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"content": "\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/covered-california-pushes-for-renewals\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/covered-california-pushes-for-renewals\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Covered California officially began mailing renewal notices for its 1.1 million enrollees who signed up during the first open enrollment period, officials announced Thursday.\u003c/p>\n\u003cp>People who want to keep their current plan will be automatically renewed. All they need do is pay their premium by Dec. 15 to continue their coverage beginning Jan 1, said Peter Lee, executive director of the exchange. People who want to make changes have until Dec. 15 to do so.\u003c/p>\n\u003cp>\"If you're happy with your plan, you don't need to do a thing, you just pay the bill, you're good,\" Lee said. \"If you want to shop around, we have the tools available online or with assisters to do that. Stability and consistency are good things, but we encourage you to shop for a better policy.\"\u003c!--more-->\u003c/p>\n\u003cp>Lee said the average premium rate in the exchange rose 4 percent from last year. \"Some went up a little more, some actually went down, but the average doesn't matter, the individual choice is what's important. So some people will want to look around.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Covered California yesterday also \u003ca title=\"http://www.coveredca.com/resources/PDFs/10-14-2014-Lessons-Learned-final.pdf\" href=\"http://www.coveredca.com/resources/PDFs/10-14-2014-Lessons-Learned-final.pdf\" target=\"_blank\">released a report \u003c/a>on lessons learned from the first open enrollment period. The next open enrollment period is Nov. 15 - Feb. 15.\u003c/p>\n\u003cp>\"The top lesson learned is the incredible response we saw from consumers,\" Lee said. \"We weren't ready for it. Our call centers weren't ready. We are changing what we're doing going into 2015.\"\u003c/p>\n\u003cp>The web portal has been improved to handle greater demand, the online chat function has been expanded and the online Spanish-language application has been improved, Lee said.\u003c/p>\n\u003cp>\"And we have dramatically increased the number of people at the call centers,\" Lee said.\u003c/p>\n\u003cp>This time around, he said, there are 1,300 people manning the phones, and 254 of them speak another language. That compares to about 400 call center workers at the opening of the first enrollment period.\u003c/p>\n\u003cp>\"In many ways it will be harder during the second enrollment period,\" Lee said. He said many of the remaining uninsured have learned to get by on no insurance, by not getting care until they have an emergency condition.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's a culture of coping,\" Lee said, \"rather than a culture of coverage.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/covered-california-pushes-for-renewals\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/covered-california-pushes-for-renewals\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Covered California officially began mailing renewal notices for its 1.1 million enrollees who signed up during the first open enrollment period, officials announced Thursday.\u003c/p>\n\u003cp>People who want to keep their current plan will be automatically renewed. All they need do is pay their premium by Dec. 15 to continue their coverage beginning Jan 1, said Peter Lee, executive director of the exchange. People who want to make changes have until Dec. 15 to do so.\u003c/p>\n\u003cp>\"If you're happy with your plan, you don't need to do a thing, you just pay the bill, you're good,\" Lee said. \"If you want to shop around, we have the tools available online or with assisters to do that. Stability and consistency are good things, but we encourage you to shop for a better policy.\"\u003c!--more-->\u003c/p>\n\u003cp>Lee said the average premium rate in the exchange rose 4 percent from last year. \"Some went up a little more, some actually went down, but the average doesn't matter, the individual choice is what's important. So some people will want to look around.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Covered California yesterday also \u003ca title=\"http://www.coveredca.com/resources/PDFs/10-14-2014-Lessons-Learned-final.pdf\" href=\"http://www.coveredca.com/resources/PDFs/10-14-2014-Lessons-Learned-final.pdf\" target=\"_blank\">released a report \u003c/a>on lessons learned from the first open enrollment period. The next open enrollment period is Nov. 15 - Feb. 15.\u003c/p>\n\u003cp>\"The top lesson learned is the incredible response we saw from consumers,\" Lee said. \"We weren't ready for it. Our call centers weren't ready. We are changing what we're doing going into 2015.\"\u003c/p>\n\u003cp>The web portal has been improved to handle greater demand, the online chat function has been expanded and the online Spanish-language application has been improved, Lee said.