\">Many workers, like Rick Warren, drive for multiple companies, including Sidecar and Lyft.\u003c/figcaption>\u003c/figure>\n\u003cp>Stride Health's involvement with the gig economy may signal a shift in attitudes and priorities. According to Stride Health CEO Noah Lang, Uber and the rest are starting to care about the needs of their workers. \"They want to make sure people don't end up in a tough spot by forgoing coverage,\" he said.\u003c/p>\n\u003cp>But critics of the gig economy say Stride Health is a bandaid solution, as workers are still on the hook to pay for their own health insurance.\u003c/p>\n\u003cp>“When we have a jobs-based social welfare system, some people get a combination of health care, disability and more,” said Ken Jacobs, chair of the Labor Center at UC Berkeley, who specializes in health care coverage and public policy. “In a world where people are operating separately from that, the safety net goes away.\"\u003c/p>\n\u003cp>\u003cstrong>How Big Is the Gig Economy, Really?\u003c/strong>\u003c/p>\n\u003cp>In cities across the United States, anyone with a smartphone can order a meal from Postmates, a ride to work via Lyft or Uber, groceries on Instacart or a home cleaning on Handy. These services are so pervasive, with billions in total sales as a group that it’s hard to believe they only sprung up in the past five years.\u003c/p>\n\u003caside class=\"pullquote alignright\">“These marketplaces care about growing and maintaining their labor pool. But at the same time, they have to minimize their risks by not stepping over any of the lines.”\u003cbr>\n\u003ccite>Noah Lang, Stride Health cofounder and CEO\u003c/cite>\u003c/aside>\n\u003cp>The on-demand economy has been hailed as the next big thing, but labor economists say it still hasn’t made much of a dent in the overall U.S. economy. The idea may be disruptive to the status quo, but the most recent data suggests that Americans are no less likely to be self-employed than a decade ago.\u003c/p>\n\u003cp>“The gig economy currently is not really even big enough to show up in the [national economic] data,” said Jacobs. “And unfortunately, we don’t yet have a good sense of how big it will be.”\u003c/p>\n\u003cp>One promising trend, according to Jacobs, is that the companies are starting to release more data on their workers. In 2014, Uber collaborated with Princeton University economist Alan Kreuger on a report that determined the company had 160,000 “driver partners” in the United States. By contrast, the Bureau of Labor Statistics estimated that there were some 230,000 taxi-drivers in the U.S. in 2012.\u003c/p>\n\u003cp>Uber may not show up in national data just yet, but it is having an outsized impact in politics and popular culture. Even the presidential candidates are taking a side: While Hilary Clinton says she wants to “crack down” on sharing economy abuses of workers, Jeb Bush was recently spotted hailing an Uber ride in San Francisco.\u003c/p>\n\u003cp>\u003cb>Independent\u003c/b>\u003cstrong> Contractors or Employees? \u003c/strong>\u003c/p>\n\u003cp>By targeting the gig economy, Stride Health has taken a central role in an ongoing debate between policymakers, investors, and litigators, about whether on-demand companies should be treating their workers as employees and paying their expenses, as well as providing health insurance and other benefits.\u003c/p>\n\u003cp>Uber, a San Francisco-based company that uses a smartphone app to link people needing car rides with drivers for hire who use their own vehicles, is currently facing a\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/09/23/uc-riverside-professor-slams-feds-stands-by-his-health-app/\"> looming class action lawsuit\u003c/a>. In the suit, three Uber drivers are collectively challenging the company on whether they should be considered employees under the law – and not independent contractors, as the company now classifies them.\u003c/p>\n\u003cp>And in June, the California Labor Commission ruled against Uber in determining that an ex-driver was entitled to reimbursement for business expenses.\u003c/p>\n\u003cp>“Many drivers have included on their list of issues that they are on their own for health insurance,” said Shannon Liss-Riordan, of Boston, Mass. the lead plaintiff attorney in the class action lawsuit against Uber. Liss-Riordan is also taking aim against Uber’s main rival, Lyft, and has spoken to hundreds of people who drive for these companies. “These drivers are left in the cold,” she said.\u003c/p>\n\u003cp>How the Uber case ends up could have national implications. If the company loses its class-action lawsuit and has to reclassify its drivers from independent contractors to employees, that would force the company to pay for things like expenses, and provide benefits to full-time drivers. One recent estimate is that Uber would need to \u003ca href=\"http://recode.net/2015/07/14/uber-could-have-to-pay-an-additional-209-million-to-reclassify-its-drivers-in-california/\">pay $209 million a year\u003c/a> to reclassify its drivers to employees – and that’s just in California.\u003c/p>\n\u003cp>Not everyone believes that Uber and the rest have left anyone out in the cold.\u003c/p>\n\u003cfigure id=\"attachment_48815\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-48815\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/10/Uber-1-800x533.jpg\" alt=\"Lyft driver Deco Carter scanning for a fare.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lyft driver Deco Carter scanning for a fare. \u003ccite>(Alan Toth/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For one thing, the Affordable Care Act has relieved the burden for many drivers, as it provides subsidies for low-income people to buy health insurance independently. Uber's CEO Travis Kalanick reportedly referred to the ACA as \"huge\" for the gig economy.\u003c/p>\n\u003cp>Some policymakers envision a middle ground, where workers have some added protections but are not full employees. One idea is a new worker category called a \"dependent contractor,\" which is legal in Germany, Canada and other countries, but not in the United States.\u003c/p>\n\u003cp>U.S. Senator Mark Warner, D-Virginia, has spent more than a year researching the on-demand economy. \u003ca href=\"http://onlabor.org/2015/06/22/a-new-category-of-worker-for-the-on-demand-economy/\">He has proposed \u003c/a>numerous paths forward to broker a peace in the legal wars, including the dependent contractor model. He has also proposed similar marketplaces to the Affordable Care Act for other key benefits, including workers' compensation.\u003c/p>\n\u003cp>But Warner doesn't agree that the ACA is a silver bullet for the gig economy, as these companies do not pay into it. Uber avoids providing health insurance to drivers, which it considers contractors, as the ACA mandates that only employers extend coverage to full-time employees. That’s a loophole that saves gig economy companies a lot of money.\u003c/p>\n\u003cp>\u003cstrong>Walking the Tightrope \u003c/strong>\u003c/p>\n\u003cp>Some \u003ca href=\"http://qz.com/299655/why-your-uber-driver-hates-uber/\">critics of Uber have painted the company’s top executives as indifferent to the plight of workers\u003c/a>. But by providing services to workers, these companies risk adding fuel to the legal argument that they should be employees and not independent contractors.\u003c/p>\n\u003cp>\u003ca href=\"http://docs.procurement.ku.edu/departmental_policies/Independent_Contractor_Excerpts.pdf\">The I.R.S. has about twenty factors\u003c/a> that it takes into account when determining a worker classification. One important distinction is how much \"control\" an employer has over the work that's being done, but it's not always clear what control means.\u003c/p>\n\u003cp>“Essentially, this [partnership with Stride Health] is about how these workers can get health care without exposing Uber and the rest to liability or responsibility,” said UC Berkeley’s Jacobs.\u003c/p>\n\u003cfigure id=\"attachment_48819\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-48819\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/10/IMG_1692-800x600.jpg\" alt=\"Stride Health's founders Noah Lang (left) and Matt Butner (right) \" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stride Health's founders Noah Lang (left) and Matt Butner (right) \u003ccite>(Christina Farr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lang doesn’t totally disagree, but paints the partnership in a more positive light: “These marketplaces care about growing and maintaining their labor pool,” he said. “But at the same time, they have to minimize their risks by not stepping over any of the lines.”\u003c/p>\n\u003cp>If these companies do nothing, their practices may draw fire from policymakers. An uninsured and at-risk population is likely to incur major health costs in the long-term, costs that could eventually be borne by taxpayers. According to Lang, about 40 percent of gig economy workers surveyed by Stride Health said they would \"not have gotten coverage otherwise.\"\u003c/p>\n\u003cp>Stride Health seems to be a safe solution for the gig economy companies. It is unclear how many workers are using the tool, but Uber said it is helping those who are uninsured drivers find an affordable health plan. And drivers seem to like it.\u003c/p>\n\u003cp>“Finding affordable, effective health insurance is top of mind for many drivers,\" an Uber spokesperson said in a press release. A spokesperson for Taskrabbit said the company “vetted other options” but ultimately opted to partner with Stride due to the “thoughtful approach for independent contractors.”\u003c/p>\n\u003cp>Postmates declined to comment on its reasons for partnering with Stride. \u003cspan class=\"s1\">Uber and Taskrabbit emailed statements that could not be attributed to any company official. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Will On-Demand Companies Ever Provide Health Insurance to Workers?\u003c/strong>\u003c/p>\n\u003cp>Critics of the on-demand economy say that Uber and the rest are the latest in a long line of companies that use fancy wordplay and questionable tactics to avoid protecting workers. These legal battles go back decades, with FedEx most recently settling a lawsuit with drivers who claimed they had been misclassified.\u003c/p>\n\u003cp>“Uber tries to argue that it’s not in the car service industry; it’s a technology platform,” said Liss-Riordan in an interview. “The court rejected that.”\u003c/p>\n\u003caside class=\"pullquote alignright\">“Some folks are working part-time for other jobs. Others have not had health insurance in a long time and need extra help navigating their options.\"\u003cbr>\n\u003ccite>An Uber spokesperson\u003c/cite>\u003c/aside>\n\u003cp>Some on-demand economy companies are now taking steps to reclassify their workers as employees, including \u003ca href=\"http://www.doctorondemand.com/\">Doctor on Demand\u003c/a>, a company that connects people with doctors online in a matter of minutes, as well as mobile delivery services Instacart and Shyp.\u003c/p>\n\u003cp>But Lang is doubtful that this will trigger a shift for the on-demand economy at large. As Lang points out, Uber’s labor pool is much larger than \u003ca href=\"http://www.businessinsider.com/why-instacart-is-reclassifing-some-of-its-workers-as-employees-2015-6\">an Instarcart\u003c/a> or Shyp and its workers are not specialized like Doctor on Demand’s physicians – all they need is a drivers’ license. “I give Shyp and Instacart kudos, of course,” he said, “but it’s also opportunistic for them.”\u003c/p>\n\u003cp>A change in federal law or a landmark Supreme Court ruling might force Uber, Lyft and others to treat their workers as employees. This wouldn’t mean that every driver would receive employee-sponsored health insurance overnight.\u003c/p>\n\u003cp>Dan Diamond, executive editor for the research and consulting firm \u003ca href=\"https://www.advisory.com/\">The Advisory Board\u003c/a>, has written about how Uber would handle the health care problem if its drivers were considered employees. Diamond does not believe that workers would immediately benefit from a reclassification.\u003c/p>\n\u003cp>Uber might opt to avoid providing health insurance by paying a fee under the Affordable Care Act (a requirement if businesses do not provide health insurance to employees who work more than 30 hours per week). It might also cap workers’ at 29 hours per week to keep them part-time employees.\u003c/p>\n\u003cp>Diamond expects that Uber will use every weapon in its arsenal to avoid such an outcome. “For Uber, none of these options are ideal.”\u003c/p>\n\u003cp>Deco Carter, a Bay Area-based Lyft driver, said he “knew the risks” when he joined the growing ranks of gig economy workers. He has been involved in two auto accidents, and lacked income for several weeks until he got his car fixed.\u003c/p>\n\u003cp>\"I really didn't have anything to fall back on,\" he said. \"If it wasn't for my fiancé, I don't know what I would have done.\"\u003c/p>\n\u003cp>In the years ahead, he hopes that Lyft would consider extending benefits to drivers, particularly to those who work full-time hours. Lyft is not currently working with Stride Health, but it drivers have access to an alternative service called the eHealth marketplace. A spokesperson denied requests from KQED for an interview.\u003c/p>\n\u003cp>But while executives at these companies may want to do more to protect workers, they are also under pressure to protect their bottom line. It would be highly expensive for them to reclassify workers.\u003c/p>\n\u003cp>Most experts are watching the presidential race as an indicator of what’s to come.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“My fear is that we’ll either re-classify everyone as an employee or trust the unfettered hand of capitalism,” said Warner. “Before that happens, I’m hoping those of us who are thinking about this in a bipartisan fashion can come up with some policy ideas that might be embraced by both sides.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For six months, Eliza Kinrose worked about ten hours a week delivering anything from cupcakes to art supplies to strangers’ homes.\u003c/p>\n\u003cp>Shortly after quitting her steady job as a recruiter, Kinrose, 29, signed up to work for a new San Francisco-based mobile delivery service called \u003ca href=\"https://postmates.com/\">Postmates\u003c/a>. She made about $15 an hour for six months, which was just enough to scrape by until she launched a yoga business.\u003c/p>\n\u003cp>Postmates is just one of an explosion of “gig economy” or “on-demand economy” companies that connect people seeking services with sellers of those services in a few minutes’ time. Those who work for the gig economy do not receive health insurance, or any of the other social protections extended to employees. Unless they are employed elsewhere, they need to find and pay for these protections on their own.\u003c/p>\n\u003cp>But one evening, Kinrose received an email from Postmates about an intriguing free \"perk\" to help her find health insurance called \u003ca href=\"https://www.stridehealth.com/\">Stride Health.\u003c/a>\u003c/p>\n\u003cp>Stride Health is a startup health insurance broker service, which makes recommendations about health plans that are tailored to people's needs. The company offers web and mobile services to assist customers once they've purchased a health plan, including premium payment reminders and guidance on whether they qualify for subsidies. Stride Health also shows customers how much scenarios, like asthma or heart disease, would affect their out of pocket costs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>San Francisco-based Stride Health is one of many startups taking advantage of new opportunities created by the \u003ca href=\"http://www.hhs.gov/healthcare/rights/\">Affordable Care Act\u003c/a> and the perceived failings of the federal and state marketplaces for individuals to buy health insurance. It is unique, however, in targeting gig economy workers like Kinrose. Uber, Postmates and Taskrabbit, three of the largest gig economy companies, market Stride Health's service to their workers.\u003c/p>\n\u003cfigure id=\"attachment_48816\" class=\"wp-caption alignright\" style=\"max-width: 307px\">\u003cimg class=\" wp-image-48816\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/10/uber-sidecar-400x600.jpg\" alt=\"Many workers, like Rick Warren, drive for multiple companies, including Sidecar and Lyft. \" width=\"307\" height=\"461\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-400x600.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-787x1180.jpg 787w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-1180x1770.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar-960x1440.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/uber-sidecar.jpg 1280w\" sizes=\"(max-width: 307px) 100vw, 307px\">\u003cfigcaption class=\"wp-caption-text\">Many workers, like Rick Warren, drive for multiple companies, including Sidecar and Lyft.\u003c/figcaption>\u003c/figure>\n\u003cp>Stride Health's involvement with the gig economy may signal a shift in attitudes and priorities. According to Stride Health CEO Noah Lang, Uber and the rest are starting to care about the needs of their workers. \"They want to make sure people don't end up in a tough spot by forgoing coverage,\" he said.\u003c/p>\n\u003cp>But critics of the gig economy say Stride Health is a bandaid solution, as workers are still on the hook to pay for their own health insurance.\u003c/p>\n\u003cp>“When we have a jobs-based social welfare system, some people get a combination of health care, disability and more,” said Ken Jacobs, chair of the Labor Center at UC Berkeley, who specializes in health care coverage and public policy. “In a world where people are operating separately from that, the safety net goes away.\"\u003c/p>\n\u003cp>\u003cstrong>How Big Is the Gig Economy, Really?\u003c/strong>\u003c/p>\n\u003cp>In cities across the United States, anyone with a smartphone can order a meal from Postmates, a ride to work via Lyft or Uber, groceries on Instacart or a home cleaning on Handy. These services are so pervasive, with billions in total sales as a group that it’s hard to believe they only sprung up in the past five years.\u003c/p>\n\u003caside class=\"pullquote alignright\">“These marketplaces care about growing and maintaining their labor pool. But at the same time, they have to minimize their risks by not stepping over any of the lines.”\u003cbr>\n\u003ccite>Noah Lang, Stride Health cofounder and CEO\u003c/cite>\u003c/aside>\n\u003cp>The on-demand economy has been hailed as the next big thing, but labor economists say it still hasn’t made much of a dent in the overall U.S. economy. The idea may be disruptive to the status quo, but the most recent data suggests that Americans are no less likely to be self-employed than a decade ago.\u003c/p>\n\u003cp>“The gig economy currently is not really even big enough to show up in the [national economic] data,” said Jacobs. “And unfortunately, we don’t yet have a good sense of how big it will be.”\u003c/p>\n\u003cp>One promising trend, according to Jacobs, is that the companies are starting to release more data on their workers. In 2014, Uber collaborated with Princeton University economist Alan Kreuger on a report that determined the company had 160,000 “driver partners” in the United States. By contrast, the Bureau of Labor Statistics estimated that there were some 230,000 taxi-drivers in the U.S. in 2012.\u003c/p>\n\u003cp>Uber may not show up in national data just yet, but it is having an outsized impact in politics and popular culture. Even the presidential candidates are taking a side: While Hilary Clinton says she wants to “crack down” on sharing economy abuses of workers, Jeb Bush was recently spotted hailing an Uber ride in San Francisco.\u003c/p>\n\u003cp>\u003cb>Independent\u003c/b>\u003cstrong> Contractors or Employees? \u003c/strong>\u003c/p>\n\u003cp>By targeting the gig economy, Stride Health has taken a central role in an ongoing debate between policymakers, investors, and litigators, about whether on-demand companies should be treating their workers as employees and paying their expenses, as well as providing health insurance and other benefits.\u003c/p>\n\u003cp>Uber, a San Francisco-based company that uses a smartphone app to link people needing car rides with drivers for hire who use their own vehicles, is currently facing a\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/09/23/uc-riverside-professor-slams-feds-stands-by-his-health-app/\"> looming class action lawsuit\u003c/a>. In the suit, three Uber drivers are collectively challenging the company on whether they should be considered employees under the law – and not independent contractors, as the company now classifies them.\u003c/p>\n\u003cp>And in June, the California Labor Commission ruled against Uber in determining that an ex-driver was entitled to reimbursement for business expenses.\u003c/p>\n\u003cp>“Many drivers have included on their list of issues that they are on their own for health insurance,” said Shannon Liss-Riordan, of Boston, Mass. the lead plaintiff attorney in the class action lawsuit against Uber. Liss-Riordan is also taking aim against Uber’s main rival, Lyft, and has spoken to hundreds of people who drive for these companies. “These drivers are left in the cold,” she said.\u003c/p>\n\u003cp>How the Uber case ends up could have national implications. If the company loses its class-action lawsuit and has to reclassify its drivers from independent contractors to employees, that would force the company to pay for things like expenses, and provide benefits to full-time drivers. One recent estimate is that Uber would need to \u003ca href=\"http://recode.net/2015/07/14/uber-could-have-to-pay-an-additional-209-million-to-reclassify-its-drivers-in-california/\">pay $209 million a year\u003c/a> to reclassify its drivers to employees – and that’s just in California.\u003c/p>\n\u003cp>Not everyone believes that Uber and the rest have left anyone out in the cold.\u003c/p>\n\u003cfigure id=\"attachment_48815\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-48815\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/10/Uber-1-800x533.jpg\" alt=\"Lyft driver Deco Carter scanning for a fare.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/Uber-1-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lyft driver Deco Carter scanning for a fare. \u003ccite>(Alan Toth/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For one thing, the Affordable Care Act has relieved the burden for many drivers, as it provides subsidies for low-income people to buy health insurance independently. Uber's CEO Travis Kalanick reportedly referred to the ACA as \"huge\" for the gig economy.\u003c/p>\n\u003cp>Some policymakers envision a middle ground, where workers have some added protections but are not full employees. One idea is a new worker category called a \"dependent contractor,\" which is legal in Germany, Canada and other countries, but not in the United States.\u003c/p>\n\u003cp>U.S. Senator Mark Warner, D-Virginia, has spent more than a year researching the on-demand economy. \u003ca href=\"http://onlabor.org/2015/06/22/a-new-category-of-worker-for-the-on-demand-economy/\">He has proposed \u003c/a>numerous paths forward to broker a peace in the legal wars, including the dependent contractor model. He has also proposed similar marketplaces to the Affordable Care Act for other key benefits, including workers' compensation.\u003c/p>\n\u003cp>But Warner doesn't agree that the ACA is a silver bullet for the gig economy, as these companies do not pay into it. Uber avoids providing health insurance to drivers, which it considers contractors, as the ACA mandates that only employers extend coverage to full-time employees. That’s a loophole that saves gig economy companies a lot of money.\u003c/p>\n\u003cp>\u003cstrong>Walking the Tightrope \u003c/strong>\u003c/p>\n\u003cp>Some \u003ca href=\"http://qz.com/299655/why-your-uber-driver-hates-uber/\">critics of Uber have painted the company’s top executives as indifferent to the plight of workers\u003c/a>. But by providing services to workers, these companies risk adding fuel to the legal argument that they should be employees and not independent contractors.\u003c/p>\n\u003cp>\u003ca href=\"http://docs.procurement.ku.edu/departmental_policies/Independent_Contractor_Excerpts.pdf\">The I.R.S. has about twenty factors\u003c/a> that it takes into account when determining a worker classification. One important distinction is how much \"control\" an employer has over the work that's being done, but it's not always clear what control means.\u003c/p>\n\u003cp>“Essentially, this [partnership with Stride Health] is about how these workers can get health care without exposing Uber and the rest to liability or responsibility,” said UC Berkeley’s Jacobs.\u003c/p>\n\u003cfigure id=\"attachment_48819\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-48819\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/10/IMG_1692-800x600.jpg\" alt=\"Stride Health's founders Noah Lang (left) and Matt Butner (right) \" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/10/IMG_1692-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stride Health's founders Noah Lang (left) and Matt Butner (right) \u003ccite>(Christina Farr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lang doesn’t totally disagree, but paints the partnership in a more positive light: “These marketplaces care about growing and maintaining their labor pool,” he said. “But at the same time, they have to minimize their risks by not stepping over any of the lines.”\u003c/p>\n\u003cp>If these companies do nothing, their practices may draw fire from policymakers. An uninsured and at-risk population is likely to incur major health costs in the long-term, costs that could eventually be borne by taxpayers. According to Lang, about 40 percent of gig economy workers surveyed by Stride Health said they would \"not have gotten coverage otherwise.\"\u003c/p>\n\u003cp>Stride Health seems to be a safe solution for the gig economy companies. It is unclear how many workers are using the tool, but Uber said it is helping those who are uninsured drivers find an affordable health plan. And drivers seem to like it.\u003c/p>\n\u003cp>“Finding affordable, effective health insurance is top of mind for many drivers,\" an Uber spokesperson said in a press release. A spokesperson for Taskrabbit said the company “vetted other options” but ultimately opted to partner with Stride due to the “thoughtful approach for independent contractors.”\u003c/p>\n\u003cp>Postmates declined to comment on its reasons for partnering with Stride. \u003cspan class=\"s1\">Uber and Taskrabbit emailed statements that could not be attributed to any company official. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Will On-Demand Companies Ever Provide Health Insurance to Workers?\u003c/strong>\u003c/p>\n\u003cp>Critics of the on-demand economy say that Uber and the rest are the latest in a long line of companies that use fancy wordplay and questionable tactics to avoid protecting workers. These legal battles go back decades, with FedEx most recently settling a lawsuit with drivers who claimed they had been misclassified.\u003c/p>\n\u003cp>“Uber tries to argue that it’s not in the car service industry; it’s a technology platform,” said Liss-Riordan in an interview. “The court rejected that.”\u003c/p>\n\u003caside class=\"pullquote alignright\">“Some folks are working part-time for other jobs. Others have not had health insurance in a long time and need extra help navigating their options.\"\u003cbr>\n\u003ccite>An Uber spokesperson\u003c/cite>\u003c/aside>\n\u003cp>Some on-demand economy companies are now taking steps to reclassify their workers as employees, including \u003ca href=\"http://www.doctorondemand.com/\">Doctor on Demand\u003c/a>, a company that connects people with doctors online in a matter of minutes, as well as mobile delivery services Instacart and Shyp.\u003c/p>\n\u003cp>But Lang is doubtful that this will trigger a shift for the on-demand economy at large. As Lang points out, Uber’s labor pool is much larger than \u003ca href=\"http://www.businessinsider.com/why-instacart-is-reclassifing-some-of-its-workers-as-employees-2015-6\">an Instarcart\u003c/a> or Shyp and its workers are not specialized like Doctor on Demand’s physicians – all they need is a drivers’ license. “I give Shyp and Instacart kudos, of course,” he said, “but it’s also opportunistic for them.”\u003c/p>\n\u003cp>A change in federal law or a landmark Supreme Court ruling might force Uber, Lyft and others to treat their workers as employees. This wouldn’t mean that every driver would receive employee-sponsored health insurance overnight.\u003c/p>\n\u003cp>Dan Diamond, executive editor for the research and consulting firm \u003ca href=\"https://www.advisory.com/\">The Advisory Board\u003c/a>, has written about how Uber would handle the health care problem if its drivers were considered employees. Diamond does not believe that workers would immediately benefit from a reclassification.\u003c/p>\n\u003cp>Uber might opt to avoid providing health insurance by paying a fee under the Affordable Care Act (a requirement if businesses do not provide health insurance to employees who work more than 30 hours per week). It might also cap workers’ at 29 hours per week to keep them part-time employees.\u003c/p>\n\u003cp>Diamond expects that Uber will use every weapon in its arsenal to avoid such an outcome. “For Uber, none of these options are ideal.”\u003c/p>\n\u003cp>Deco Carter, a Bay Area-based Lyft driver, said he “knew the risks” when he joined the growing ranks of gig economy workers. He has been involved in two auto accidents, and lacked income for several weeks until he got his car fixed.\u003c/p>\n\u003cp>\"I really didn't have anything to fall back on,\" he said. \"If it wasn't for my fiancé, I don't know what I would have done.\"\u003c/p>\n\u003cp>In the years ahead, he hopes that Lyft would consider extending benefits to drivers, particularly to those who work full-time hours. Lyft is not currently working with Stride Health, but it drivers have access to an alternative service called the eHealth marketplace. A spokesperson denied requests from KQED for an interview.\u003c/p>\n\u003cp>But while executives at these companies may want to do more to protect workers, they are also under pressure to protect their bottom line. It would be highly expensive for them to reclassify workers.\u003c/p>\n\u003cp>Most experts are watching the presidential race as an indicator of what’s to come.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“My fear is that we’ll either re-classify everyone as an employee or trust the unfettered hand of capitalism,” said Warner. “Before that happens, I’m hoping those of us who are thinking about this in a bipartisan fashion can come up with some policy ideas that might be embraced by both sides.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Houston workers who checked the fine print said they weren’t sure whether they were joining an employee wellness program or a marketing scheme.\u003c/p>\n\u003cp>Last fall the city of Houston required employees to tell an online wellness company about their disease history, drug and seat-belt use, blood pressure and other delicate information.\u003c/p>\n\u003caside class=\"pullquote alignright\">At worst, shared information about sensitive conditions could support discrimination by employers, banks, life insurance companies and others.\u003c/aside>\n\u003cp>The company, hired to improve worker health and lower medical costs, could pass the data to “third party vendors acting on our behalf,” according to an authorization form. The information might be posted in areas “that are reviewable to the public.” It might also be “subject to re-disclosure” and “no longer protected by privacy law.”\u003c/p>\n\u003cp>Employees could refuse to give permission or opt not to take the screen, called a health risk assessment — but only if they paid an extra $300 a year for medical coverage.\u003c/p>\n\u003cp>“We don’t mind giving our information to our health care providers,” said Ray Hunt, president of the Houston Police Officers’ Union, which objected so strongly along with other employees that the city switched to a different program. “But we don’t want to give it to a vendor that has carte blanche to give that information to anybody they want to.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Millions of people find themselves in the same position as that of the Houston cops. As more employers grasp wellness as the latest promised solution to soaring health costs, they’re pressuring workers to give unfamiliar companies detailed data about the most sensitive parts of their lives.\u003c/p>\n\u003cp>But whether or not that information stays private is anything but clear, an examination by Kaiser Health News shows.\u003c/p>\n\u003cp>In many workplace wellness programs, “it seems by taking the health risk assessment you are waiving your privacy rights,” said Jennifer Mathis, director of programs at the Bazelon Center for Mental Health Law.\u003c/p>\n\u003cp>At worst, shared information about sensitive conditions could support discrimination by employers, banks, life insurance companies and others. Wellness data is already escaping into what one expert calls “the great American marketing machine” that pitches products according to your diseases and lifestyles, privacy scholars say.\u003c/p>\n\u003cp>Wellness vendors charge employers a per-person fee to assess workers’ health and motivate them to exercise, eat well, see doctors and take pills. Companies push workers to participate with gift cards, insurance discounts and other rewards or penalties.\u003c/p>\n\u003cp>As employers flock to the wellness parade, corporate wellness vendors make up what research firm IBISWorld predicts will be a $12 billion industry by 2020 — six times its estimated size in 2011.\u003c/p>\n\u003cp>Privacy advocates see a void of regulation or even voluntary standards to ensure the information is used as intended. By all accounts the amount of worker wellness data being collected — through the Web, company surveys, wearable devices, gym records and lab tests — is exploding.\u003c/p>\n\u003cp>“The privacy issues are profound,” said Pam Dixon, executive director of the World Privacy Forum, an advocacy group. “If people are being asked to wear a biometric electronic device, or use a mobile app or work within a wellness program, that data can be used in ways that may be very, very surprising to people.”\u003c/p>\n\u003cp>Numerous wellness vendors say flatly that privacy is critical to their reputation and that they don’t share information on individual workers with employers, data brokers or marketing companies. But as the Houston employees found out, the fine print isn’t so plain or reassuring.\u003c/p>\n\u003cul>\n\u003cli>Few workers know that wellness contractors are often unbound by the strict privacy law, known as the Health Insurance Portability and Accountability Act (HIPAA), that restricts doctors and hospitals.\u003c/li>\n\u003cli>A review of privacy policies shows that many wellness vendors adopt policies allowing them to share identifiable data with unidentified “third parties” and “agents” working to improve employee health.\u003c/li>\n\u003cli>The industry boom has drawn a widening network of fitness centers, websites, app publishers, wearable device makers and other affiliates working with wellness plans to collect employee health information — each with its own complicated privacy policy. That boosts chances data will be misused, privacy advocates say.\u003c/li>\n\u003cli>Wellness companies and their contractors routinely share almost completely unregulated “de-identified” data showing group heath results with employers, researchers and others. Scientists have shown such information can be “re-identified” and used for marketing, potential credit screening and other purposes.\u003c/li>\n\u003c/ul>\n\u003cp>Wellness vendor Audax Health, whose work with Houston resulted in “an overwhelming number of employees who were uncomfortable with the privacy statement,” according to a city statement to employees, said it keeps information strictly confidential. Audax’s online portal for employees is called Zensey.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\n“What are the vendors doing with the data they collect? Are they selling it? I would be surprised if they’re not selling it, because it’s valuable.”\u003cbr>\n\u003ccite>Ifeoma Ajunwa, health law professor, University of the District of Columbia\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>“We do not sell or resell personal health information to anyone,” including marketing companies and data brokers, David Sclar, Audax’s chief privacy officer, said through a spokesman. “We do not allow third parties to market to Zensey users.”\u003c/p>\n\u003cp>But Audax’s \u003ca href=\"https://www.zensey.com/corporate/privacy\" target=\"_blank\">own fine print\u003c/a> contradicts the second part of his statement, saying the vendor may direct marketing pitches from third parties to wellness members based on “attributes” it collects from those employees. Audax is majority-owned by insurer UnitedHealth Group.\u003c/p>\n\u003cp>Other big wellness vendors, including venture-capital backed Welltok, include similar language in their disclosures. Under the heading, “Information Collected by Third Parties,” Welltok says its \u003ca href=\"https://www.cafewell.com/pages/terms#policy\" target=\"_blank\">CaféWell portal \u003c/a>might “target advertisements to you based on products and services you may be interested in.”\u003c/p>\n\u003cp>Jeff Cohen, Welltok’s co-founder, expressed surprise at the statement.\u003c/p>\n\u003cp>“That goes against everything we represent — probably one of those where a lawyer told us to put it in there,” he said in an interview. “I’m going to go back and talk to our compliance person” about the language, he said.\u003c/p>\n\u003cp>Cohen said Welltok doesn’t “use and sell and share the data from our platform about users to third parties.”\u003c/p>\n\u003cp>But as of Sept. 25, the disclosure language was unchanged. And that’s what matters legally, privacy lawyers said.\u003c/p>\n\u003cp>Primary wellness vendors such as Audax and Welltok aren’t the only ones collecting employee health data. Wearable device makers, test labs, gym chains, data centers, workout-app publishers are also part of the gold rush.\u003c/p>\n\u003cp>As frequent partners of employers and wellness providers, each of those companies also gathers worker information of varying sensitivity — often with employers pushing workers to participate — in what amounts to a widening wellness data web.\u003c/p>\n\u003cp>The most advanced employee wellness programs can even “ping your cell phone when you’re at the gym” to record your visit through a geo-location app, said Erick Hathorn, a consultant to wellness companies and contractors. “Or they can ping it 30 minutes later to know you stayed.”\u003c/p>\n\u003cp>Lose It!, one of the most popular diet apps for smartphones, works with employee wellness plans to track your calories and weight via a wireless scale.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.loseit.com/privacy/\" target=\"_blank\">app’s privacy policy \u003c/a>assures users of Apple products that information on their weight and eating habits won’t be used for “advertising or other use-based data mining purposes” except for health research. Results for non-Apple users, on the other hand, might be given to “advertisers and potential business partners” with the identities removed.\u003c/p>\n\u003cp>That’s a lower level of protection, even without identification, lawyers said.\u003c/p>\n\u003cp>Nobody at Boston-based Lose It! was available to answer questions about corporate wellness and privacy, a spokeswoman said.\u003c/p>\n\u003cp>“What are the vendors doing with the data they collect? They aren’t telling us,” said Ifeoma Ajunwa, who teaches health law at the University of the District of Columbia. “Are they selling it? I would be surprised if they’re not selling it, because it’s valuable.”\u003c/p>\n\u003cp>Two years ago Under Armour bought MapMyFitness, another app promoted for use in corporate-wellness programs, and turned it into an ad vehicle for its athletic apparel.\u003c/p>\n\u003cp>The app records workout routes, times and speeds and shares data with wellness vendors and Under Armour itself, \u003ca href=\"http://about.mapmyfitness.com/under-armour-user-privacy-policy/\" target=\"_blank\">according to a disclosure statement\u003c/a>. Users see ads for Under Armour gear and other products on their smartphones and computers.\u003c/p>\n\u003cp>Data from MapMyFitness and other apps bought by Under Armour “is going to be extraordinary,” company CEO Kevin Plank told industry analysts this year. “This will help us sell more shirts and shoes,” he has repeatedly said.\u003c/p>\n\u003cp>An Under Armour spokeswoman referred a reporter asking about data policies and wellness programs to MapMyFitness’ privacy statement.\u003c/p>\n\u003cp>More than 13 million Fitbits and other wearable health devices will be used in corporate wellness plans by 2018, \u003ca href=\"https://www.abiresearch.com/press/corporate-wellness-is-a-13-million-unit-wearable-w/\" target=\"_blank\">ABI Research has projected\u003c/a>. Data gathered by the Fitbit can include height, weight, heart rates and sleeping and exercise patterns.\u003c/p>\n\u003cp>“Now Fitbit has that information and the wellness program has it,” said Robert Gellman, a privacy consultant and former congressional staffer. “I don’t know of any best practices from wellness industry [to handle the data]. It’s the Wild West.”\u003c/p>\n\u003cp>Fitbit did not respond to several requests to discuss privacy. The company won’t “sell any data that could identify you” and shares information only when necessary to provide the service, when the data are anonymous or with user permission,\u003ca href=\"http://www.fitbit.com/privacy\" target=\"_blank\"> its written policy says\u003c/a>.\u003c/p>\n\u003cp>Employer wellness programs even follow you to the supermarket.\u003c/p>\n\u003cp>A firm called \u003ca href=\"http://www.nutrisavings.com\" target=\"_blank\">NutriSavings\u003c/a> assigns health grades to thousands of food products and lets grocers record member shopping. Stores report scores — but not specific purchases — to the wellness vendor, says NutriSavings. Members get rewards from their employer based on what they buy.\u003c/p>\n\u003cp>Wellness information isn’t just valuable for selling stuff. Privacy advocates especially worry that the results might be shared with data brokers who crunch information and sell it to banks and other financial firms.\u003c/p>\n\u003cp>“That’s where the data then moves into other parts of the economy — lending decisions, credit decisions, mortgage decisions,” said Scott Peppet, a law professor and privacy specialist at the University of Colorado. “Once these data are in the hands of a data broker, they can be blended into any kind of formula.”\u003c/p>\n\u003cp>Credit-card companies could raise rates for employees that wellness programs reveal to be couch potatoes, inferring that they are more likely to default. Life insurers could deny coverage or raise prices based on unhealthy wellness results. \u003ca href=\"http://www.npr.org/sections/thetwo-way/2015/04/08/398306430/john-hancock-hopes-youll-trade-activity-data-for-insurance-discounts\" target=\"_blank\">Insurer John Hancock has already started offering discounts\u003c/a> to life insurance customers who agree to wear a Fitbit, share data and attain certain scores.\u003c/p>\n\u003cp>No one knows whether data brokers are getting workplace wellness information. But despite what many employees believe, not all wellness information is protected by \u003ca href=\"http://www.hhs.gov/ocr/privacy/\" target=\"_blank\">HIPAA\u003c/a>, which authorizes only doctors, insurance plans and others close to a patients’ care to see their medical data.\u003c/p>\n\u003cp>“People assume all their health information is covered by HIPAA and that’s just not true,” Gellman said. “Wellness programs are on the border. Some are and some aren’t. How can a mere mortal tell? A lot of information can escape into the great American marketing machine, which is desperate to get information on a person’s health.”\u003c/p>\n\u003cp>Wellness vendors are supposed to obey HIPAA restrictions if they’re part of an \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/wellness/index.html\" target=\"_blank\">employer’s insurance plan\u003c/a>. But it’s far from clear what that means.\u003c/p>\n\u003cp>The National Committee for Quality Assurance, a respected health care certification group, asks workplace wellness groups it accredits to observe HIPAA rules and require the same from third parties they work with.\u003c/p>\n\u003cp>But NCQA recognizes only about 30 wellness vendors out of hundreds. Even a “HIPAA-compliant” program could induce workers to waive their rights without knowing it, consumer advocates said.\u003cbr>\nNor does HIPAA protect the de-identified health information that wellness providers routinely share with employers and other, unidentified outside parties, according to their privacy policies. De-identified data might include blood pressure, cholesterol, drug use and disease history.\u003c/p>\n\u003cp>Researchers have shown that such information can be linked to the subject by combining it with voter lists, credit-card records and other databases. Harvard investigators used birthdays and zip codes in a de-identified genetics survey two years ago to figure out who \u003ca href=\"http://dataprivacylab.org/projects/pgp/1021-1.pdf\" target=\"_blank\">more than a fifth of the participants were\u003c/a>.\u003c/p>\n\u003cp>Until recently, Audax’s policy stated that the company could use de-identified employee data “for any business purpose.” It removed that language after KHN inquired about privacy.\u003c/p>\n\u003cp>Fitbit and Limeade, a wellness provider in Bellevue, Wash., \u003ca href=\"http://www.limeade.com/privacy-policy/\" target=\"_blank\">forbid third parties\u003c/a> using their anonymized data from trying to re-identify the users.\u003c/p>\n\u003cp>But that policy — \u003ca href=\"https://www.ftc.gov/system/files/documents/public_statements/202151/140220princetonbigdata_0.pdf\" target=\"_blank\">the kind recommended by Federal Trade Commissioner Julie Brill \u003c/a>and others — is unusual among wellness providers, KHN’s review shows.\u003c/p>\n\u003cp>“We haven’t really stepped into regulating this or decided to regulate this,” said Peppet, who favors employer wellness efforts despite his concerns about confidentiality. “I’m expecting over the next couple of years we’ll probably see some problems.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Jay Hancock is a reporter with \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>. \u003c/em>\u003cem>Julie Appleby contributed to this story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Houston workers who checked the fine print said they weren’t sure whether they were joining an employee wellness program or a marketing scheme.\u003c/p>\n\u003cp>Last fall the city of Houston required employees to tell an online wellness company about their disease history, drug and seat-belt use, blood pressure and other delicate information.\u003c/p>\n\u003caside class=\"pullquote alignright\">At worst, shared information about sensitive conditions could support discrimination by employers, banks, life insurance companies and others.\u003c/aside>\n\u003cp>The company, hired to improve worker health and lower medical costs, could pass the data to “third party vendors acting on our behalf,” according to an authorization form. The information might be posted in areas “that are reviewable to the public.” It might also be “subject to re-disclosure” and “no longer protected by privacy law.”\u003c/p>\n\u003cp>Employees could refuse to give permission or opt not to take the screen, called a health risk assessment — but only if they paid an extra $300 a year for medical coverage.\u003c/p>\n\u003cp>“We don’t mind giving our information to our health care providers,” said Ray Hunt, president of the Houston Police Officers’ Union, which objected so strongly along with other employees that the city switched to a different program. “But we don’t want to give it to a vendor that has carte blanche to give that information to anybody they want to.