\u003c/p>\n\u003cp>\"And we have dramatically increased the number of people at the call centers,\" Lee said.\u003c/p>\n\u003cp>This time around, he said, there are 1,300 people manning the phones, and 254 of them speak another language. That compares to about 400 call center workers at the opening of the first enrollment period.\u003c/p>\n\u003cp>\"In many ways it will be harder during the second enrollment period,\" Lee said. He said many of the remaining uninsured have learned to get by on no insurance, by not getting care until they have an emergency condition.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's a culture of coping,\" Lee said, \"rather than a culture of coverage.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Prop. 45 Fight Worthy of Television Drama",
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"content": "\u003cfigure id=\"attachment_22018\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/469263795-e1413059491589.jpg\">\u003cimg class=\"size-large wp-image-22018\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/469263795-640x448.jpg\" alt='Kevin Spacey stars as Frank Underwood in the Netflix series \"House of Cards.\" (Kevin Winter/Getty Images)' width=\"640\" height=\"448\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kevin Spacey stars as Frank Underwood in the Netflix series \"House of Cards.\" (Kevin Winter/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The power play behind Proposition 45 could be fodder for an episode of House of Cards:\u003c/p>\n\u003caside class=\"pullquote alignleft\">Dave Jones might not like this comparison, but he's the Frank Underwood in this fight.\u003c/aside>\n\u003cp>“Power is a lot like real estate. It’s all about location, location, location. The closer you are to the source, the higher your property value,” so goes protagonist Frank Underwood, who plays the menacing House majority whip scheming to get closer to the president.\u003c/p>\n\u003cp>You'd never think there'd be such positioning over who gets to regulate health insurance.\u003c/p>\n\u003cp>But this is California. And no less than three state agencies want to have a say in this one.\u003c!--more-->\u003c/p>\n\u003cp>“I’ve taken a look at the regulation at the Department of Insurance and concluded it’s abysmal,” says Dave Jones the state’s insurance commissioner. “It’s too weak, it doesn’t provide enough teeth.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jones wouldn't like this comparison, but he's the Frank in this fight. Now, I’m not saying Jones is sneaky or evil. But he is campaigning for Prop. 45 to give himself the power to reject rate hikes in health insurance, even though there are two state agencies that already review rates: the Department of Insurance and the Department of Managed Health Care.\u003c/p>\n\u003cp>“But neither department has the ability to actually reject health insurance rates that are excessive,” Jones says. “And review simply isn’t enough. We’ve been reviewing for four years now and rates continue to climb.”\u003c/p>\n\u003cp>It's a message that resonates with a lot of voters. Many have been waiting for someone to do something about skyrocketing health premiums. Like Josh Libresco, a market researcher in San Rafael who buys his own insurance. Health care costs for his family have gone up more than a thousand percent in the last fifteen years.\u003c/p>\n\u003cp>“It has become our single biggest expense. Bigger than my mortgage. Bigger than my daughters’ college tuition, which is incredible,” he says.\u003c/p>\n\u003cp>Testimonials like this make Prop. 45 seem like a slam dunk. But here’s the plot twist.\u003c/p>\n\u003cp>The commissioners’ own allies are against him on this one.\u003c/p>\n\u003cp>Covered California is the state agency tasked with implementing the Affordable Care Act in California. Susan Kennedy is a member of the board. It’s a stretch, but let’s cast her as Jackie Sharp from Season Two of House of Cards.\u003c/p>\n\u003cp>“I’ve been in politics and government for the last 25, 30 years,” Kennedy says. She served as cabinet secretary for Governor Gray Davis and chief of staff to Gov. Arnold Schwarzenegger.\u003c/p>\n\u003cp>In the show, Jackie and Frank are united on most issues –- until they aren’t. Similarly, Commissioner Jones and Covered California are on the same side when it comes to Obamacare.\u003c/p>\n\u003cp>But they disagree big time on whether Prop. 45 would help health reform or undermine it.\u003c/p>\n\u003cp>Jones says Prop. 45 is the missing piece of the Affordable Care Act; Kennedy says the timing is all wrong, and that the measure would interfere with Covered California’s ability to do its job.\u003c/p>\n\u003cp>“It would be one thing if we were to vote for Prop. 45 before we had begun implementing Obamacare, but I just don’t see how it’s possible to inject an entirely different system into an existing one and not expect it to cause chaos, delay, and cost,” she says.