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Millions of people find themselves in the same position as that of the Houston cops. As more employers grasp wellness as the latest promised solution to soaring health costs, they’re pressuring workers to give unfamiliar companies detailed data about the most sensitive parts of their lives.\u003c/p>\n\u003cp>But whether or not that information stays private is anything but clear, an examination by Kaiser Health News shows.\u003c/p>\n\u003cp>In many workplace wellness programs, “it seems by taking the health risk assessment you are waiving your privacy rights,” said Jennifer Mathis, director of programs at the Bazelon Center for Mental Health Law.\u003c/p>\n\u003cp>At worst, shared information about sensitive conditions could support discrimination by employers, banks, life insurance companies and others. Wellness data is already escaping into what one expert calls “the great American marketing machine” that pitches products according to your diseases and lifestyles, privacy scholars say.\u003c/p>\n\u003cp>Wellness vendors charge employers a per-person fee to assess workers’ health and motivate them to exercise, eat well, see doctors and take pills. Companies push workers to participate with gift cards, insurance discounts and other rewards or penalties.\u003c/p>\n\u003cp>As employers flock to the wellness parade, corporate wellness vendors make up what research firm IBISWorld predicts will be a $12 billion industry by 2020 — six times its estimated size in 2011.\u003c/p>\n\u003cp>Privacy advocates see a void of regulation or even voluntary standards to ensure the information is used as intended. By all accounts the amount of worker wellness data being collected — through the Web, company surveys, wearable devices, gym records and lab tests — is exploding.\u003c/p>\n\u003cp>“The privacy issues are profound,” said Pam Dixon, executive director of the World Privacy Forum, an advocacy group. “If people are being asked to wear a biometric electronic device, or use a mobile app or work within a wellness program, that data can be used in ways that may be very, very surprising to people.”\u003c/p>\n\u003cp>Numerous wellness vendors say flatly that privacy is critical to their reputation and that they don’t share information on individual workers with employers, data brokers or marketing companies. But as the Houston employees found out, the fine print isn’t so plain or reassuring.\u003c/p>\n\u003cul>\n\u003cli>Few workers know that wellness contractors are often unbound by the strict privacy law, known as the Health Insurance Portability and Accountability Act (HIPAA), that restricts doctors and hospitals.\u003c/li>\n\u003cli>A review of privacy policies shows that many wellness vendors adopt policies allowing them to share identifiable data with unidentified “third parties” and “agents” working to improve employee health.\u003c/li>\n\u003cli>The industry boom has drawn a widening network of fitness centers, websites, app publishers, wearable device makers and other affiliates working with wellness plans to collect employee health information — each with its own complicated privacy policy. That boosts chances data will be misused, privacy advocates say.\u003c/li>\n\u003cli>Wellness companies and their contractors routinely share almost completely unregulated “de-identified” data showing group heath results with employers, researchers and others. Scientists have shown such information can be “re-identified” and used for marketing, potential credit screening and other purposes.\u003c/li>\n\u003c/ul>\n\u003cp>Wellness vendor Audax Health, whose work with Houston resulted in “an overwhelming number of employees who were uncomfortable with the privacy statement,” according to a city statement to employees, said it keeps information strictly confidential. Audax’s online portal for employees is called Zensey.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\n“What are the vendors doing with the data they collect? Are they selling it? I would be surprised if they’re not selling it, because it’s valuable.”\u003cbr>\n\u003ccite>Ifeoma Ajunwa, health law professor, University of the District of Columbia\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>“We do not sell or resell personal health information to anyone,” including marketing companies and data brokers, David Sclar, Audax’s chief privacy officer, said through a spokesman. “We do not allow third parties to market to Zensey users.”\u003c/p>\n\u003cp>But Audax’s \u003ca href=\"https://www.zensey.com/corporate/privacy\" target=\"_blank\">own fine print\u003c/a> contradicts the second part of his statement, saying the vendor may direct marketing pitches from third parties to wellness members based on “attributes” it collects from those employees. Audax is majority-owned by insurer UnitedHealth Group.\u003c/p>\n\u003cp>Other big wellness vendors, including venture-capital backed Welltok, include similar language in their disclosures. Under the heading, “Information Collected by Third Parties,” Welltok says its \u003ca href=\"https://www.cafewell.com/pages/terms#policy\" target=\"_blank\">CaféWell portal \u003c/a>might “target advertisements to you based on products and services you may be interested in.”\u003c/p>\n\u003cp>Jeff Cohen, Welltok’s co-founder, expressed surprise at the statement.\u003c/p>\n\u003cp>“That goes against everything we represent — probably one of those where a lawyer told us to put it in there,” he said in an interview. “I’m going to go back and talk to our compliance person” about the language, he said.\u003c/p>\n\u003cp>Cohen said Welltok doesn’t “use and sell and share the data from our platform about users to third parties.”\u003c/p>\n\u003cp>But as of Sept. 25, the disclosure language was unchanged. And that’s what matters legally, privacy lawyers said.\u003c/p>\n\u003cp>Primary wellness vendors such as Audax and Welltok aren’t the only ones collecting employee health data. Wearable device makers, test labs, gym chains, data centers, workout-app publishers are also part of the gold rush.\u003c/p>\n\u003cp>As frequent partners of employers and wellness providers, each of those companies also gathers worker information of varying sensitivity — often with employers pushing workers to participate — in what amounts to a widening wellness data web.\u003c/p>\n\u003cp>The most advanced employee wellness programs can even “ping your cell phone when you’re at the gym” to record your visit through a geo-location app, said Erick Hathorn, a consultant to wellness companies and contractors. “Or they can ping it 30 minutes later to know you stayed.”\u003c/p>\n\u003cp>Lose It!, one of the most popular diet apps for smartphones, works with employee wellness plans to track your calories and weight via a wireless scale.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.loseit.com/privacy/\" target=\"_blank\">app’s privacy policy \u003c/a>assures users of Apple products that information on their weight and eating habits won’t be used for “advertising or other use-based data mining purposes” except for health research. Results for non-Apple users, on the other hand, might be given to “advertisers and potential business partners” with the identities removed.\u003c/p>\n\u003cp>That’s a lower level of protection, even without identification, lawyers said.\u003c/p>\n\u003cp>Nobody at Boston-based Lose It! was available to answer questions about corporate wellness and privacy, a spokeswoman said.\u003c/p>\n\u003cp>“What are the vendors doing with the data they collect? They aren’t telling us,” said Ifeoma Ajunwa, who teaches health law at the University of the District of Columbia. “Are they selling it? I would be surprised if they’re not selling it, because it’s valuable.”\u003c/p>\n\u003cp>Two years ago Under Armour bought MapMyFitness, another app promoted for use in corporate-wellness programs, and turned it into an ad vehicle for its athletic apparel.\u003c/p>\n\u003cp>The app records workout routes, times and speeds and shares data with wellness vendors and Under Armour itself, \u003ca href=\"http://about.mapmyfitness.com/under-armour-user-privacy-policy/\" target=\"_blank\">according to a disclosure statement\u003c/a>. Users see ads for Under Armour gear and other products on their smartphones and computers.\u003c/p>\n\u003cp>Data from MapMyFitness and other apps bought by Under Armour “is going to be extraordinary,” company CEO Kevin Plank told industry analysts this year. “This will help us sell more shirts and shoes,” he has repeatedly said.\u003c/p>\n\u003cp>An Under Armour spokeswoman referred a reporter asking about data policies and wellness programs to MapMyFitness’ privacy statement.\u003c/p>\n\u003cp>More than 13 million Fitbits and other wearable health devices will be used in corporate wellness plans by 2018, \u003ca href=\"https://www.abiresearch.com/press/corporate-wellness-is-a-13-million-unit-wearable-w/\" target=\"_blank\">ABI Research has projected\u003c/a>. Data gathered by the Fitbit can include height, weight, heart rates and sleeping and exercise patterns.\u003c/p>\n\u003cp>“Now Fitbit has that information and the wellness program has it,” said Robert Gellman, a privacy consultant and former congressional staffer. “I don’t know of any best practices from wellness industry [to handle the data]. It’s the Wild West.”\u003c/p>\n\u003cp>Fitbit did not respond to several requests to discuss privacy. The company won’t “sell any data that could identify you” and shares information only when necessary to provide the service, when the data are anonymous or with user permission,\u003ca href=\"http://www.fitbit.com/privacy\" target=\"_blank\"> its written policy says\u003c/a>.\u003c/p>\n\u003cp>Employer wellness programs even follow you to the supermarket.\u003c/p>\n\u003cp>A firm called \u003ca href=\"http://www.nutrisavings.com\" target=\"_blank\">NutriSavings\u003c/a> assigns health grades to thousands of food products and lets grocers record member shopping. Stores report scores — but not specific purchases — to the wellness vendor, says NutriSavings. Members get rewards from their employer based on what they buy.\u003c/p>\n\u003cp>Wellness information isn’t just valuable for selling stuff. Privacy advocates especially worry that the results might be shared with data brokers who crunch information and sell it to banks and other financial firms.\u003c/p>\n\u003cp>“That’s where the data then moves into other parts of the economy — lending decisions, credit decisions, mortgage decisions,” said Scott Peppet, a law professor and privacy specialist at the University of Colorado. “Once these data are in the hands of a data broker, they can be blended into any kind of formula.”\u003c/p>\n\u003cp>Credit-card companies could raise rates for employees that wellness programs reveal to be couch potatoes, inferring that they are more likely to default. Life insurers could deny coverage or raise prices based on unhealthy wellness results. \u003ca href=\"http://www.npr.org/sections/thetwo-way/2015/04/08/398306430/john-hancock-hopes-youll-trade-activity-data-for-insurance-discounts\" target=\"_blank\">Insurer John Hancock has already started offering discounts\u003c/a> to life insurance customers who agree to wear a Fitbit, share data and attain certain scores.\u003c/p>\n\u003cp>No one knows whether data brokers are getting workplace wellness information. But despite what many employees believe, not all wellness information is protected by \u003ca href=\"http://www.hhs.gov/ocr/privacy/\" target=\"_blank\">HIPAA\u003c/a>, which authorizes only doctors, insurance plans and others close to a patients’ care to see their medical data.\u003c/p>\n\u003cp>“People assume all their health information is covered by HIPAA and that’s just not true,” Gellman said. “Wellness programs are on the border. Some are and some aren’t. How can a mere mortal tell? A lot of information can escape into the great American marketing machine, which is desperate to get information on a person’s health.”\u003c/p>\n\u003cp>Wellness vendors are supposed to obey HIPAA restrictions if they’re part of an \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/wellness/index.html\" target=\"_blank\">employer’s insurance plan\u003c/a>. But it’s far from clear what that means.\u003c/p>\n\u003cp>The National Committee for Quality Assurance, a respected health care certification group, asks workplace wellness groups it accredits to observe HIPAA rules and require the same from third parties they work with.\u003c/p>\n\u003cp>But NCQA recognizes only about 30 wellness vendors out of hundreds. Even a “HIPAA-compliant” program could induce workers to waive their rights without knowing it, consumer advocates said.\u003cbr>\nNor does HIPAA protect the de-identified health information that wellness providers routinely share with employers and other, unidentified outside parties, according to their privacy policies. De-identified data might include blood pressure, cholesterol, drug use and disease history.\u003c/p>\n\u003cp>Researchers have shown that such information can be linked to the subject by combining it with voter lists, credit-card records and other databases. Harvard investigators used birthdays and zip codes in a de-identified genetics survey two years ago to figure out who \u003ca href=\"http://dataprivacylab.org/projects/pgp/1021-1.pdf\" target=\"_blank\">more than a fifth of the participants were\u003c/a>.\u003c/p>\n\u003cp>Until recently, Audax’s policy stated that the company could use de-identified employee data “for any business purpose.” It removed that language after KHN inquired about privacy.\u003c/p>\n\u003cp>Fitbit and Limeade, a wellness provider in Bellevue, Wash., \u003ca href=\"http://www.limeade.com/privacy-policy/\" target=\"_blank\">forbid third parties\u003c/a> using their anonymized data from trying to re-identify the users.\u003c/p>\n\u003cp>But that policy — \u003ca href=\"https://www.ftc.gov/system/files/documents/public_statements/202151/140220princetonbigdata_0.pdf\" target=\"_blank\">the kind recommended by Federal Trade Commissioner Julie Brill \u003c/a>and others — is unusual among wellness providers, KHN’s review shows.\u003c/p>\n\u003cp>“We haven’t really stepped into regulating this or decided to regulate this,” said Peppet, who favors employer wellness efforts despite his concerns about confidentiality. “I’m expecting over the next couple of years we’ll probably see some problems.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Jay Hancock is a reporter with \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>. \u003c/em>\u003cem>Julie Appleby contributed to this story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Brushing and flossing are key to your dental health. So is choosing the right dental coverage.\u003c/p>\n\u003cp>While dental insurance doesn’t command the attention that medical insurance does, it also can have significant implications for your pocketbook.\u003c/p>\n\u003cp>You know exactly what I mean if you have the most common type of health insurance (more on that later) and have ever needed a procedure such as a crown or root canal.\u003c/p>\n\u003cp>Read: $$$$\u003c/p>\n\u003cp>More than 19 million Californians had commercial dental insurance in 2014, and most of them obtained it through their employers, according to the\u003ca href=\"http://www.nadp.org/home\" target=\"_blank\"> National Association of Dental Plans\u003c/a> (NADP).\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But “in a way, it shouldn’t even be called insurance,” says Jeff Album, a vice president at Delta Dental, California’s largest dental insurer.\u003c/p>\n\u003cp>Album prefers calling it “a prepaid plan” for preventive and basic services, such as cleanings and fillings.\u003c/p>\n\u003cp>If you need a more complicated procedure, “you’re going to end up paying a big part of the bill out of pocket,” he says.\u003c/p>\n\u003cp>Here are five tips I'm offering on how to best use your dental benefits to save you money and frustration.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE THE RIGHT PLAN\u003c/strong>\u003c/p>\n\u003cp>It’s open-enrollment season, time to determine which dental plan is best for you.\u003c/p>\n\u003cp>There are two primary types of dental plans: \u003ca href=\"https://www.deltadentalins.com/individuals/plans/plan-types.html\" target=\"_blank\">HMOs and PPOs.\u003c/a>\u003c/p>\n\u003cp>The vast majority of Californians with commercial dental coverage – more than 14 million – have PPOs, the NADP says.\u003c/p>\n\u003cp>Here’s how a dental PPO works:\u003c/p>\n\u003cp>• In addition to your monthly premiums, you may owe a deductible before your insurance kicks in. Deductibles typically are under $50 and generally aren’t applied to preventive services, Album says.\u003cbr>\n• You face annual limits on your coverage, typically between $1,000 and $2,000, which is the maximum your insurance will pay out in one year.\u003cbr>\n• Twice-yearly cleanings and other preventive services are usually fully covered. You’ll pay a percentage of the cost for other services, such as 20 percent for a filling or 50 percent for a crown. Which adds up fast.\u003c/p>\n\u003cp>A dental HMO operates differently:\u003c/p>\n\u003cp>• Your premiums will be lower.\u003cbr>\n• You probably won’t have deductibles or benefit maximums.\u003cbr>\n• You’ll pay fixed copayments for treatments.\u003c/p>\n\u003cp>However, with an HMO, “your choices of dentists is much, much smaller,” Album says.\u003c/p>\n\u003cp>How much smaller? About 90 percent of California’s practicing dentists participate in PPOs, whereas about one quarter participate in HMOs, the NADP says.\u003c/p>\n\u003cp>You may also have fewer treatment options with an HMO, says Long Beach dentist Gary Glasband. For example, an HMO may agree to cover a metal crown. But if you prefer a ceramic crown that blends in with your other teeth, you may have to pay an additional cost, he says.\u003c/p>\n\u003cp>“You’re going to look at this choice differently if you’re a 20-year-old who has very little dental needs compared to someone who needs complex work,” he says.\u003c/p>\n\u003cp>If you have children, consider whether the plan covers orthodontic benefits, Glasband adds.\u003c/p>\n\u003cp>Once you’ve chosen your plan, understand your coverage. For instance, if your plan covers two cleanings a year, can they occur at any time or do they have to be more than six months apart?\u003c/p>\n\u003cp>“One cleaning every six months is not the same as two cleanings a year,” Glasband says.\u003c/p>\n\u003cp>\u003cstrong>STAY IN NETWORK\u003c/strong>\u003c/p>\n\u003cp>You will spend the least amount out of pocket by staying in your dental plan’s network, whether you have an HMO or a PPO.\u003c/p>\n\u003cp>With an HMO, you usually won’t receive any coverage out of network.\u003c/p>\n\u003cp>In the case of a PPO, you will receive the highest level of coverage from an in-network dentist plus reduced rates on the amount you have to spend out of pocket, Album says.\u003c/p>\n\u003cp>If you opt for an out-of-network dentist, you will still receive coverage, but at a reduced level.\u003c/p>\n\u003cp>Once your dentist has determined your treatment, always request a pre-treatment estimate from your plan. That will help you determine how much you’ll owe, Album says.\u003c/p>\n\u003cp>\u003cstrong>TIMING IS EVERYTHING\u003c/strong>\u003c/p>\n\u003cp>Schedule your procedures to make the most of your dental coverage.\u003c/p>\n\u003cp>Let’s say your dentist recommends four fillings and two crowns. If you do them all at once, you’ll likely exceed your maximum benefits and spend hundreds of dollars (or more) out of pocket.\u003c/p>\n\u003cp>If it’s not an emergency, find out when your annual benefits renew, Glasband says. For most people it’s Jan. 1.\u003c/p>\n\u003cp>In that case, Glasband suggests getting two fillings and a crown in November and the remaining procedures early the following year, which essentially doubles the amount of coverage at your disposal.\u003c/p>\n\u003cp>“Count on your dentist to help you time your benefits,” Album says.\u003c/p>\n\u003cp>\u003cstrong>SHOP AROUND\u003c/strong>\u003c/p>\n\u003cp>Like medical procedures, the prices of dental treatments can vary dramatically within the same region.\u003c/p>\n\u003cp>Why should you care about prices if you’re insured? Remember your annual maximums, which are easily surpassed with one dental procedure.\u003c/p>\n\u003cp>“Even if you have great coverage, you could be paying hundreds of dollars more out of pocket by choosing one dentist over another one down the street,” says Jason Szczuka, general manager of \u003ca href=\"https://www.deltadentalins.com/individuals/plans/plan-types.html\" target=\"_blank\">Brighter.com\u003c/a>, a California company that manages dental benefits for some businesses.\u003c/p>\n\u003cp>Don’t be afraid to call around and ask dentists for their prices, he says.\u003c/p>\n\u003cp>You can also check online resources such as FAIR Health’s “Dental Cost Lookup” tool at \u003ca href=\"http://fairhealthconsumer.org/dentalcostlookup.php\" target=\"_blank\">FairHealthConsumer.org\u003c/a> to get an idea of how much others are being charged for similar services.\u003c/p>\n\u003cp>\u003cstrong>DISCOUNT PLANS\u003c/strong>\u003c/p>\n\u003cp>If you don’t have dental insurance, consider purchasing a discount dental plan. These plans, which are not insurance, give you access to certain dentists who have agreed to perform procedures at discounted, cash prices.\u003c/p>\n\u003cp>The discounts are usually 20 to 30 percent, sometimes more, says Evelyn Ireland, executive director of the NADP.\u003c/p>\n\u003cp>If you’re interested in purchasing one, she suggests using the “Find a Dental Plan” tool on NADP’s website (\u003ca href=\"http://www.nadp.org\" target=\"_blank\">www.nadp.org\u003c/a>), or checking with \u003ca href=\"http://www.dentalplans.com/\" target=\"_blank\">DentalPlans.com\u003c/a> or retailers such as Costco.\u003c/p>\n\u003cp>\u003cem>Questions for Emily:\u003c/em> \u003ca href=\"AskEmily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/p>\n\u003cp>\u003cem>Click \u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a> to find previous Ask Emily columns.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Emily produced this story for the \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> which partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu/\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org/\" target=\"_blank\">California HealthCare Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Brushing and flossing are key to your dental health. So is choosing the right dental coverage.\u003c/p>\n\u003cp>While dental insurance doesn’t command the attention that medical insurance does, it also can have significant implications for your pocketbook.\u003c/p>\n\u003cp>You know exactly what I mean if you have the most common type of health insurance (more on that later) and have ever needed a procedure such as a crown or root canal.\u003c/p>\n\u003cp>Read: $$$$\u003c/p>\n\u003cp>More than 19 million Californians had commercial dental insurance in 2014, and most of them obtained it through their employers, according to the\u003ca href=\"http://www.nadp.org/home\" target=\"_blank\"> National Association of Dental Plans\u003c/a> (NADP).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But “in a way, it shouldn’t even be called insurance,” says Jeff Album, a vice president at Delta Dental, California’s largest dental insurer.\u003c/p>\n\u003cp>Album prefers calling it “a prepaid plan” for preventive and basic services, such as cleanings and fillings.\u003c/p>\n\u003cp>If you need a more complicated procedure, “you’re going to end up paying a big part of the bill out of pocket,” he says.\u003c/p>\n\u003cp>Here are five tips I'm offering on how to best use your dental benefits to save you money and frustration.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE THE RIGHT PLAN\u003c/strong>\u003c/p>\n\u003cp>It’s open-enrollment season, time to determine which dental plan is best for you.\u003c/p>\n\u003cp>There are two primary types of dental plans: \u003ca href=\"https://www.deltadentalins.com/individuals/plans/plan-types.html\" target=\"_blank\">HMOs and PPOs.\u003c/a>\u003c/p>\n\u003cp>The vast majority of Californians with commercial dental coverage – more than 14 million – have PPOs, the NADP says.\u003c/p>\n\u003cp>Here’s how a dental PPO works:\u003c/p>\n\u003cp>• In addition to your monthly premiums, you may owe a deductible before your insurance kicks in. Deductibles typically are under $50 and generally aren’t applied to preventive services, Album says.\u003cbr>\n• You face annual limits on your coverage, typically between $1,000 and $2,000, which is the maximum your insurance will pay out in one year.\u003cbr>\n• Twice-yearly cleanings and other preventive services are usually fully covered. You’ll pay a percentage of the cost for other services, such as 20 percent for a filling or 50 percent for a crown. Which adds up fast.\u003c/p>\n\u003cp>A dental HMO operates differently:\u003c/p>\n\u003cp>• Your premiums will be lower.\u003cbr>\n• You probably won’t have deductibles or benefit maximums.\u003cbr>\n• You’ll pay fixed copayments for treatments.\u003c/p>\n\u003cp>However, with an HMO, “your choices of dentists is much, much smaller,” Album says.\u003c/p>\n\u003cp>How much smaller? About 90 percent of California’s practicing dentists participate in PPOs, whereas about one quarter participate in HMOs, the NADP says.\u003c/p>\n\u003cp>You may also have fewer treatment options with an HMO, says Long Beach dentist Gary Glasband. For example, an HMO may agree to cover a metal crown. But if you prefer a ceramic crown that blends in with your other teeth, you may have to pay an additional cost, he says.\u003c/p>\n\u003cp>“You’re going to look at this choice differently if you’re a 20-year-old who has very little dental needs compared to someone who needs complex work,” he says.\u003c/p>\n\u003cp>If you have children, consider whether the plan covers orthodontic benefits, Glasband adds.\u003c/p>\n\u003cp>Once you’ve chosen your plan, understand your coverage. For instance, if your plan covers two cleanings a year, can they occur at any time or do they have to be more than six months apart?\u003c/p>\n\u003cp>“One cleaning every six months is not the same as two cleanings a year,” Glasband says.\u003c/p>\n\u003cp>\u003cstrong>STAY IN NETWORK\u003c/strong>\u003c/p>\n\u003cp>You will spend the least amount out of pocket by staying in your dental plan’s network, whether you have an HMO or a PPO.\u003c/p>\n\u003cp>With an HMO, you usually won’t receive any coverage out of network.\u003c/p>\n\u003cp>In the case of a PPO, you will receive the highest level of coverage from an in-network dentist plus reduced rates on the amount you have to spend out of pocket, Album says.\u003c/p>\n\u003cp>If you opt for an out-of-network dentist, you will still receive coverage, but at a reduced level.\u003c/p>\n\u003cp>Once your dentist has determined your treatment, always request a pre-treatment estimate from your plan. That will help you determine how much you’ll owe, Album says.\u003c/p>\n\u003cp>\u003cstrong>TIMING IS EVERYTHING\u003c/strong>\u003c/p>\n\u003cp>Schedule your procedures to make the most of your dental coverage.\u003c/p>\n\u003cp>Let’s say your dentist recommends four fillings and two crowns. If you do them all at once, you’ll likely exceed your maximum benefits and spend hundreds of dollars (or more) out of pocket.\u003c/p>\n\u003cp>If it’s not an emergency, find out when your annual benefits renew, Glasband says. For most people it’s Jan. 1.\u003c/p>\n\u003cp>In that case, Glasband suggests getting two fillings and a crown in November and the remaining procedures early the following year, which essentially doubles the amount of coverage at your disposal.\u003c/p>\n\u003cp>“Count on your dentist to help you time your benefits,” Album says.\u003c/p>\n\u003cp>\u003cstrong>SHOP AROUND\u003c/strong>\u003c/p>\n\u003cp>Like medical procedures, the prices of dental treatments can vary dramatically within the same region.\u003c/p>\n\u003cp>Why should you care about prices if you’re insured? Remember your annual maximums, which are easily surpassed with one dental procedure.\u003c/p>\n\u003cp>“Even if you have great coverage, you could be paying hundreds of dollars more out of pocket by choosing one dentist over another one down the street,” says Jason Szczuka, general manager of \u003ca href=\"https://www.deltadentalins.com/individuals/plans/plan-types.html\" target=\"_blank\">Brighter.com\u003c/a>, a California company that manages dental benefits for some businesses.\u003c/p>\n\u003cp>Don’t be afraid to call around and ask dentists for their prices, he says.\u003c/p>\n\u003cp>You can also check online resources such as FAIR Health’s “Dental Cost Lookup” tool at \u003ca href=\"http://fairhealthconsumer.org/dentalcostlookup.php\" target=\"_blank\">FairHealthConsumer.org\u003c/a> to get an idea of how much others are being charged for similar services.\u003c/p>\n\u003cp>\u003cstrong>DISCOUNT PLANS\u003c/strong>\u003c/p>\n\u003cp>If you don’t have dental insurance, consider purchasing a discount dental plan. These plans, which are not insurance, give you access to certain dentists who have agreed to perform procedures at discounted, cash prices.\u003c/p>\n\u003cp>The discounts are usually 20 to 30 percent, sometimes more, says Evelyn Ireland, executive director of the NADP.\u003c/p>\n\u003cp>If you’re interested in purchasing one, she suggests using the “Find a Dental Plan” tool on NADP’s website (\u003ca href=\"http://www.nadp.org\" target=\"_blank\">www.nadp.org\u003c/a>), or checking with \u003ca href=\"http://www.dentalplans.com/\" target=\"_blank\">DentalPlans.com\u003c/a> or retailers such as Costco.\u003c/p>\n\u003cp>\u003cem>Questions for Emily:\u003c/em> \u003ca href=\"AskEmily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/p>\n\u003cp>\u003cem>Click \u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a> to find previous Ask Emily columns.\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>Emily produced this story for the \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> which partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu/\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org/\" target=\"_blank\">California HealthCare Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Contra Costa Restores Health Care for Undocumented Adults",
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"content": "\u003cp>The Contra Costa County Board of Supervisors voted Tuesday to restore primary health care services to undocumented adults living in the county. The services had been cut in 2009 during the economic downturn. The county had never ceased covering undocumented children.\u003c/p>\n\u003cp>Contra Costa, which includes the cities of Richmond, Concord and Antioch, now joins 46 other California counties that have approved non-emergency care to undocumented immigrants.\u003c/p>\n\u003cp>“Providing health care coverage to all is not only about the human morality issue that we should address, but also from a cost effective point of view … this is absolutely the right thing,” said Jane Garcia, CEO of La Clínica de la Raza, which serves 25,000 patients in Contra Costa, many of them low-income Latinos.\u003c/p>\n\u003cp>The program is not full scope insurance, but will provide preventive care. Health care providers and other supporters, such as Supervisor John Gioia, say that increasing access to preventive services will cut down visits to the emergency room and save the county money in the long run.\u003c/p>\n\u003cp>“It will mean better health care access for all, improved public health, lower cost to our health care system, and it’s just the right thing to do for people, especially undocumented adults who are not covered under the Affordable Care Act,” said Gioia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In its first year, the program, Contra Costa Cares, will assign up to 3,000 people a “medical home” at a community health center. Benefits will include regular physician checkups, immunizations, a nurse advice line and mental health services.\u003c/p>\n\u003cp>Rosa Arriaga, 72, joined the dozens of supporters wearing “Health4All” t-shirts who packed the meeting. She currently buys over-the-counter medication to help ease the arthritic pains she feels in her knees and along her left arm, but hopes to get regular medical treatment for her asthma and depression as well.\u003c/p>\n\u003cp>“I have worked, paid taxes and never asked for anything from the government. But now I feel sick, and I need to see a doctor,” said Arriaga in Spanish. She has lived in Richmond for 24 years.\u003c/p>\n\u003cp>“It’s not just me. A lot of other people in the county need this program,” added Arriaga, who is currently unemployed and says she has trouble paying the rent for a single room she shares with her nephew.\u003c/p>\n\u003cfigure id=\"attachment_82336\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut.jpg\">\u003cimg class=\"size-thumbnail wp-image-82336\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-400x267.jpg\" alt=\"Alvaro Fuentes, executive director of the Community Clinic Consortium, led the planning effort to revive health care services for undocumented in Contra Costa.\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alvaro Fuentes, executive director of the Community Clinic Consortium, led the planning effort to revive health care services for undocumented in Contra Costa. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Cares program is being established as a year-long pilot program. It will benefit 16 percent of the estimated undocumented population in Contra Costa, about 19,000 people. Advocates hope the program will continue and be expanded after this first year.\u003c/p>\n\u003cp>The Board of Supervisors agreed to allocate $500,000 to Cares. In addition, three local hospitals -- including Kaiser, Sutter Health and John Muir Health -- have promised an additional $500,000 in funding.\u003c/p>\n\u003cp>The vote was 4-1. Supervisor Candace Andersen cast the lone dissenting vote. She said she worries that the funding for the program is not sustainable.\u003c/p>\n\u003cp>“To me when you start a pilot program, you need to see where to go next, and I don’t see the funding in place right now,” said Andersen, who represents District II. “I’m very troubled that we are having to take half a million dollars from our (county's) general fund.”\u003c/p>\n\u003cp>Before the summer, only a few counties in California provided health care services to undocumented immigrants. In June, a group of 35 mostly-rural counties in California opted to cover all residents regardless of immigration status, according to the advocacy group Health Access. As recently as last week, the Monterey County Board of Supervisors gave a thumbs-up to expanding health care services.\u003c/p>\n\u003cp>\"Contra Costa is in good company in regards to this,” said Anthony Wright, executive director of Health Access. “It’s a really important step forward.\"\u003c/p>\n\u003cp>Contra Costa Cares could begin as early as November.\u003c/p>\n\u003cp>Statewide, an estimated one million undocumented immigrants remain uninsured, said Wright.\u003c/p>\n\u003cp>The movement to increase health care access to more residents has also made strides at the state level. In June, the California legislature and Gov. Jerry Brown announced a budget deal to provide public healthcare coverage for undocumented children from low income families as early as May 2016.\u003c/p>\n\u003cp>Tanya Broder, staff attorney at the National Immigration Law Center, said that a number of California counties were already covering children regardless of immigration status, and that paved the way for the statewide agreement.\u003c/p>\n\u003cp>“California is one of the few states with a large immigrant population that recognizes that it makes sense to provide healthcare to immigrants ineligible for federal care,” said Broder. “And the state is taking steps to provide coverage to all residents, but it’s not there yet.”\u003c/p>\n\u003cp>Since 2014, at least two recent proposals to expand health coverage to undocumented adults were unsuccessful in the state legislature. However, Broder believes the issue will resurface next year.\u003c/p>\n\u003cp>“Now, the conversation is not whether we should cover people regardless of immigration status. It’s how do we do it,” said Broder.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Washington, Illinois, New York, Massachusetts and District of Columbia already provide health coverage for immigrant children. But D.C. goes even further. At the state level, only D.C. allows for all qualifying residents, including the undocumented, to receive public health coverage through the \u003ca href=\"http://dhcf.dc.gov/service/health-care-alliance\" target=\"_blank\">DC Healthcare Alliance\u003c/a> program, according to \u003ca href=\"///Users/faridajhabvala/Downloads/med-services-for-imms-in-states-2015-09.pdf\" target=\"_blank\">data\u003c/a> by the National Immigration Law Center.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Contra Costa County Board of Supervisors voted Tuesday to restore primary health care services to undocumented adults living in the county. The services had been cut in 2009 during the economic downturn. The county had never ceased covering undocumented children.\u003c/p>\n\u003cp>Contra Costa, which includes the cities of Richmond, Concord and Antioch, now joins 46 other California counties that have approved non-emergency care to undocumented immigrants.\u003c/p>\n\u003cp>“Providing health care coverage to all is not only about the human morality issue that we should address, but also from a cost effective point of view … this is absolutely the right thing,” said Jane Garcia, CEO of La Clínica de la Raza, which serves 25,000 patients in Contra Costa, many of them low-income Latinos.\u003c/p>\n\u003cp>The program is not full scope insurance, but will provide preventive care. Health care providers and other supporters, such as Supervisor John Gioia, say that increasing access to preventive services will cut down visits to the emergency room and save the county money in the long run.\u003c/p>\n\u003cp>“It will mean better health care access for all, improved public health, lower cost to our health care system, and it’s just the right thing to do for people, especially undocumented adults who are not covered under the Affordable Care Act,” said Gioia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In its first year, the program, Contra Costa Cares, will assign up to 3,000 people a “medical home” at a community health center. Benefits will include regular physician checkups, immunizations, a nurse advice line and mental health services.\u003c/p>\n\u003cp>Rosa Arriaga, 72, joined the dozens of supporters wearing “Health4All” t-shirts who packed the meeting. She currently buys over-the-counter medication to help ease the arthritic pains she feels in her knees and along her left arm, but hopes to get regular medical treatment for her asthma and depression as well.\u003c/p>\n\u003cp>“I have worked, paid taxes and never asked for anything from the government. But now I feel sick, and I need to see a doctor,” said Arriaga in Spanish. She has lived in Richmond for 24 years.\u003c/p>\n\u003cp>“It’s not just me. A lot of other people in the county need this program,” added Arriaga, who is currently unemployed and says she has trouble paying the rent for a single room she shares with her nephew.\u003c/p>\n\u003cfigure id=\"attachment_82336\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut.jpg\">\u003cimg class=\"size-thumbnail wp-image-82336\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-400x267.jpg\" alt=\"Alvaro Fuentes, executive director of the Community Clinic Consortium, led the planning effort to revive health care services for undocumented in Contra Costa.\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/RS16747_IMG_9633.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alvaro Fuentes, executive director of the Community Clinic Consortium, led the planning effort to revive health care services for undocumented in Contra Costa. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Cares program is being established as a year-long pilot program. It will benefit 16 percent of the estimated undocumented population in Contra Costa, about 19,000 people. Advocates hope the program will continue and be expanded after this first year.\u003c/p>\n\u003cp>The Board of Supervisors agreed to allocate $500,000 to Cares. In addition, three local hospitals -- including Kaiser, Sutter Health and John Muir Health -- have promised an additional $500,000 in funding.\u003c/p>\n\u003cp>The vote was 4-1. Supervisor Candace Andersen cast the lone dissenting vote. She said she worries that the funding for the program is not sustainable.\u003c/p>\n\u003cp>“To me when you start a pilot program, you need to see where to go next, and I don’t see the funding in place right now,” said Andersen, who represents District II. “I’m very troubled that we are having to take half a million dollars from our (county's) general fund.”\u003c/p>\n\u003cp>Before the summer, only a few counties in California provided health care services to undocumented immigrants. In June, a group of 35 mostly-rural counties in California opted to cover all residents regardless of immigration status, according to the advocacy group Health Access. As recently as last week, the Monterey County Board of Supervisors gave a thumbs-up to expanding health care services.\u003c/p>\n\u003cp>\"Contra Costa is in good company in regards to this,” said Anthony Wright, executive director of Health Access. “It’s a really important step forward.\"\u003c/p>\n\u003cp>Contra Costa Cares could begin as early as November.\u003c/p>\n\u003cp>Statewide, an estimated one million undocumented immigrants remain uninsured, said Wright.\u003c/p>\n\u003cp>The movement to increase health care access to more residents has also made strides at the state level. In June, the California legislature and Gov. Jerry Brown announced a budget deal to provide public healthcare coverage for undocumented children from low income families as early as May 2016.\u003c/p>\n\u003cp>Tanya Broder, staff attorney at the National Immigration Law Center, said that a number of California counties were already covering children regardless of immigration status, and that paved the way for the statewide agreement.\u003c/p>\n\u003cp>“California is one of the few states with a large immigrant population that recognizes that it makes sense to provide healthcare to immigrants ineligible for federal care,” said Broder. “And the state is taking steps to provide coverage to all residents, but it’s not there yet.”\u003c/p>\n\u003cp>Since 2014, at least two recent proposals to expand health coverage to undocumented adults were unsuccessful in the state legislature. However, Broder believes the issue will resurface next year.\u003c/p>\n\u003cp>“Now, the conversation is not whether we should cover people regardless of immigration status. It’s how do we do it,” said Broder.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Washington, Illinois, New York, Massachusetts and District of Columbia already provide health coverage for immigrant children. But D.C. goes even further. At the state level, only D.C. allows for all qualifying residents, including the undocumented, to receive public health coverage through the \u003ca href=\"http://dhcf.dc.gov/service/health-care-alliance\" target=\"_blank\">DC Healthcare Alliance\u003c/a> program, according to \u003ca href=\"///Users/faridajhabvala/Downloads/med-services-for-imms-in-states-2015-09.pdf\" target=\"_blank\">data\u003c/a> by the National Immigration Law Center.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Employers Continue to Shift Health Costs to Workers, Survey Finds",
"title": "Employers Continue to Shift Health Costs to Workers, Survey Finds",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Employers are leaving a bigger chunk of the bill for care to workers who use their health insurance, and benefits experts see few signs of this trend slowing.\u003c/p>\n\u003cp>Most companies now offer health coverage that requires employees to pay an annual deductible before insurance kicks in, and the size of that deductible has soared in the past decade, \u003ca href=\"http://kff.org/health-costs/report/2015-employer-health-benefits-survey/\" target=\"_blank\">according to a survey \u003c/a>released Tuesday by the Kaiser Family Foundation and Health Research & Educational Trust.\u003c/p>\n\u003caside class=\"pullquote alignright\">A cost shift that is 'a quiet revolution in health insurance.'\u003c/aside>\n\u003cp>The average general deductible for workers with single coverage totaled $1,077 this year, compared with only $303 in 2006. That deductible has climbed nearly seven times faster than wages, on average, over the past five years.\u003c/p>\n\u003cp>\"That has an impact on family budgets,\" Kaiser CEO Drew Altman said.\u003c/p>\n\u003cp>The study also found that 46 percent of workers with single coverage have a deductible of $1,000 or more. That's up from only 10 percent in 2006. Kaiser's study didn't measure family coverage deductibles, which can be more complex, but researchers say those have grown as well.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Altman calls this cost shift a \"quiet revolution in health insurance,\" obscured in recent years by the health care overhaul's coverage expansion for people who don't have coverage through work.\u003c/p>\n\u003cp>\"It's funny, we used to think of $1,000 as a very high deductible, and now it's almost commonplace,\" he said. \"Consumers have much more skin in the game, and that may be fine if you're healthier and don't use a lot of health care. That could be a real problem if you're chronically ill.\"\u003c/p>\n\u003cfigure id=\"attachment_82031\" class=\"wp-caption aligncenter\" style=\"max-width: 765px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\">\u003cimg class=\"wp-image-82031 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\" alt=\"Worker contributions to health insurance have increased 83 percent in 10 years. \" width=\"765\" height=\"634\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png 765w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM-400x332.png 400w\" sizes=\"(max-width: 765px) 100vw, 765px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Worker contributions to health insurance have increased 83 percent in 10 years.\u003c/figcaption>\u003c/figure>\n\u003cp>Employer-sponsored health insurance is the most common form of coverage in the United States, with about 147 million people enrolled. Companies of all sizes offer coverage as a way to keep workers and make sure they stay healthy. But years of rising costs have forced many businesses to scale back their coverage. One of the quickest ways they have to control the growth in premiums, or cost of coverage, without significantly changing the insurance is to raise an employee's deductible.\u003c/p>\n\u003cp>Altman said the increase in deductibles has helped restrain premium growth for the past several years. In 2015, premiums rose an average of 4 percent for single and family coverage.\u003c/p>\n\u003cp>The employer generally pays most of the premium and has the remaining share taken out of the employee's paycheck before taxes.\u003c/p>\n\u003cp>Kaiser's research found that the size of a health plan's deductible can depend on the employer. Small firms had an average of $1,836, while big businesses had $1,105. Many companies pair that coverage with accounts that let employees set aside money before taxes for medical expenses.\u003c/p>\n\u003cp>Commercial painting company Steve Reiff Inc. offers single coverage with a deductible of $5,950. The South Whitley, Indiana, company also helps cover about half the cost of that deductible with contributions to an employee health reimbursement arrangement account, Controller Eric Trump said.\u003c/p>\n\u003cp>The business switched to a high-deductible plan several years ago to help restrain premium growth. That move helped, but Trump worries about leaving roughly 30 people on their coverage with the high deductible.\u003c/p>\n\u003cp>\"It's really hard to like a lot of health insurance options right now,\" he said. \"It's still a big expense for people that are making $10 to $15 an hour.\"\u003c/p>\n\u003cp>Paducah, Kentucky, resident Emmett Krall says the annual deductible of $3,500 on his employer-sponsored health insurance makes him think about cost more than he wants to, especially since his 10-year-old son was diagnosed with Type 1 diabetes last year.\u003c/p>\n\u003cp>Krall said he has to come up with about $200 a month to cover his son's insulin, needles and pump. The 46-year-old carpet manufacturer sales representative said he has cut down on going out to eat, and he's watching where he spends his money.\u003c/p>\n\u003cp>\"It causes an anxiety and a stress on my part, because I do get stressed about it, and I don't want him to know about it,\" he said.\u003c/p>\n\u003cp>College professor Bill Cantor said he's seen his premium fall to only $95 a month for family coverage from around $300 since he switched to a high-deductible health plan a few years ago. He uses a health savings account to set aside money for expenses, and he likes how the plan has made him more aware of costs.\u003c/p>\n\u003cp>The 53-year-old said he caught a $200 mistake on a medical bill that he might have missed if insurance had just covered the claim.\u003c/p>\n\u003cp>\"I think it would hold down insurance rates more if people thought about their spending,\" said Cantor, who teaches information science and technology at Penn State's York, Pennsylvania, campus.\u003c/p>\n\u003cp>Kaiser's survey focused on benefits for this year and doesn't predict what will happen in 2016, something many workers will learn about in a couple of months when their employers detail coverage plans for the new year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaiser Vice President Gary Claxton said he doesn't expect the trend toward higher deductibles to ease much in 2016. He noted that employers tend to make their coverage more generous as the economy improves. But companies still will be intent on controlling costs to prepare for an overhaul-imposed tax on expensive benefit plans that starts in 2018.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Employers are leaving a bigger chunk of the bill for care to workers who use their health insurance, and benefits experts see few signs of this trend slowing.\u003c/p>\n\u003cp>Most companies now offer health coverage that requires employees to pay an annual deductible before insurance kicks in, and the size of that deductible has soared in the past decade, \u003ca href=\"http://kff.org/health-costs/report/2015-employer-health-benefits-survey/\" target=\"_blank\">according to a survey \u003c/a>released Tuesday by the Kaiser Family Foundation and Health Research & Educational Trust.\u003c/p>\n\u003caside class=\"pullquote alignright\">A cost shift that is 'a quiet revolution in health insurance.'\u003c/aside>\n\u003cp>The average general deductible for workers with single coverage totaled $1,077 this year, compared with only $303 in 2006. That deductible has climbed nearly seven times faster than wages, on average, over the past five years.\u003c/p>\n\u003cp>\"That has an impact on family budgets,\" Kaiser CEO Drew Altman said.\u003c/p>\n\u003cp>The study also found that 46 percent of workers with single coverage have a deductible of $1,000 or more. That's up from only 10 percent in 2006. Kaiser's study didn't measure family coverage deductibles, which can be more complex, but researchers say those have grown as well.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Altman calls this cost shift a \"quiet revolution in health insurance,\" obscured in recent years by the health care overhaul's coverage expansion for people who don't have coverage through work.\u003c/p>\n\u003cp>\"It's funny, we used to think of $1,000 as a very high deductible, and now it's almost commonplace,\" he said. \"Consumers have much more skin in the game, and that may be fine if you're healthier and don't use a lot of health care. That could be a real problem if you're chronically ill.\"\u003c/p>\n\u003cfigure id=\"attachment_82031\" class=\"wp-caption aligncenter\" style=\"max-width: 765px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\">\u003cimg class=\"wp-image-82031 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\" alt=\"Worker contributions to health insurance have increased 83 percent in 10 years. \" width=\"765\" height=\"634\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png 765w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM-400x332.png 400w\" sizes=\"(max-width: 765px) 100vw, 765px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Worker contributions to health insurance have increased 83 percent in 10 years.\u003c/figcaption>\u003c/figure>\n\u003cp>Employer-sponsored health insurance is the most common form of coverage in the United States, with about 147 million people enrolled. Companies of all sizes offer coverage as a way to keep workers and make sure they stay healthy. But years of rising costs have forced many businesses to scale back their coverage. One of the quickest ways they have to control the growth in premiums, or cost of coverage, without significantly changing the insurance is to raise an employee's deductible.\u003c/p>\n\u003cp>Altman said the increase in deductibles has helped restrain premium growth for the past several years. In 2015, premiums rose an average of 4 percent for single and family coverage.\u003c/p>\n\u003cp>The employer generally pays most of the premium and has the remaining share taken out of the employee's paycheck before taxes.\u003c/p>\n\u003cp>Kaiser's research found that the size of a health plan's deductible can depend on the employer. Small firms had an average of $1,836, while big businesses had $1,105. Many companies pair that coverage with accounts that let employees set aside money before taxes for medical expenses.\u003c/p>\n\u003cp>Commercial painting company Steve Reiff Inc. offers single coverage with a deductible of $5,950. The South Whitley, Indiana, company also helps cover about half the cost of that deductible with contributions to an employee health reimbursement arrangement account, Controller Eric Trump said.\u003c/p>\n\u003cp>The business switched to a high-deductible plan several years ago to help restrain premium growth. That move helped, but Trump worries about leaving roughly 30 people on their coverage with the high deductible.\u003c/p>\n\u003cp>\"It's really hard to like a lot of health insurance options right now,\" he said. \"It's still a big expense for people that are making $10 to $15 an hour.\"\u003c/p>\n\u003cp>Paducah, Kentucky, resident Emmett Krall says the annual deductible of $3,500 on his employer-sponsored health insurance makes him think about cost more than he wants to, especially since his 10-year-old son was diagnosed with Type 1 diabetes last year.\u003c/p>\n\u003cp>Krall said he has to come up with about $200 a month to cover his son's insulin, needles and pump. The 46-year-old carpet manufacturer sales representative said he has cut down on going out to eat, and he's watching where he spends his money.\u003c/p>\n\u003cp>\"It causes an anxiety and a stress on my part, because I do get stressed about it, and I don't want him to know about it,\" he said.\u003c/p>\n\u003cp>College professor Bill Cantor said he's seen his premium fall to only $95 a month for family coverage from around $300 since he switched to a high-deductible health plan a few years ago. He uses a health savings account to set aside money for expenses, and he likes how the plan has made him more aware of costs.\u003c/p>\n\u003cp>The 53-year-old said he caught a $200 mistake on a medical bill that he might have missed if insurance had just covered the claim.\u003c/p>\n\u003cp>\"I think it would hold down insurance rates more if people thought about their spending,\" said Cantor, who teaches information science and technology at Penn State's York, Pennsylvania, campus.\u003c/p>\n\u003cp>Kaiser's survey focused on benefits for this year and doesn't predict what will happen in 2016, something many workers will learn about in a couple of months when their employers detail coverage plans for the new year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaiser Vice President Gary Claxton said he doesn't expect the trend toward higher deductibles to ease much in 2016. He noted that employers tend to make their coverage more generous as the economy improves. But companies still will be intent on controlling costs to prepare for an overhaul-imposed tax on expensive benefit plans that starts in 2018.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Attention Shoppers! New Calif. Website Details Costs, Quality of Medical Procedures",
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"content": "\u003cp>Having a baby in California?\u003c/p>\n\u003cp>Your average out-of-pocket costs for an uncomplicated birth could cost a lot less in San Mateo County ($920) than in Alameda County ($1,300), Santa Clara County ($1,500) or Orange County ($1,800).\u003c/p>\n\u003cp>Thinking about a knee replacement?\u003c/p>\n\u003cp>You’ll find a surprisingly wide variation in quality ratings among Bay Area hospitals for the procedure.\u003c/p>\n\u003cp>These are among the insights from a new consumer website unveiled Monday by the California Department of Insurance to help Californians better shop for health care based on both quality and price.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The site, \u003ca href=\"http://www.cahealthcarecompare.org/search.jsp\" target=\"_blank\">California Healthcare Compare\u003c/a>, was created for the state insurance agency by UC San Francisco researchers and Consumer Reports with a federal grant from the Centers for Medicare & Medicaid Services.\u003c/p>\n\u003cp>The site provides information on quality for five common conditions or procedures: childbirth, hip and knee replacement, colon cancer screening, diabetes and back pain. And it gives cost information -- by county for 100 procedures, ranging from treating a broken ankle to cancer chemotherapy.\u003c/p>\n\u003cp>“When it comes to health care cost and quality, it’s really a black box for consumers. They don’t know how much they’re going to pay,” said Doris Peter, director of the \u003ca href=\"http://consumerhealthchoices.org/a-look-at-the-health-ratings-center/\" target=\"_blank\">Consumer Reports Health Ratings Center\u003c/a>. “This website is a first step toward providing this information.”\u003c/p>\n\u003cp>Websites to help consumers evaluate the quality of hospitals and other health providers have been around for years. But they often focus on cost or quality, not both, and remain a work in progress – even as consumers with high-deductible health plans under the Affordable Care Act are looking for better information to make smart health care decisions.\u003c/p>\n\u003cp>Nationally, the Centers for Medicare & Medicaid Services’ \u003ca href=\"https://www.medicare.gov/hospitalcompare/search.html\" target=\"_blank\">HospitalCompare\u003c/a> website offers data on quality for 4,000 hospitals, allowing patients to review how well hospitals treat conditions like asthma, heart attacks, stroke or pneumonia, among other measures.\u003c/p>\n\u003cp>Californians also can find health care quality -- but not cost -- data at \u003ca href=\"http://www.calqualitycare.org/\" target=\"_blank\">CalQualityCare.org\u003c/a>, which provides information on the state’s hospitals, doctor groups, nursing homes, assisted living facilities, home health and hospice services, adult day care, and services for the developmentally disabled. The site is run by the Oakland-based California HealthCare Foundation.\u003c/p>\n\u003cp>Patients can find the sites complicated to use, and providers \u003ca href=\"http://www.modernhealthcare.com/article/20140531/MAGAZINE/305319980\" target=\"_blank\">have pushed back\u003c/a> against some quality rating methodologies. Rather than scrutinizing a website, consumers often will rely on personal recommendations from their physicians or friends and family to decide on where to have a procedure done.\u003c/p>\n\u003cp>Data on health care costs, much of it closely held by health insurers, can be even harder to gather and share with the public, although many ventures are trying, including \u003ca href=\"https://healthcarebluebook.com\" target=\"_blank\">Healthcare Bluebook\u003c/a> and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">KQED's PriceCheck,\u003c/a> a crowdsourcing collaboration with KPCC in Los Angeles and with \u003ca href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a health care cost transparency startup.\u003c/p>\n\u003cp>The creators of the California Department of Insurance’s new site, California Healthcare Compare, are trying to push past those hurdles.\u003c/p>\n\u003cp>They’ve gathered health quality and cost data from state and federal agencies, including HospitalCompare, the \u003ca href=\"http://www.nbch.org/PPR-Case-Study---Integrated-Health-Association\" target=\"_blank\">Integrated Healthcare Association\u003c/a>, \u003ca href=\"https://www.cmqcc.org/maternal-data-center\">California Maternal Quality Care Collaborative\u003c/a> and insurance claims data.\u003c/p>\n\u003cp>Cost data is available for all counties except Kern, which had only one insurer at the time the cost data was last collected, in 2013.\u003c/p>\n\u003cp>In a written statement, California Insurance Commissioner Dave Jones said: \"This is ... a first step toward convincing doctors, hospitals and insurers and legislators of the benefits of sharing more detailed price information to allow consumers faced with high deductible plans to make better decisions.\"\u003c/p>\n\u003cp>While California Healthcare Compare aims to be more comprehensive than other data sources, its usefulness for consumers remains to be seen. While the site breaks down average out-of-pocket costs for consumers and average costs that insurers pay, it can be difficult for consumers to figure out what their own costs will be.\u003c/p>\n\u003cp>The site helpfully links consumers to online out-of-pocket cost calculators maintained by major insurers, including Kaiser Permanente, Aetna and Anthem Blue Cross, but some insurers still lack them. In addition, the site averages the low out-of-pocket costs of Medi-Cal patients with those of privately insured patients, which can be far higher. And consumers may find the disconnect between the total cost of a procedure – what insurers and consumers jointly pay to a provider – and their own out-of-pocket costs to be confusing.\u003c/p>\n\u003cp>Take total knee replacements. In Alameda County, where the surgery’s total average cost for consumers and employers is listed as more than $55,000 – the highest in the state -- the site estimates average out-of-pocket costs at only $86. In comparison, the total cost for the same surgery in Santa Clara County is just under $40,000 – but the average out-of-pocket cost is about $300.\u003c/p>\n\u003cp>The site will evolve over time if funding can be sustained, said Dr. R. Adams Dudley, director of the UCSF Center for Healthcare Value, which led the project. He hopes to add quality and cost data for many more conditions, and also provide cost data for individual hospitals and doctors’ groups.\u003c/p>\n\u003cp>What’s important is to continue the push to make health care cost and quality information more transparent, he said.\u003c/p>\n\u003cp>Public reporting of some quality measures, such as the rate of hospital-acquired infections, has forced providers to improve. Consumers wondering why their insurers pay so much for procedures in one county compared with another might talk to their company’s human resources department, which in turn can question insurers about those costs.\u003c/p>\n\u003cp>“These are the kind of conversations we want people to be having and the kind of shopping we want them to be doing,” Dudley said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder Ostrov reported this story for \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Having a baby in California?\u003c/p>\n\u003cp>Your average out-of-pocket costs for an uncomplicated birth could cost a lot less in San Mateo County ($920) than in Alameda County ($1,300), Santa Clara County ($1,500) or Orange County ($1,800).\u003c/p>\n\u003cp>Thinking about a knee replacement?\u003c/p>\n\u003cp>You’ll find a surprisingly wide variation in quality ratings among Bay Area hospitals for the procedure.\u003c/p>\n\u003cp>These are among the insights from a new consumer website unveiled Monday by the California Department of Insurance to help Californians better shop for health care based on both quality and price.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The site, \u003ca href=\"http://www.cahealthcarecompare.org/search.jsp\" target=\"_blank\">California Healthcare Compare\u003c/a>, was created for the state insurance agency by UC San Francisco researchers and Consumer Reports with a federal grant from the Centers for Medicare & Medicaid Services.\u003c/p>\n\u003cp>The site provides information on quality for five common conditions or procedures: childbirth, hip and knee replacement, colon cancer screening, diabetes and back pain. And it gives cost information -- by county for 100 procedures, ranging from treating a broken ankle to cancer chemotherapy.\u003c/p>\n\u003cp>“When it comes to health care cost and quality, it’s really a black box for consumers. They don’t know how much they’re going to pay,” said Doris Peter, director of the \u003ca href=\"http://consumerhealthchoices.org/a-look-at-the-health-ratings-center/\" target=\"_blank\">Consumer Reports Health Ratings Center\u003c/a>. “This website is a first step toward providing this information.”\u003c/p>\n\u003cp>Websites to help consumers evaluate the quality of hospitals and other health providers have been around for years. But they often focus on cost or quality, not both, and remain a work in progress – even as consumers with high-deductible health plans under the Affordable Care Act are looking for better information to make smart health care decisions.\u003c/p>\n\u003cp>Nationally, the Centers for Medicare & Medicaid Services’ \u003ca href=\"https://www.medicare.gov/hospitalcompare/search.html\" target=\"_blank\">HospitalCompare\u003c/a> website offers data on quality for 4,000 hospitals, allowing patients to review how well hospitals treat conditions like asthma, heart attacks, stroke or pneumonia, among other measures.\u003c/p>\n\u003cp>Californians also can find health care quality -- but not cost -- data at \u003ca href=\"http://www.calqualitycare.org/\" target=\"_blank\">CalQualityCare.org\u003c/a>, which provides information on the state’s hospitals, doctor groups, nursing homes, assisted living facilities, home health and hospice services, adult day care, and services for the developmentally disabled. The site is run by the Oakland-based California HealthCare Foundation.\u003c/p>\n\u003cp>Patients can find the sites complicated to use, and providers \u003ca href=\"http://www.modernhealthcare.com/article/20140531/MAGAZINE/305319980\" target=\"_blank\">have pushed back\u003c/a> against some quality rating methodologies. Rather than scrutinizing a website, consumers often will rely on personal recommendations from their physicians or friends and family to decide on where to have a procedure done.\u003c/p>\n\u003cp>Data on health care costs, much of it closely held by health insurers, can be even harder to gather and share with the public, although many ventures are trying, including \u003ca href=\"https://healthcarebluebook.com\" target=\"_blank\">Healthcare Bluebook\u003c/a> and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">KQED's PriceCheck,\u003c/a> a crowdsourcing collaboration with KPCC in Los Angeles and with \u003ca href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a health care cost transparency startup.\u003c/p>\n\u003cp>The creators of the California Department of Insurance’s new site, California Healthcare Compare, are trying to push past those hurdles.\u003c/p>\n\u003cp>They’ve gathered health quality and cost data from state and federal agencies, including HospitalCompare, the \u003ca href=\"http://www.nbch.org/PPR-Case-Study---Integrated-Health-Association\" target=\"_blank\">Integrated Healthcare Association\u003c/a>, \u003ca href=\"https://www.cmqcc.org/maternal-data-center\">California Maternal Quality Care Collaborative\u003c/a> and insurance claims data.\u003c/p>\n\u003cp>Cost data is available for all counties except Kern, which had only one insurer at the time the cost data was last collected, in 2013.\u003c/p>\n\u003cp>In a written statement, California Insurance Commissioner Dave Jones said: \"This is ... a first step toward convincing doctors, hospitals and insurers and legislators of the benefits of sharing more detailed price information to allow consumers faced with high deductible plans to make better decisions.\"\u003c/p>\n\u003cp>While California Healthcare Compare aims to be more comprehensive than other data sources, its usefulness for consumers remains to be seen. While the site breaks down average out-of-pocket costs for consumers and average costs that insurers pay, it can be difficult for consumers to figure out what their own costs will be.\u003c/p>\n\u003cp>The site helpfully links consumers to online out-of-pocket cost calculators maintained by major insurers, including Kaiser Permanente, Aetna and Anthem Blue Cross, but some insurers still lack them. In addition, the site averages the low out-of-pocket costs of Medi-Cal patients with those of privately insured patients, which can be far higher. And consumers may find the disconnect between the total cost of a procedure – what insurers and consumers jointly pay to a provider – and their own out-of-pocket costs to be confusing.\u003c/p>\n\u003cp>Take total knee replacements. In Alameda County, where the surgery’s total average cost for consumers and employers is listed as more than $55,000 – the highest in the state -- the site estimates average out-of-pocket costs at only $86. In comparison, the total cost for the same surgery in Santa Clara County is just under $40,000 – but the average out-of-pocket cost is about $300.\u003c/p>\n\u003cp>The site will evolve over time if funding can be sustained, said Dr. R. Adams Dudley, director of the UCSF Center for Healthcare Value, which led the project. He hopes to add quality and cost data for many more conditions, and also provide cost data for individual hospitals and doctors’ groups.\u003c/p>\n\u003cp>What’s important is to continue the push to make health care cost and quality information more transparent, he said.\u003c/p>\n\u003cp>Public reporting of some quality measures, such as the rate of hospital-acquired infections, has forced providers to improve. Consumers wondering why their insurers pay so much for procedures in one county compared with another might talk to their company’s human resources department, which in turn can question insurers about those costs.\u003c/p>\n\u003cp>“These are the kind of conversations we want people to be having and the kind of shopping we want them to be doing,” Dudley said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder Ostrov reported this story for \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How to Save Money on Prescription Drugs -- Whether You're Insured or Not",
"title": "How to Save Money on Prescription Drugs -- Whether You're Insured or Not",
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"content": "\u003cp>If you haven’t experienced it yourself, you’ve no doubt heard about the outrageous – and rapidly growing – prices of certain prescription medications.\u003c/p>\n\u003cp>The average price of about one year of cancer-drug therapy has skyrocketed from $10,000 (or less) before 2000 to more than $100,000 by 2012, according to \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(15)00101-9/abstract\" target=\"_blank\">a recent Mayo Clinic study\u003c/a>.\u003c/p>\n\u003cp>The new hepatitis C drug Sovaldi comes at a \u003ca href=\"http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426\" target=\"_blank\">retail price tag of $84,000\u003c/a> for a 12-week course.\u003c/p>\n\u003cp>Prices are even spiking for some generics that have been around for years. Take the cost of the commonly used antibiotic, \u003ca href=\"https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682063.html\" target=\"_blank\">doxycycline\u003c/a>, which jumped from $20 for 500 pills in Oct. 2013 to $1,849 in April 2014, \u003ca href=\"http://www.aarp.org/health/drugs-supplements/info-2015/prices-spike-for-generic-drugs.2.html\" target=\"_blank\">according to AARP\u003c/a>.\u003c/p>\n\u003cp>The unaffordability of drugs is a real and growing threat, even for people with health insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today I’m going to offer some tips on how to save money on your prescription drugs, whether you’re insured or not.\u003c/p>\n\u003cp>\u003cstrong>Q: I was recently diagnosed with cancer and had my first round of chemo. The nurse gave me a prescription for a generic anti-nausea medication. When my wife took it to the drug store, she was quoted a price of $900 for a 30-day supply. How is that possible?\u003c/strong>\u003c/p>\n\u003cp>A: I wish I could answer the question from Jim Buchanan of Hemet, but I don’t know why a generic anti-nausea drug would cost $900 out of pocket, even \u003cem>with\u003c/em> his insurance applied to the prescription.\u003c/p>\n\u003cp>I can say that his wife, Susan Buchanan, did the right thing when she didn’t take $900 for an answer. Though “totally in shock” from the quoted price, she asked what the cost of the prescription would be without applying insurance.\u003c/p>\n\u003cp>$45\u003c/p>\n\u003cp>Counterintuitive? Yes. Confusing? Definitely.\u003c/p>\n\u003cp>“In some cases, people may be better off not using their insurance,” says Betsy Imholz, special projects director at \u003ca href=\"http://consumersunion.org/\" target=\"_blank\">Consumers Union\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Lesson 1: Shop smart.\u003c/strong>\u003c/p>\n\u003cp>When you get your prescription, call multiple pharmacies and negotiate, even for generics. Neighborhood pharmacies may have more autonomy to lower prices than chain stores, Imholz says.\u003c/p>\n\u003cp>If you don’t have insurance, however, Costco has the lowest price of chain stores on average, she says. You don’t have to be a member to use its pharmacy.\u003c/p>\n\u003cp>Finally, ask your doctor to write a prescription for a 90-day supply of drugs instead of 30 days. “You’ll be avoiding copays and trips to the pharmacy,” she says.\u003c/p>\n\u003cp>\u003cstrong>Lesson 2: Appeal for coverage.\u003c/strong>\u003c/p>\n\u003cp>Let’s say your doctor wants you to take a medication that’s not on your plan’s formulary and you’re faced with paying full cost.\u003c/p>\n\u003cp>Before you empty your pockets, file an appeal with your insurer, which in most cases must cover medically necessary drugs that aren’t on their formularies – if your condition warrants their use.\u003c/p>\n\u003cp>If your health plan rejects your appeal, contact your regulator and request an independent medical review, which is free. The health plan’s denial letter will specify your regulator, or try the state Department of Managed Health Care (888-466-2219 or \u003ca href=\"http://www.HealthHelp.ca.gov\" target=\"_blank\">www.HealthHelp.ca.gov\u003c/a>) or the state Department of Insurance (800-927-4357 or \u003ca href=\"http://www.insurance.ca.gov/\" target=\"_blank\">www.Insurance.ca.gov\u003c/a>).\u003c/p>\n\u003cp>You’ll need to work with your doctor through this process to help you prove medical necessity.\u003c/p>\n\u003cp>\u003cstrong>Lesson 3: Look for financial assistance.\u003c/strong>\u003c/p>\n\u003cp>There are a slew of programs offered by drug companies and foundations, and many websites that help you search for them. One is NeedyMeds (\u003ca href=\"http://www.NeedyMeds.org\" target=\"_blank\">www.NeedyMeds.org\u003c/a>), a national nonprofit that helps connect people with assistance.\u003c/p>\n\u003cp>“Pharmaceutical companies give away billions of dollars in drugs every year to people in need,” says NeedyMeds President Richard Sagall.\u003c/p>\n\u003cp>Financial help from pharmaceutical companies is generally for brand-name drugs that don’t have generic equivalents. These programs have eligibility requirements based on four categories, Sagall says:\u003c/p>\n\u003cul>\n\u003cli>Citizenship and immigration status.\u003c/li>\n\u003cli>Many have relatively generous thresholds that include middle-class families.\u003c/li>\n\u003cli>Some will only help people who are uninsured or have no drug coverage.\u003c/li>\n\u003cli>Some are disease- or diagnosis-specific.\u003c/li>\n\u003c/ul>\n\u003cp>All require some input from the doctor who prescribed the medication, Sagall says.\u003c/p>\n\u003cp>If you have drug coverage but can’t afford your copay, there are programs that may help with that, too.\u003c/p>\n\u003cp>Other helpful websites for financial assistance include the Partnership for Prescription Assistance (\u003ca href=\"https://www.pparx.org/\" target=\"_blank\">www.pparx.org\u003c/a>); Patient Services, Inc. (\u003ca href=\"http://www.patientservicesinc.org\" target=\"_blank\">www.PatientServicesInc.org\u003c/a>); and the Patient Advocate Foundation’s National Financial Resource Directory (\u003ca href=\"http://www.patientadvocate.org/NURD/index2.php?application=financial\" target=\"_blank\">www.PatientAdvocate.org\u003c/a>).\u003c/p>\n\u003cp>You can also reach out to disease-based organizations like the \u003ca href=\"https://www.lls.org/\" target=\"_blank\">Leukemia & Lymphoma Society\u003c/a> or the \u003ca href=\"http://www.diabetes.org/?referrer=https://www.google.com/\" target=\"_blank\">American Diabetes Association\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Lesson 4: Use prescription discount cards and programs.\u003c/strong>\u003c/p>\n\u003cp>There are two types of drug discount cards. The first comes from pharmaceutical companies and generally offers discounts for a specific drug, Sagall says.\u003c/p>\n\u003cp>The other discounts multiple drugs and is offered by \u003ca href=\"http://www.aarphealthcare.com/health-discounts/prescription-discounts.html\">AARP\u003c/a>, \u003ca href=\"http://www.costco.com/pharmacy/member-prescription-program-frequently-asked-questions.html\">Costco\u003c/a>, \u003ca href=\"http://www.needymeds.org/questions-faqs\">NeedyMeds\u003c/a> and others. However, “you cannot use these in conjunction with insurance or state-federal programs such as Medicare,” he says.\u003c/p>\n\u003cp>But don’t forget the Buchanans of Hemet, who got a better deal without their insurance.\u003c/p>\n\u003cp>\u003cstrong>Lesson 5: Choose insurance with drug coverage you need.\u003c/strong>\u003c/p>\n\u003cp>One of the best ways to limit your out-of-pocket costs is to choose the best plan for your situation. You’ll have a chance to do that in your next open-enrollment period, which is fast approaching for most people.\u003c/p>\n\u003cp>If you have a chronic condition or take a lot of medications, try to avoid high-deductible plans, which include the “bronze” level plans sold by Covered California.\u003c/p>\n\u003cp>“If you have to pay a little higher premium but have lower out-of-pocket costs, that’s a better choice,” says Liz Helms, president/CEO of the \u003ca href=\"http://chroniccareca.publishpath.com/\" target=\"_blank\">California Chronic Care Coalition\u003c/a>.\u003c/p>\n\u003cp>\u003cem>Qu\u003c/em>\u003cem>esti\u003c/em>\u003cem>ons for Emily Bazar: \u003c/em>\u003ca href=\"mailto:AskEmily@usc.edu\">\u003cem>AskEmily@usc.edu\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cem>Click \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">\u003cem>here\u003c/em>\u003c/a>\u003cem> to find previous Ask Emily columns. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The \u003c/em>\u003ca href=\"http://www.centerforhealthreporting.org/\" target=\"_blank\">\u003cem>CHCF Center for Health Reporting\u003c/em>\u003c/a>\u003cem> partners with news organizations to cover California health policy. Located at the \u003c/em>\u003ca href=\"http://annenberg.usc.edu/\" target=\"_blank\">\u003cem>USC Annenberg School for Communication and Journalism\u003c/em>\u003c/a>\u003cem>, it is funded by the nonpartisan \u003c/em>\u003ca href=\"http://www.chcf.org/\" target=\"_blank\">\u003cem>California HealthCare Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you haven’t experienced it yourself, you’ve no doubt heard about the outrageous – and rapidly growing – prices of certain prescription medications.\u003c/p>\n\u003cp>The average price of about one year of cancer-drug therapy has skyrocketed from $10,000 (or less) before 2000 to more than $100,000 by 2012, according to \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(15)00101-9/abstract\" target=\"_blank\">a recent Mayo Clinic study\u003c/a>.\u003c/p>\n\u003cp>The new hepatitis C drug Sovaldi comes at a \u003ca href=\"http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426\" target=\"_blank\">retail price tag of $84,000\u003c/a> for a 12-week course.\u003c/p>\n\u003cp>Prices are even spiking for some generics that have been around for years. Take the cost of the commonly used antibiotic, \u003ca href=\"https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682063.html\" target=\"_blank\">doxycycline\u003c/a>, which jumped from $20 for 500 pills in Oct. 2013 to $1,849 in April 2014, \u003ca href=\"http://www.aarp.org/health/drugs-supplements/info-2015/prices-spike-for-generic-drugs.2.html\" target=\"_blank\">according to AARP\u003c/a>.\u003c/p>\n\u003cp>The unaffordability of drugs is a real and growing threat, even for people with health insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today I’m going to offer some tips on how to save money on your prescription drugs, whether you’re insured or not.\u003c/p>\n\u003cp>\u003cstrong>Q: I was recently diagnosed with cancer and had my first round of chemo. The nurse gave me a prescription for a generic anti-nausea medication. When my wife took it to the drug store, she was quoted a price of $900 for a 30-day supply. How is that possible?\u003c/strong>\u003c/p>\n\u003cp>A: I wish I could answer the question from Jim Buchanan of Hemet, but I don’t know why a generic anti-nausea drug would cost $900 out of pocket, even \u003cem>with\u003c/em> his insurance applied to the prescription.\u003c/p>\n\u003cp>I can say that his wife, Susan Buchanan, did the right thing when she didn’t take $900 for an answer. Though “totally in shock” from the quoted price, she asked what the cost of the prescription would be without applying insurance.\u003c/p>\n\u003cp>$45\u003c/p>\n\u003cp>Counterintuitive? Yes. Confusing? Definitely.\u003c/p>\n\u003cp>“In some cases, people may be better off not using their insurance,” says Betsy Imholz, special projects director at \u003ca href=\"http://consumersunion.org/\" target=\"_blank\">Consumers Union\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Lesson 1: Shop smart.\u003c/strong>\u003c/p>\n\u003cp>When you get your prescription, call multiple pharmacies and negotiate, even for generics. Neighborhood pharmacies may have more autonomy to lower prices than chain stores, Imholz says.\u003c/p>\n\u003cp>If you don’t have insurance, however, Costco has the lowest price of chain stores on average, she says. You don’t have to be a member to use its pharmacy.\u003c/p>\n\u003cp>Finally, ask your doctor to write a prescription for a 90-day supply of drugs instead of 30 days. “You’ll be avoiding copays and trips to the pharmacy,” she says.\u003c/p>\n\u003cp>\u003cstrong>Lesson 2: Appeal for coverage.\u003c/strong>\u003c/p>\n\u003cp>Let’s say your doctor wants you to take a medication that’s not on your plan’s formulary and you’re faced with paying full cost.\u003c/p>\n\u003cp>Before you empty your pockets, file an appeal with your insurer, which in most cases must cover medically necessary drugs that aren’t on their formularies – if your condition warrants their use.\u003c/p>\n\u003cp>If your health plan rejects your appeal, contact your regulator and request an independent medical review, which is free. The health plan’s denial letter will specify your regulator, or try the state Department of Managed Health Care (888-466-2219 or \u003ca href=\"http://www.HealthHelp.ca.gov\" target=\"_blank\">www.HealthHelp.ca.gov\u003c/a>) or the state Department of Insurance (800-927-4357 or \u003ca href=\"http://www.insurance.ca.gov/\" target=\"_blank\">www.Insurance.ca.gov\u003c/a>).\u003c/p>\n\u003cp>You’ll need to work with your doctor through this process to help you prove medical necessity.\u003c/p>\n\u003cp>\u003cstrong>Lesson 3: Look for financial assistance.\u003c/strong>\u003c/p>\n\u003cp>There are a slew of programs offered by drug companies and foundations, and many websites that help you search for them. One is NeedyMeds (\u003ca href=\"http://www.NeedyMeds.org\" target=\"_blank\">www.NeedyMeds.org\u003c/a>), a national nonprofit that helps connect people with assistance.\u003c/p>\n\u003cp>“Pharmaceutical companies give away billions of dollars in drugs every year to people in need,” says NeedyMeds President Richard Sagall.\u003c/p>\n\u003cp>Financial help from pharmaceutical companies is generally for brand-name drugs that don’t have generic equivalents. These programs have eligibility requirements based on four categories, Sagall says:\u003c/p>\n\u003cul>\n\u003cli>Citizenship and immigration status.\u003c/li>\n\u003cli>Many have relatively generous thresholds that include middle-class families.\u003c/li>\n\u003cli>Some will only help people who are uninsured or have no drug coverage.\u003c/li>\n\u003cli>Some are disease- or diagnosis-specific.\u003c/li>\n\u003c/ul>\n\u003cp>All require some input from the doctor who prescribed the medication, Sagall says.\u003c/p>\n\u003cp>If you have drug coverage but can’t afford your copay, there are programs that may help with that, too.\u003c/p>\n\u003cp>Other helpful websites for financial assistance include the Partnership for Prescription Assistance (\u003ca href=\"https://www.pparx.org/\" target=\"_blank\">www.pparx.org\u003c/a>); Patient Services, Inc. (\u003ca href=\"http://www.patientservicesinc.org\" target=\"_blank\">www.PatientServicesInc.org\u003c/a>); and the Patient Advocate Foundation’s National Financial Resource Directory (\u003ca href=\"http://www.patientadvocate.org/NURD/index2.php?application=financial\" target=\"_blank\">www.PatientAdvocate.org\u003c/a>).\u003c/p>\n\u003cp>You can also reach out to disease-based organizations like the \u003ca href=\"https://www.lls.org/\" target=\"_blank\">Leukemia & Lymphoma Society\u003c/a> or the \u003ca href=\"http://www.diabetes.org/?referrer=https://www.google.com/\" target=\"_blank\">American Diabetes Association\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Lesson 4: Use prescription discount cards and programs.\u003c/strong>\u003c/p>\n\u003cp>There are two types of drug discount cards. The first comes from pharmaceutical companies and generally offers discounts for a specific drug, Sagall says.\u003c/p>\n\u003cp>The other discounts multiple drugs and is offered by \u003ca href=\"http://www.aarphealthcare.com/health-discounts/prescription-discounts.html\">AARP\u003c/a>, \u003ca href=\"http://www.costco.com/pharmacy/member-prescription-program-frequently-asked-questions.html\">Costco\u003c/a>, \u003ca href=\"http://www.needymeds.org/questions-faqs\">NeedyMeds\u003c/a> and others. However, “you cannot use these in conjunction with insurance or state-federal programs such as Medicare,” he says.\u003c/p>\n\u003cp>But don’t forget the Buchanans of Hemet, who got a better deal without their insurance.\u003c/p>\n\u003cp>\u003cstrong>Lesson 5: Choose insurance with drug coverage you need.\u003c/strong>\u003c/p>\n\u003cp>One of the best ways to limit your out-of-pocket costs is to choose the best plan for your situation. You’ll have a chance to do that in your next open-enrollment period, which is fast approaching for most people.\u003c/p>\n\u003cp>If you have a chronic condition or take a lot of medications, try to avoid high-deductible plans, which include the “bronze” level plans sold by Covered California.\u003c/p>\n\u003cp>“If you have to pay a little higher premium but have lower out-of-pocket costs, that’s a better choice,” says Liz Helms, president/CEO of the \u003ca href=\"http://chroniccareca.publishpath.com/\" target=\"_blank\">California Chronic Care Coalition\u003c/a>.\u003c/p>\n\u003cp>\u003cem>Qu\u003c/em>\u003cem>esti\u003c/em>\u003cem>ons for Emily Bazar: \u003c/em>\u003ca href=\"mailto:AskEmily@usc.edu\">\u003cem>AskEmily@usc.edu\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cem>Click \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">\u003cem>here\u003c/em>\u003c/a>\u003cem> to find previous Ask Emily columns. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The \u003c/em>\u003ca href=\"http://www.centerforhealthreporting.org/\" target=\"_blank\">\u003cem>CHCF Center for Health Reporting\u003c/em>\u003c/a>\u003cem> partners with news organizations to cover California health policy. Located at the \u003c/em>\u003ca href=\"http://annenberg.usc.edu/\" target=\"_blank\">\u003cem>USC Annenberg School for Communication and Journalism\u003c/em>\u003c/a>\u003cem>, it is funded by the nonpartisan \u003c/em>\u003ca href=\"http://www.chcf.org/\" target=\"_blank\">\u003cem>California HealthCare Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>SACRAMENTO, Calif. (AP) -- Miriam Uribe enrolled in Medi-Cal, California's low-income health insurance program, last November. But 10 months later, she still hasn't found a primary care doctor who can see her.\u003c/p>\n\u003cp>\"Once you have (insurance), you actually still don't have it because it's still a struggle to find someone,\" the 20-year-old college student from Bellflower said.\u003c/p>\n\u003cp>Uribe isn't alone. Even though Latinos make up nearly half of California's 12.5 million Medi-Cal enrollees, \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/M/PDF%20MediCalAccessComparedUCLA.pdf\" target=\"_blank\">a report \u003c/a>by the independent California HealthCare Foundation found that 36 percent of the Spanish-speaking Medi-Cal population has been told that a physician won't take them, compared to 7 percent of the overall Medi-Cal population. Even those who speak both English and Spanish reported similar difficulty accessing doctors.\u003c/p>\n\u003cp>\"The numbers are very, very shocking,\" said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, a multicultural health advocacy group.\u003c/p>\n\u003cp>De Guia said the study doesn't explain why Latinos — whether they speak English or Spanish — are being turned away at higher rates, but public policy officials say the biggest obstacle is finding doctors who are willing to take the lower payments offered by Medi-Cal. Language barriers also play a role.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study, which compared people on Medi-Cal to those with employer-sponsored health insurance, found Latinos and Asian-Americans reported the highest rate of needing language assistance to understand their doctor. Specifically, 28 percent of Asian-Americans said their doctor does not listen carefully, compared to 15 percent of all Medi-Cal enrollees.\u003c/p>\n\u003cp>Shana Alex Charles, a research scientist at the UCLA Center for Health Policy Research who helped conduct the study, said there may not be enough providers who speak Spanish — or there could be an overall shortage of providers in communities of color.\u003c/p>\n\u003cp>Miriam Lagos, 53, a recent Medi-Cal enrollee who lives in Sherman Oaks, said she was told she has to wait a year just to see a specialist for hearing trouble in her right ear.\u003c/p>\n\u003cp>\"We are not well-regarded by the doctors. They don't want to see us,\" Lagos said in an interview in Spanish.\u003c/p>\n\u003cp>Medi-Cal, which is California's version of Medicaid, has grown rapidly in recent years as the state embraced an optional expansion under the Affordable Care Act. That surge has already led to widespread complaints about delays in patients being able to see doctors, specialists and dentists.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KAFIl6XdCpNjavq1j56T3GJSiyALel8g\"]Doctors and hospitals say the state pays much less for medical services than private insurance or Medicare, which means fewer primary care doctors and specialists are willing to treat Medi-Cal patients. Lawmakers have convened a special legislative session to discuss increasing provider payments but there is no agreement yet on how to pay for them.\u003c/p>\n\u003cp>California's regulators says the state is committed to giving Medi-Cal recipients full and equal access to health care. The Department of Health Care Services says it works with health plans to monitor and reduce disparities in health care, and Medi-Cal provides materials and offers hotline assistance in 13 spoken and 12 written languages.\u003c/p>\n\u003cp>The California Medical Association, which represents the state's doctors, encourages its members to be sensitive to language and cultural differences as millions more residents gain access to health care, said spokeswoman Molly Weedn. The group is part of a coalition pushing for higher Medi-Cal provider payments and supports a bill by Assembly Speaker Toni Atkins, D-San Diego, seeking federal funding for medical interpreters in Medi-Cal.\u003c/p>\n\u003cp>The industry could also do more to train a more diverse medical and clinical workforce, said Xavier Morales, executive director of the Latino Coalition for A Healthy California. A 2014 review by the California HealthCare Foundation found Latinos are \u003ca href=\"http://www.chcf.org/publications/2014/03/california-physicians\" target=\"_blank\">underrepresented in the physician workforce\u003c/a>: 38 percent of the state's population is Latino but only 4 percent of physicians were Latino.\u003c/p>\n\u003cp>\"When you look at graduates from medical schools, they don't really match the population,\" Morales said.\u003c/p>\n\u003cp>Andrea Castillo, 21, a Medi-Cal recipient from McFarland, said it would be nice to see more Latino doctors. Growing up the oldest daughter of farm laborers, Castillo recalls driving long distances to translate for relatives at the doctor's office.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"You don't often see a provider who looks like you, who understands you,\" Castillo said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SACRAMENTO, Calif. (AP) -- Miriam Uribe enrolled in Medi-Cal, California's low-income health insurance program, last November. But 10 months later, she still hasn't found a primary care doctor who can see her.\u003c/p>\n\u003cp>\"Once you have (insurance), you actually still don't have it because it's still a struggle to find someone,\" the 20-year-old college student from Bellflower said.\u003c/p>\n\u003cp>Uribe isn't alone. Even though Latinos make up nearly half of California's 12.5 million Medi-Cal enrollees, \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/M/PDF%20MediCalAccessComparedUCLA.pdf\" target=\"_blank\">a report \u003c/a>by the independent California HealthCare Foundation found that 36 percent of the Spanish-speaking Medi-Cal population has been told that a physician won't take them, compared to 7 percent of the overall Medi-Cal population. Even those who speak both English and Spanish reported similar difficulty accessing doctors.\u003c/p>\n\u003cp>\"The numbers are very, very shocking,\" said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, a multicultural health advocacy group.\u003c/p>\n\u003cp>De Guia said the study doesn't explain why Latinos — whether they speak English or Spanish — are being turned away at higher rates, but public policy officials say the biggest obstacle is finding doctors who are willing to take the lower payments offered by Medi-Cal. Language barriers also play a role.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study, which compared people on Medi-Cal to those with employer-sponsored health insurance, found Latinos and Asian-Americans reported the highest rate of needing language assistance to understand their doctor. Specifically, 28 percent of Asian-Americans said their doctor does not listen carefully, compared to 15 percent of all Medi-Cal enrollees.\u003c/p>\n\u003cp>Shana Alex Charles, a research scientist at the UCLA Center for Health Policy Research who helped conduct the study, said there may not be enough providers who speak Spanish — or there could be an overall shortage of providers in communities of color.\u003c/p>\n\u003cp>Miriam Lagos, 53, a recent Medi-Cal enrollee who lives in Sherman Oaks, said she was told she has to wait a year just to see a specialist for hearing trouble in her right ear.\u003c/p>\n\u003cp>\"We are not well-regarded by the doctors. They don't want to see us,\" Lagos said in an interview in Spanish.\u003c/p>\n\u003cp>Medi-Cal, which is California's version of Medicaid, has grown rapidly in recent years as the state embraced an optional expansion under the Affordable Care Act. That surge has already led to widespread complaints about delays in patients being able to see doctors, specialists and dentists.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Doctors and hospitals say the state pays much less for medical services than private insurance or Medicare, which means fewer primary care doctors and specialists are willing to treat Medi-Cal patients. Lawmakers have convened a special legislative session to discuss increasing provider payments but there is no agreement yet on how to pay for them.\u003c/p>\n\u003cp>California's regulators says the state is committed to giving Medi-Cal recipients full and equal access to health care. The Department of Health Care Services says it works with health plans to monitor and reduce disparities in health care, and Medi-Cal provides materials and offers hotline assistance in 13 spoken and 12 written languages.\u003c/p>\n\u003cp>The California Medical Association, which represents the state's doctors, encourages its members to be sensitive to language and cultural differences as millions more residents gain access to health care, said spokeswoman Molly Weedn. The group is part of a coalition pushing for higher Medi-Cal provider payments and supports a bill by Assembly Speaker Toni Atkins, D-San Diego, seeking federal funding for medical interpreters in Medi-Cal.\u003c/p>\n\u003cp>The industry could also do more to train a more diverse medical and clinical workforce, said Xavier Morales, executive director of the Latino Coalition for A Healthy California. A 2014 review by the California HealthCare Foundation found Latinos are \u003ca href=\"http://www.chcf.org/publications/2014/03/california-physicians\" target=\"_blank\">underrepresented in the physician workforce\u003c/a>: 38 percent of the state's population is Latino but only 4 percent of physicians were Latino.\u003c/p>\n\u003cp>\"When you look at graduates from medical schools, they don't really match the population,\" Morales said.\u003c/p>\n\u003cp>Andrea Castillo, 21, a Medi-Cal recipient from McFarland, said it would be nice to see more Latino doctors. Growing up the oldest daughter of farm laborers, Castillo recalls driving long distances to translate for relatives at the doctor's office.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"You don't often see a provider who looks like you, who understands you,\" Castillo said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "More Obamacare Choices for Rural Northern California Consumers",
"title": "More Obamacare Choices for Rural Northern California Consumers",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>People who live in rural Northern California will see more choice and competition in the health insurance marketplace next year, giving consumers a better chance of finding a plan -- and a doctor -- that can meet their needs.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\" target=\"_blank\">The changes\u003c/a>, unveiled last month by the state’s Affordable Care Act marketplace Covered California, will now allow some consumers to cross state lines for care. That means Californians living near the Oregon or Nevada borders can get subsidies to buy plans that pay for routine care in those states, something that previously was allowed only in emergencies.\u003c/p>\n\u003cp>In addition, all 22 counties that had areas with only one choice of insurer in 2015 and 2014 will now have at least three insurers selling plans.\u003c/p>\n\u003cp>Northern California customers may notice a jump in their premium costs next year, however. Region-wide, they will have a 10.6 percent increase over this year, while the statewide average increase is 4 percent.\u003c/p>\n\u003cfigure id=\"attachment_559016\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"wp-image-559016 size-khn-article-small\" src=\"https://kaiserhealthnews.files.wordpress.com/2015/08/bartolone-california-lomas-570.jpg?w=370&h=247&crop=1\" alt=\"Lori Lomas, an insurance agent with Feather Financial in Quincy, California, has noticed that her clients in San Francisco have many more health carrier options than her mountain neighbors. (Photo by Pauline Bartolone/Capital Public Radio).\" width=\"370\" height=\"247\">\u003cfigcaption class=\"wp-caption-text\">Lori Lomas, an insurance agent with Feather Financial in Quincy, California, welcomes the increased choices Covered California will have for mountain communities in 2016. (Photo by Pauline Bartolone)\u003c/figcaption>\u003c/figure>\n\u003cp>Lori Lomas, a health insurance agent with Feather Financial in Quincy, California, said not being able to travel to Reno, Nevada for medical care has been a hardship for many of her clients who live in isolated communities in the Sierra Nevada mountains.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s disrupted their care,” she said. “It’s affected people’s relationship with their doctors and it’s affected their trust in their insurance companies, big time.”\u003c/p>\n\u003cp>Next year, the two major insurers in the area, Anthem Blue Cross and Blue Shield of California, will offer routine out-of-state doctor coverage in 2016 individual policies.\u003c/p>\n\u003cp>A minimum of three insurers will be offering plans in each ZIP code of a 22 county region, a vast rural area that stretches south from the border of Oregon to the Sacramento County line. Two additional insurers will be selling in some parts of the area.\u003c/p>\n\u003cp>[contextly_sidebar id=\"veGNr4nvAF4rcegfdnCuKBnobHzY4S8o\"]Anthem Blue Cross, which has 91.7 percent of the health exchange’s market share in the Northern California region, says it made the decision to reinstate out-of-state coverage after hearing from consumers that they wanted the benefit.\u003c/p>\n\u003cp>“At the earliest opportunity to make substantive changes to our Covered California policies, we did,” says Darrel Ng, spokesman for Anthem Blue Cross.\u003c/p>\n\u003cp>Consumer demand also motivated Blue Shield of California to expand into areas where they had retreated from in 2014. Before new market rules under the Affordable Care Act, it had sold individual policies in all areas of the state. After Jan. 1, 2014, it stopped selling in about 250 ZIP codes, including vast areas of Northern California, in order to keep “premiums low.”\u003c/p>\n\u003cp>The company now says that decision “created a lot of disruption in the marketplace,” and in 2016 the company will be selling again in all ZIP codes.\u003c/p>\n\u003cp>“We’ve been able to now provide a network that would support us offering coverage in those ZIP codes that we didn’t have covered in 2015,” said Jeff Smith, general manager and vice president for Individual and Family Plans for Blue Shield of California.\u003c/p>\n\u003cp>[contextly_sidebar id=\"vPbPrbLkhNceuPvuX4550TQeJ66OM6lF\"]In the individual market next year, the company will be offering statewide preferred provider organizations (PPOs) and will discontinue the exclusive provider organizations (EPOs) offered this year, which restricted coverage to doctors only in a fixed geographic area.\u003c/p>\n\u003cp>Covered California would not comment on how its negotiations with insurers may have influenced the companies’ decision-making, but the exchange says it is pleased that consumers will get more choices next year.\u003c/p>\n\u003cp>“It’s no secret that Covered California looked to plans to expand and provide stronger and more comprehensive value to consumers, ” says Dana Howard, deputy director of communications for Covered California.\u003c/p>\n\u003cp>United Healthcare and Health Net will also be selling policies in Northern California next year. Covered California consumers may take a good look at those new options next open enrollment period. Lomas says the restricted doctor coverage and Blue Shield’s black out in certain ZIP codes had given the two companies a “bad name.”\u003c/p>\n\u003cp>“Now I’m going to show people the screen and it will be [more] choices for everyone,” says Lomas about the next open enrollment period.\u003c/p>\n\u003cp>In some areas of Northern California, health insurance shoppers will see even more options.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is from \u003ca href=\"http://khn.org\">Kaiser Health News\u003c/a>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "For starters, people living near Oregon or Nevada will now be able to travel there for routine care, which wasn't covered in past years.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People who live in rural Northern California will see more choice and competition in the health insurance marketplace next year, giving consumers a better chance of finding a plan -- and a doctor -- that can meet their needs.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\" target=\"_blank\">The changes\u003c/a>, unveiled last month by the state’s Affordable Care Act marketplace Covered California, will now allow some consumers to cross state lines for care. That means Californians living near the Oregon or Nevada borders can get subsidies to buy plans that pay for routine care in those states, something that previously was allowed only in emergencies.\u003c/p>\n\u003cp>In addition, all 22 counties that had areas with only one choice of insurer in 2015 and 2014 will now have at least three insurers selling plans.\u003c/p>\n\u003cp>Northern California customers may notice a jump in their premium costs next year, however. Region-wide, they will have a 10.6 percent increase over this year, while the statewide average increase is 4 percent.\u003c/p>\n\u003cfigure id=\"attachment_559016\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"wp-image-559016 size-khn-article-small\" src=\"https://kaiserhealthnews.files.wordpress.com/2015/08/bartolone-california-lomas-570.jpg?w=370&h=247&crop=1\" alt=\"Lori Lomas, an insurance agent with Feather Financial in Quincy, California, has noticed that her clients in San Francisco have many more health carrier options than her mountain neighbors. (Photo by Pauline Bartolone/Capital Public Radio).\" width=\"370\" height=\"247\">\u003cfigcaption class=\"wp-caption-text\">Lori Lomas, an insurance agent with Feather Financial in Quincy, California, welcomes the increased choices Covered California will have for mountain communities in 2016. (Photo by Pauline Bartolone)\u003c/figcaption>\u003c/figure>\n\u003cp>Lori Lomas, a health insurance agent with Feather Financial in Quincy, California, said not being able to travel to Reno, Nevada for medical care has been a hardship for many of her clients who live in isolated communities in the Sierra Nevada mountains.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s disrupted their care,” she said. “It’s affected people’s relationship with their doctors and it’s affected their trust in their insurance companies, big time.”\u003c/p>\n\u003cp>Next year, the two major insurers in the area, Anthem Blue Cross and Blue Shield of California, will offer routine out-of-state doctor coverage in 2016 individual policies.\u003c/p>\n\u003cp>A minimum of three insurers will be offering plans in each ZIP code of a 22 county region, a vast rural area that stretches south from the border of Oregon to the Sacramento County line. Two additional insurers will be selling in some parts of the area.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Anthem Blue Cross, which has 91.7 percent of the health exchange’s market share in the Northern California region, says it made the decision to reinstate out-of-state coverage after hearing from consumers that they wanted the benefit.\u003c/p>\n\u003cp>“At the earliest opportunity to make substantive changes to our Covered California policies, we did,” says Darrel Ng, spokesman for Anthem Blue Cross.\u003c/p>\n\u003cp>Consumer demand also motivated Blue Shield of California to expand into areas where they had retreated from in 2014. Before new market rules under the Affordable Care Act, it had sold individual policies in all areas of the state. After Jan. 1, 2014, it stopped selling in about 250 ZIP codes, including vast areas of Northern California, in order to keep “premiums low.”\u003c/p>\n\u003cp>The company now says that decision “created a lot of disruption in the marketplace,” and in 2016 the company will be selling again in all ZIP codes.\u003c/p>\n\u003cp>“We’ve been able to now provide a network that would support us offering coverage in those ZIP codes that we didn’t have covered in 2015,” said Jeff Smith, general manager and vice president for Individual and Family Plans for Blue Shield of California.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In the individual market next year, the company will be offering statewide preferred provider organizations (PPOs) and will discontinue the exclusive provider organizations (EPOs) offered this year, which restricted coverage to doctors only in a fixed geographic area.\u003c/p>\n\u003cp>Covered California would not comment on how its negotiations with insurers may have influenced the companies’ decision-making, but the exchange says it is pleased that consumers will get more choices next year.\u003c/p>\n\u003cp>“It’s no secret that Covered California looked to plans to expand and provide stronger and more comprehensive value to consumers, ” says Dana Howard, deputy director of communications for Covered California.\u003c/p>\n\u003cp>United Healthcare and Health Net will also be selling policies in Northern California next year. Covered California consumers may take a good look at those new options next open enrollment period. Lomas says the restricted doctor coverage and Blue Shield’s black out in certain ZIP codes had given the two companies a “bad name.”\u003c/p>\n\u003cp>“Now I’m going to show people the screen and it will be [more] choices for everyone,” says Lomas about the next open enrollment period.\u003c/p>\n\u003cp>In some areas of Northern California, health insurance shoppers will see even more options.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is from \u003ca href=\"http://khn.org\">Kaiser Health News\u003c/a>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Start Up Insurer Coming to California, Seeks to 'Revolutionize' Health Care. Really?",
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"content": "\u003cp>Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\" target=\"_blank\">made it official late last month\u003c/a>: the buzzed-about startup health insurer Oscar is coming to California. The company will start selling plans in Los Angeles and Orange County during the next open enrollment starting in November.\u003c/p>\n\u003cp>But can Oscar's services live up to its \u003ca href=\"http://www.nytimes.com/2014/03/29/business/start-up-health-insurer-finds-foothold-in-new-york.html?_r=1\" target=\"_blank\">press clippings\u003c/a>? And is the New York-based company ready to compete in a brand-new market, more than 3,000 miles away from its home base?\u003c/p>\n\u003cp>\u003cstrong>Why Covered California Let Oscar In\u003c/strong>\u003c/p>\n\u003cp>California's exchange is infamous for its selectivity; unlike nearly every other exchange across the country, the number of plans participating in Covered California \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2014/most-insurance-exchanges-just-got-bigger-covered-california-is-getting-smaller\" target=\"_blank\">actually shrunk\u003c/a> last year.\u003c/p>\n\u003cp>\"Choice is important,\" Covered California's director Peter Lee said at a January 2015 board meeting, not long after \u003ca href=\"http://www.capradio.org/articles/2014/12/23/oregon-based-insurer-rejected-from-covered-california/\" target=\"_blank\">news broke\u003c/a> that the exchange had turned away Moda Health, a popular Oregon-based insurer. \"But adding more plans that are either not by price, network, or design substantially different is not necessarily an advantage for consumers.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Yet Oscar's entrance into the California market seems almost preordained.\u003c/p>\n\u003cp>CEO Mario Schlosser and his co-founders have a Silicon Valley pedigree -- they have youth, Harvard degrees, and experience with firms like Instagram, Microsoft and Vostu. They're backed by venture capitalists like Peter Thiel.\u003c/p>\n\u003cp>They've got an Internet company-like valuation: After officially launching in New York two years ago, Oscar is \u003ca href=\"http://www.nytimes.com/2015/04/21/business/dealbook/oscar-a-health-insurance-start-up-valued-at-1-5-billion.html\" target=\"_blank\">already valued\u003c/a> at $1.5 billion -- despite having just 40,000 members.\u003c/p>\n\u003cp>(In comparison, UnitedHealthcare is valued at $115 billion and has about 45 million members. A smaller rival insurer, Health Net, is valued at about $5 billion -- and has more than 3 million members.)\u003c/p>\n\u003cp>And Oscar's staff evangelizes about its product in a way that's familiar to anyone who's spent much time in the San Francisco startup scene.\u003c/p>\n\u003cp>\"Health care is broken; we're trying to fix it,\" Oscar's \u003ca href=\"https://www.linkedin.com/company/oscar-health\" target=\"_blank\">LinkedIn page\u003c/a> reads. \"Backed by a renowned set of investors and advisors, we've set out to revolutionize health care.\"\u003c/p>\n\u003cp>\"Oscar was created by people with a background in technology,\" co-founder \u003ca href=\"http://board.coveredca.com/meetings/2015/1-15/Comments%20to%20the%20Board%20-%20Master_January%2015%202015%20(External).pdf\" target=\"_blank\">Kevin Nazemi wrote\u003c/a> to the Covered California board in January 2015, as the company began to lay the groundwork for its arrival. \"Oscar's founders were frustrated with the available health insurance choices and thought there was a better way to provide health insurance coverage.\"\u003c/p>\n\u003cp>Oscar has tried to distinguish itself through Web savvy, like its personalized search engine for members, and mobile-friendly services.\u003c/p>\n\u003cp>And that tech-heavy message resonated with Covered California, spokesperson Lizelda Lopez told me\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\"While our examination of Oscar's experience in New York gave us confidence they understood the complexities of operating in a state-based Exchange environment, and could be successful in California, that was not our principal reason for adding them,\" Lopez said via email.\u003c/p>\n\u003cp>The level of innovation they bring to the marketplace is what we found most compelling.\"\u003c/p>\n\u003cp>\u003cstrong>Oscar's Hype vs. Oscar's Reviews\u003c/strong>\u003c/p>\n\u003cp>One of the state's leading consumer advocates is hailing the move to add Oscar.\u003c/p>\n\u003cp>\"I think it's positive that [Oscar] is coming into the California market,\" California Insurance Commissioner Dave Jones told \u003cem>California Healthline. \u003c/em>(He's been critical of Covered California's selectivity in the past.) \"The more insurers the better,\" Jones added.\u003c/p>\n\u003cp>But as Oscar starts to introduce itself to Californians, there's still a big question about the company: How much is skillful marketing, and how much is actual breakthrough innovation?\u003c/p>\n\u003cp>For instance, CEO Schlosser touted Oscar's \"unique set of features for its customers, including 24/7 telemedicine and incentivized health and fitness goals.\"\u003c/p>\n\u003cp>It's worth noting that Anthem, already one of the major players on the exchange, \u003ca href=\"https://livehealthonline.com/\" target=\"_blank\">offers its own\u003c/a> 24/7 telemedicine service. And many insurers are debuting or have already launched their own wellness services, too.\u003c/p>\n\u003cp>Schlosser also said that Oscar's simple message and ease-of-use will set it apart. \"As in New York and New Jersey, the Oscar approach suits the needs of Californians looking for accessible, transparent and human health care in the current consumer health care landscape,\" he said\u003cem>.\u003c/em>\u003c/p>\n\u003cp>But more than a few New York-area customers have complained that Oscar's smooth packaging hasn't always delivered a similarly smooth experience with the health care system. Some customers have warned that they were misinformed about Oscar's provider networks and copays.\u003c/p>\n\u003cp>\"Agree with the rest here,\" a user named \u003ca href=\"http://www.yelp.com/biz/oscar-insurance-corporation-new-york?hrid=PsUXsiRaIDHCPa0awgh91g&utm_campaign=www_review_share_popup&utm_medium=copy_link&utm_source=(direct)\" target=\"_blank\">Mary B. writes\u003c/a> on Yelp. \"Slick on the surface. Bad coverage for the money.\"\u003c/p>\n\u003cp>Another disgruntled Oscar \u003ca href=\"http://valleywag.gawker.com/what-happens-when-a-healthcare-startup-leaves-you-with-1598186714\" target=\"_blank\">customer ranted\u003c/a> to the much-read blog \"Valleywag\" last year, sharing personal communications with the company and even posting pictures of the bill.\u003c/p>\n\u003cp>\"In the emerging health and wellness markets, startups like Oscar intimately disrupt and destroy their customer's lives through incorrect datasets where an A/B testing mentality results in exorbitant fees, angry hospital administrators and patients with no recourse except to bankrupt themselves paying bills they didn't expect,\" the customer wrote.\u003c/p>\n\u003cp>\u003cstrong>Can Oscar Succeed in California?\u003c/strong>\u003c/p>\n\u003cp>It's tough to know how much stock to place in Oscar's grouches. Despite all the disgruntled online reviews, Oscar's mediocre 2.5 stars on Yelp in New York are downright luxurious compared to the one star for United Healthcare and other insurance companies.\u003c/p>\n\u003cp>But experts agree that Oscar will face at least one major challenge in California: How can the company compete in a state that's already dominated by a handful of health insurers?\u003c/p>\n\u003cp>\"We still have a problem with the degree of concentration that the top four insurers have,\" Jones said, pointing out that Anthem, Blue Shield, Health Net and Kaiser Permanente, are collectively responsible for 94 percent of all enrollment on Covered California. As I've previously reported, small health plans have \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2014/most-small-health-plans-arent-thriving-in-covered-california-meet-two-exceptions\" target=\"_blank\">consistently had trouble\u003c/a> attracting customers on the state's exchange.\u003c/p>\n\u003cp>Oscar's advertising strategy will be interesting to watch. The company gained awareness in New York City thanks to ubiquitous, clever \u003ca href=\"https://twitter.com/ddiamond/status/540665174408323072\" target=\"_blank\">advertisements in the city's subway\u003c/a>; Southern Californians aren't known for their love of public transportation.\u003c/p>\n\u003cp>(Oscar declined to comment on the company's goals for the next enrollment period.)\u003c/p>\n\u003cp>And in the growing retail insurance market, where customers often shop by price, Oscar is not slated to have the \u003ca href=\"http://www.coveredca.com/PDFs/7-27-CoveredCA-2016PlanRates-prelim.pdf\" target=\"_blank\">cheapest plan\u003c/a> -- or the biggest, most recognizable name. That could scare away some would-be customers, several experts said.\u003c/p>\n\u003cp>\"I agree that Oscar's price may be prohibitive for many people, but they may have decided to compete on network and choice,\" said Dylan Roby of UCLA's Center for Health Policy Research.\u003c/p>\n\u003cp>He pointed out that Oscar does have one ace in the hole in Southern California: They're including UCLA Medical Center in their network. The pricey hospital had been \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/when-health-plans-drop-your-doctor-are-narrow-networks-a-bad-idea\" target=\"_blank\">left out\u003c/a> of nearly every other Covered California plan.\u003c/p>\n\u003cp>\"They are an EPO plan,\" Roby added, \"so perhaps they will try to draw the smaller group of people who want UCLA doctors and no gatekeeper as would occur in an HMO product.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cspan id=\"page_0_content_0_Author_Authors_Name_0\" class=\"author__name\">This story was originally published in \u003c/span>\u003cspan id=\"page_0_content_0_Author_Authors_Title_0\" class=\"author__title\">\u003ca href=\"http://www.californiahealthline.org/road-to-reform/2015/oscar-wants-to-revolutionize-health-care-but-will-it-even-survive-covered-california\" target=\"_blank\">California Healthline\u003c/a>, where Dan Diamond is a contributing editor.\u003c/span>\u003c/em>\u003c/p>\n\n",
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"description": "Covered California made it official late last month: the buzzed-about startup health insurer Oscar is coming to California. The company will start selling plans in Los Angeles and Orange County during the next open enrollment starting in November. But can Oscar's services live up to its press clippings? And is the New York-based company ready",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/27/covered-california-2016-premiums-to-increase-modestly/\" target=\"_blank\">made it official late last month\u003c/a>: the buzzed-about startup health insurer Oscar is coming to California. The company will start selling plans in Los Angeles and Orange County during the next open enrollment starting in November.\u003c/p>\n\u003cp>But can Oscar's services live up to its \u003ca href=\"http://www.nytimes.com/2014/03/29/business/start-up-health-insurer-finds-foothold-in-new-york.html?_r=1\" target=\"_blank\">press clippings\u003c/a>? And is the New York-based company ready to compete in a brand-new market, more than 3,000 miles away from its home base?\u003c/p>\n\u003cp>\u003cstrong>Why Covered California Let Oscar In\u003c/strong>\u003c/p>\n\u003cp>California's exchange is infamous for its selectivity; unlike nearly every other exchange across the country, the number of plans participating in Covered California \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2014/most-insurance-exchanges-just-got-bigger-covered-california-is-getting-smaller\" target=\"_blank\">actually shrunk\u003c/a> last year.\u003c/p>\n\u003cp>\"Choice is important,\" Covered California's director Peter Lee said at a January 2015 board meeting, not long after \u003ca href=\"http://www.capradio.org/articles/2014/12/23/oregon-based-insurer-rejected-from-covered-california/\" target=\"_blank\">news broke\u003c/a> that the exchange had turned away Moda Health, a popular Oregon-based insurer. \"But adding more plans that are either not by price, network, or design substantially different is not necessarily an advantage for consumers.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Yet Oscar's entrance into the California market seems almost preordained.\u003c/p>\n\u003cp>CEO Mario Schlosser and his co-founders have a Silicon Valley pedigree -- they have youth, Harvard degrees, and experience with firms like Instagram, Microsoft and Vostu. They're backed by venture capitalists like Peter Thiel.\u003c/p>\n\u003cp>They've got an Internet company-like valuation: After officially launching in New York two years ago, Oscar is \u003ca href=\"http://www.nytimes.com/2015/04/21/business/dealbook/oscar-a-health-insurance-start-up-valued-at-1-5-billion.html\" target=\"_blank\">already valued\u003c/a> at $1.5 billion -- despite having just 40,000 members.\u003c/p>\n\u003cp>(In comparison, UnitedHealthcare is valued at $115 billion and has about 45 million members. A smaller rival insurer, Health Net, is valued at about $5 billion -- and has more than 3 million members.)\u003c/p>\n\u003cp>And Oscar's staff evangelizes about its product in a way that's familiar to anyone who's spent much time in the San Francisco startup scene.\u003c/p>\n\u003cp>\"Health care is broken; we're trying to fix it,\" Oscar's \u003ca href=\"https://www.linkedin.com/company/oscar-health\" target=\"_blank\">LinkedIn page\u003c/a> reads. \"Backed by a renowned set of investors and advisors, we've set out to revolutionize health care.\"\u003c/p>\n\u003cp>\"Oscar was created by people with a background in technology,\" co-founder \u003ca href=\"http://board.coveredca.com/meetings/2015/1-15/Comments%20to%20the%20Board%20-%20Master_January%2015%202015%20(External).pdf\" target=\"_blank\">Kevin Nazemi wrote\u003c/a> to the Covered California board in January 2015, as the company began to lay the groundwork for its arrival. \"Oscar's founders were frustrated with the available health insurance choices and thought there was a better way to provide health insurance coverage.\"\u003c/p>\n\u003cp>Oscar has tried to distinguish itself through Web savvy, like its personalized search engine for members, and mobile-friendly services.\u003c/p>\n\u003cp>And that tech-heavy message resonated with Covered California, spokesperson Lizelda Lopez told me\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\"While our examination of Oscar's experience in New York gave us confidence they understood the complexities of operating in a state-based Exchange environment, and could be successful in California, that was not our principal reason for adding them,\" Lopez said via email.\u003c/p>\n\u003cp>The level of innovation they bring to the marketplace is what we found most compelling.\"\u003c/p>\n\u003cp>\u003cstrong>Oscar's Hype vs. Oscar's Reviews\u003c/strong>\u003c/p>\n\u003cp>One of the state's leading consumer advocates is hailing the move to add Oscar.\u003c/p>\n\u003cp>\"I think it's positive that [Oscar] is coming into the California market,\" California Insurance Commissioner Dave Jones told \u003cem>California Healthline. \u003c/em>(He's been critical of Covered California's selectivity in the past.) \"The more insurers the better,\" Jones added.\u003c/p>\n\u003cp>But as Oscar starts to introduce itself to Californians, there's still a big question about the company: How much is skillful marketing, and how much is actual breakthrough innovation?\u003c/p>\n\u003cp>For instance, CEO Schlosser touted Oscar's \"unique set of features for its customers, including 24/7 telemedicine and incentivized health and fitness goals.\"\u003c/p>\n\u003cp>It's worth noting that Anthem, already one of the major players on the exchange, \u003ca href=\"https://livehealthonline.com/\" target=\"_blank\">offers its own\u003c/a> 24/7 telemedicine service. And many insurers are debuting or have already launched their own wellness services, too.\u003c/p>\n\u003cp>Schlosser also said that Oscar's simple message and ease-of-use will set it apart. \"As in New York and New Jersey, the Oscar approach suits the needs of Californians looking for accessible, transparent and human health care in the current consumer health care landscape,\" he said\u003cem>.\u003c/em>\u003c/p>\n\u003cp>But more than a few New York-area customers have complained that Oscar's smooth packaging hasn't always delivered a similarly smooth experience with the health care system. Some customers have warned that they were misinformed about Oscar's provider networks and copays.\u003c/p>\n\u003cp>\"Agree with the rest here,\" a user named \u003ca href=\"http://www.yelp.com/biz/oscar-insurance-corporation-new-york?hrid=PsUXsiRaIDHCPa0awgh91g&utm_campaign=www_review_share_popup&utm_medium=copy_link&utm_source=(direct)\" target=\"_blank\">Mary B. writes\u003c/a> on Yelp. \"Slick on the surface. Bad coverage for the money.\"\u003c/p>\n\u003cp>Another disgruntled Oscar \u003ca href=\"http://valleywag.gawker.com/what-happens-when-a-healthcare-startup-leaves-you-with-1598186714\" target=\"_blank\">customer ranted\u003c/a> to the much-read blog \"Valleywag\" last year, sharing personal communications with the company and even posting pictures of the bill.\u003c/p>\n\u003cp>\"In the emerging health and wellness markets, startups like Oscar intimately disrupt and destroy their customer's lives through incorrect datasets where an A/B testing mentality results in exorbitant fees, angry hospital administrators and patients with no recourse except to bankrupt themselves paying bills they didn't expect,\" the customer wrote.\u003c/p>\n\u003cp>\u003cstrong>Can Oscar Succeed in California?\u003c/strong>\u003c/p>\n\u003cp>It's tough to know how much stock to place in Oscar's grouches. Despite all the disgruntled online reviews, Oscar's mediocre 2.5 stars on Yelp in New York are downright luxurious compared to the one star for United Healthcare and other insurance companies.\u003c/p>\n\u003cp>But experts agree that Oscar will face at least one major challenge in California: How can the company compete in a state that's already dominated by a handful of health insurers?\u003c/p>\n\u003cp>\"We still have a problem with the degree of concentration that the top four insurers have,\" Jones said, pointing out that Anthem, Blue Shield, Health Net and Kaiser Permanente, are collectively responsible for 94 percent of all enrollment on Covered California. As I've previously reported, small health plans have \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2014/most-small-health-plans-arent-thriving-in-covered-california-meet-two-exceptions\" target=\"_blank\">consistently had trouble\u003c/a> attracting customers on the state's exchange.\u003c/p>\n\u003cp>Oscar's advertising strategy will be interesting to watch. The company gained awareness in New York City thanks to ubiquitous, clever \u003ca href=\"https://twitter.com/ddiamond/status/540665174408323072\" target=\"_blank\">advertisements in the city's subway\u003c/a>; Southern Californians aren't known for their love of public transportation.\u003c/p>\n\u003cp>(Oscar declined to comment on the company's goals for the next enrollment period.)\u003c/p>\n\u003cp>And in the growing retail insurance market, where customers often shop by price, Oscar is not slated to have the \u003ca href=\"http://www.coveredca.com/PDFs/7-27-CoveredCA-2016PlanRates-prelim.pdf\" target=\"_blank\">cheapest plan\u003c/a> -- or the biggest, most recognizable name. That could scare away some would-be customers, several experts said.\u003c/p>\n\u003cp>\"I agree that Oscar's price may be prohibitive for many people, but they may have decided to compete on network and choice,\" said Dylan Roby of UCLA's Center for Health Policy Research.\u003c/p>\n\u003cp>He pointed out that Oscar does have one ace in the hole in Southern California: They're including UCLA Medical Center in their network. The pricey hospital had been \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/when-health-plans-drop-your-doctor-are-narrow-networks-a-bad-idea\" target=\"_blank\">left out\u003c/a> of nearly every other Covered California plan.\u003c/p>\n\u003cp>\"They are an EPO plan,\" Roby added, \"so perhaps they will try to draw the smaller group of people who want UCLA doctors and no gatekeeper as would occur in an HMO product.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Sure, there's a deductible with your health insurance. But then what's the hospital deductible? Your insurer may have multiple deductibles, and it pays to know which apply when. These questions and answers tackle deductibles, whether an ex-spouse has to pay for an adult child's insurance, and balance billing.\u003c/p>\n\u003cp>\u003cstrong>Recently I took my son to see a pediatric gastroenterologist. When I arrived at the office, I saw it was located adjacent to the hospital. My insurance has a large hospitalization deductible so I worried that the visit would not be covered. Nobody in the office could tell me how much an office visit would cost. Why not? Isn't that something I should be able to expect?\u003c/strong>\u003c/p>\n\u003cp>Your plan's hospital deductible won't affect how much you pay for the visit to the specialist, whether or not his office is affiliated with the hospital, says Richard Gundling, vice president at the Healthcare Financial Management Association, a professional group.\u003c/p>\n\u003cp>Here's how it works. Most health plans have \u003ca href=\"http://www.npr.org/sections/health-shots/2015/06/10/411982831/some-insured-patients-still-skipping-care-because-of-high-costs\" target=\"_blank\">medical deductibles\u003c/a> that must be satisfied before the plan starts paying for most services. Preventive care is an important exception; there's no deductible for that. Some plans like yours also have separate hospital deductibles. But your hospital deductible would generally only come into play if you were admitted as an inpatient.\u003c/p>\n\u003cp>\"Even if the facility is hospital based, her visit would still be an outpatient procedure and wouldn't affect her hospital deductible,\" Gundling says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Though your hospital deductible wouldn't be an issue in this case, if your plan has a regular medical deductible and you haven't yet satisfied it for the year, you may have to pay for the specialist visit anyway.\u003c/p>\n\u003cp>The doctor's office should have been able to tell you how much the office visit would cost, Gundling says, but you may be better off checking with your insurer to find out how much you'll actually owe out of pocket. Your insurer will have \u003ca href=\"http://www.hfma.org/Content.aspx?id=22274\" target=\"_blank\">information\u003c/a> about both how much it has agreed to pay the provider for an office visit and how much you'll owe based on your health plan deductible and copayment details.\u003c/p>\n\u003cp>\u003cstrong>I have insurance coverage through the Affordable Care Act's marketplace. When I visited a cancer clinic for a routine blood check, I asked upfront three times (first over the phone and again when I was there) if all services would be in-network. The answer was yes each time. Afterward I received a bill from an out-of-network lab for $570. Is there anything I could have done to avoid this charge?\u003c/strong>\u003c/p>\n\u003cp>In theory, you could have asked the clinic for the name of the lab that it would use for your blood work and checked with your insurer to make sure that it too was in network, says Kevin Lucia, a senior research fellow at Georgetown University's Center on Health Insurance Reforms who co-authored a recent \u003ca href=\"http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf420966\" target=\"_blank\">study\u003c/a> on state efforts to protect consumers from surprise out-of-network bills.\u003c/p>\n\u003cp>However, \"that seems to be a lot of work for the consumer,\" Lucia says.\u003c/p>\n\u003cp>New rules take effect next year for plans sold on the marketplace that will require health plans to maintain up-to-date lists of providers that are easily accessible to consumers.\u003c/p>\n\u003cp>A CMS official was unable to clarify whether plans must also provide up-to-date listings of labs in addition to other providers.\u003c/p>\n\u003cp>In the meantime, check with your insurer, Lucia advises. It's not unusual for providers to bill patients for services that are ultimately covered by their plan.\u003c/p>\n\u003cp>\u003cstrong>My ex-husband is responsible for health care premiums for our dependent daughter who will turn 21 in October. Under the Affordable Care Act, children can remain on their parents' plans until age 26, but my ex is planning to drop our daughter's coverage when she turns 21. Can he do that?\u003c/strong>\u003c/p>\n\u003cp>Yes, he probably can. Although the law requires health plans to offer coverage until adult children turn 26 in most instances, there's nothing that requires parents to provide it. If your divorce agreement \u003ca href=\"http://www.npr.org/sections/health-shots/2014/08/12/339627570/can-divorced-dad-be-forced-to-cover-insurance-for-adult-kids\" target=\"_blank\">required\u003c/a> him to pay for your daughter's health insurance until she turns 21, his obligation will likely be satisfied at that point.\u003c/p>\n\u003cp>If your ex-husband chooses to drop your daughter's coverage and she doesn't sign up for her own plan, however, he may be on the hook for any financial penalty she owes for not having insurance.\u003c/p>\n\u003cp>Under the health law, most people have to have insurance or face \u003ca href=\"https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/\" target=\"_blank\">penalties\u003c/a>. In 2015, the penalty is the greater of 2 percent of household income or $325 per person.\u003c/p>\n\u003cp>If he claims her as his dependent, \"When he does his taxes he'll have to show that everyone in his household has insurance, and then he'll have to pay the penalty,\" says Karen Pollitz, a senior fellow at the Kaiser Family Foundation.\u003c/p>\n\u003cp>Since she's part of his household, the penalty would be based on his income, not hers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As for your daughter, if she loses coverage she'll be eligible for a special enrollment period to sign up on the exchange, or she may be eligible for Medicaid if she lives in one of the roughly two-thirds of states that have expanded coverage to adults with incomes up to 138 percent of the federal poverty level, currently $16,243.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Untangling+The+Many+Deductibles+Of+Health+Insurance&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sure, there's a deductible with your health insurance. But then what's the hospital deductible? Your insurer may have multiple deductibles, and it pays to know which apply when. These questions and answers tackle deductibles, whether an ex-spouse has to pay for an adult child's insurance, and balance billing.\u003c/p>\n\u003cp>\u003cstrong>Recently I took my son to see a pediatric gastroenterologist. When I arrived at the office, I saw it was located adjacent to the hospital. My insurance has a large hospitalization deductible so I worried that the visit would not be covered. Nobody in the office could tell me how much an office visit would cost. Why not? Isn't that something I should be able to expect?\u003c/strong>\u003c/p>\n\u003cp>Your plan's hospital deductible won't affect how much you pay for the visit to the specialist, whether or not his office is affiliated with the hospital, says Richard Gundling, vice president at the Healthcare Financial Management Association, a professional group.\u003c/p>\n\u003cp>Here's how it works. Most health plans have \u003ca href=\"http://www.npr.org/sections/health-shots/2015/06/10/411982831/some-insured-patients-still-skipping-care-because-of-high-costs\" target=\"_blank\">medical deductibles\u003c/a> that must be satisfied before the plan starts paying for most services. Preventive care is an important exception; there's no deductible for that. Some plans like yours also have separate hospital deductibles. But your hospital deductible would generally only come into play if you were admitted as an inpatient.\u003c/p>\n\u003cp>\"Even if the facility is hospital based, her visit would still be an outpatient procedure and wouldn't affect her hospital deductible,\" Gundling says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Though your hospital deductible wouldn't be an issue in this case, if your plan has a regular medical deductible and you haven't yet satisfied it for the year, you may have to pay for the specialist visit anyway.\u003c/p>\n\u003cp>The doctor's office should have been able to tell you how much the office visit would cost, Gundling says, but you may be better off checking with your insurer to find out how much you'll actually owe out of pocket. Your insurer will have \u003ca href=\"http://www.hfma.org/Content.aspx?id=22274\" target=\"_blank\">information\u003c/a> about both how much it has agreed to pay the provider for an office visit and how much you'll owe based on your health plan deductible and copayment details.\u003c/p>\n\u003cp>\u003cstrong>I have insurance coverage through the Affordable Care Act's marketplace. When I visited a cancer clinic for a routine blood check, I asked upfront three times (first over the phone and again when I was there) if all services would be in-network. The answer was yes each time. Afterward I received a bill from an out-of-network lab for $570. Is there anything I could have done to avoid this charge?\u003c/strong>\u003c/p>\n\u003cp>In theory, you could have asked the clinic for the name of the lab that it would use for your blood work and checked with your insurer to make sure that it too was in network, says Kevin Lucia, a senior research fellow at Georgetown University's Center on Health Insurance Reforms who co-authored a recent \u003ca href=\"http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf420966\" target=\"_blank\">study\u003c/a> on state efforts to protect consumers from surprise out-of-network bills.\u003c/p>\n\u003cp>However, \"that seems to be a lot of work for the consumer,\" Lucia says.\u003c/p>\n\u003cp>New rules take effect next year for plans sold on the marketplace that will require health plans to maintain up-to-date lists of providers that are easily accessible to consumers.\u003c/p>\n\u003cp>A CMS official was unable to clarify whether plans must also provide up-to-date listings of labs in addition to other providers.\u003c/p>\n\u003cp>In the meantime, check with your insurer, Lucia advises. It's not unusual for providers to bill patients for services that are ultimately covered by their plan.\u003c/p>\n\u003cp>\u003cstrong>My ex-husband is responsible for health care premiums for our dependent daughter who will turn 21 in October. Under the Affordable Care Act, children can remain on their parents' plans until age 26, but my ex is planning to drop our daughter's coverage when she turns 21. Can he do that?\u003c/strong>\u003c/p>\n\u003cp>Yes, he probably can. Although the law requires health plans to offer coverage until adult children turn 26 in most instances, there's nothing that requires parents to provide it. If your divorce agreement \u003ca href=\"http://www.npr.org/sections/health-shots/2014/08/12/339627570/can-divorced-dad-be-forced-to-cover-insurance-for-adult-kids\" target=\"_blank\">required\u003c/a> him to pay for your daughter's health insurance until she turns 21, his obligation will likely be satisfied at that point.\u003c/p>\n\u003cp>If your ex-husband chooses to drop your daughter's coverage and she doesn't sign up for her own plan, however, he may be on the hook for any financial penalty she owes for not having insurance.\u003c/p>\n\u003cp>Under the health law, most people have to have insurance or face \u003ca href=\"https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/\" target=\"_blank\">penalties\u003c/a>. In 2015, the penalty is the greater of 2 percent of household income or $325 per person.\u003c/p>\n\u003cp>If he claims her as his dependent, \"When he does his taxes he'll have to show that everyone in his household has insurance, and then he'll have to pay the penalty,\" says Karen Pollitz, a senior fellow at the Kaiser Family Foundation.\u003c/p>\n\u003cp>Since she's part of his household, the penalty would be based on his income, not hers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As for your daughter, if she loses coverage she'll be eligible for a special enrollment period to sign up on the exchange, or she may be eligible for Medicaid if she lives in one of the roughly two-thirds of states that have expanded coverage to adults with incomes up to 138 percent of the federal poverty level, currently $16,243.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Untangling+The+Many+Deductibles+Of+Health+Insurance&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"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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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"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.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"order": 1
},
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"title": "Code Switch / Life Kit",
"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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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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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": {
"id": "hidden-brain",
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"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.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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},
"jerrybrown": {
"id": "jerrybrown",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"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",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"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": {
"id": "masters-of-scale",
"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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"meta": {
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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",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
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"source": "wnyc"
},
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