\u003c/p>\n\u003cp>Covered California has its own power to negotiate with insurers who want to sell health plans through the state’s individual and small business marketplace. The agency keeps an eye to cost already, but Kennedy says that’s not its only priority.\u003c/p>\n\u003cp>“For the last hundred years, health care reform has been about controlling the cost of health care. And, we want to improve quality of care and the outcomes of health care as opposed to just the cost,” she says. “Those are sometimes very conflicting goals.”\u003c/p>\n\u003cp>In the Hollywood version of this debate, one side self-implodes, or pulls out a dirty trick to throw the others’ credibility into question. But in real life in Sacramento, this is where the debate spirals into a long he-said-she-said and ends with Dave Jones swearing it can all work out and everyone can work together.\u003c/p>\n\u003cp>“The Department of Insurance, which has had over 25 years’ experience with rate regulation for all these other insurance products has reviewed Prop. 45 and concluded that Prop. 45 can be implemented consistent with Covered California,” he says.\u003c/p>\n\u003cp>Polls show support for the measure is slipping, with a third of voters still undecided.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So I guess by my own metaphor, this makes me journalist Zoe Barnes, a comparison I do not appreciate, thank you very much. I assure you there were no shady deals in the making if this story. Though I’m pretty sure Dave Jones and Susan Kennedy will not be responding to my texts for a while.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22018\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/469263795-e1413059491589.jpg\">\u003cimg class=\"size-large wp-image-22018\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/469263795-640x448.jpg\" alt='Kevin Spacey stars as Frank Underwood in the Netflix series \"House of Cards.\" (Kevin Winter/Getty Images)' width=\"640\" height=\"448\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kevin Spacey stars as Frank Underwood in the Netflix series \"House of Cards.\" (Kevin Winter/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The power play behind Proposition 45 could be fodder for an episode of House of Cards:\u003c/p>\n\u003caside class=\"pullquote alignleft\">Dave Jones might not like this comparison, but he's the Frank Underwood in this fight.\u003c/aside>\n\u003cp>“Power is a lot like real estate. It’s all about location, location, location. The closer you are to the source, the higher your property value,” so goes protagonist Frank Underwood, who plays the menacing House majority whip scheming to get closer to the president.\u003c/p>\n\u003cp>You'd never think there'd be such positioning over who gets to regulate health insurance.\u003c/p>\n\u003cp>But this is California. And no less than three state agencies want to have a say in this one.\u003c!--more-->\u003c/p>\n\u003cp>“I’ve taken a look at the regulation at the Department of Insurance and concluded it’s abysmal,” says Dave Jones the state’s insurance commissioner. “It’s too weak, it doesn’t provide enough teeth.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jones wouldn't like this comparison, but he's the Frank in this fight. Now, I’m not saying Jones is sneaky or evil. But he is campaigning for Prop. 45 to give himself the power to reject rate hikes in health insurance, even though there are two state agencies that already review rates: the Department of Insurance and the Department of Managed Health Care.\u003c/p>\n\u003cp>“But neither department has the ability to actually reject health insurance rates that are excessive,” Jones says. “And review simply isn’t enough. We’ve been reviewing for four years now and rates continue to climb.”\u003c/p>\n\u003cp>It's a message that resonates with a lot of voters. Many have been waiting for someone to do something about skyrocketing health premiums. Like Josh Libresco, a market researcher in San Rafael who buys his own insurance. Health care costs for his family have gone up more than a thousand percent in the last fifteen years.\u003c/p>\n\u003cp>“It has become our single biggest expense. Bigger than my mortgage. Bigger than my daughters’ college tuition, which is incredible,” he says.\u003c/p>\n\u003cp>Testimonials like this make Prop. 45 seem like a slam dunk. But here’s the plot twist.\u003c/p>\n\u003cp>The commissioners’ own allies are against him on this one.\u003c/p>\n\u003cp>Covered California is the state agency tasked with implementing the Affordable Care Act in California. Susan Kennedy is a member of the board. It’s a stretch, but let’s cast her as Jackie Sharp from Season Two of House of Cards.\u003c/p>\n\u003cp>“I’ve been in politics and government for the last 25, 30 years,” Kennedy says. She served as cabinet secretary for Governor Gray Davis and chief of staff to Gov. Arnold Schwarzenegger.\u003c/p>\n\u003cp>In the show, Jackie and Frank are united on most issues –- until they aren’t. Similarly, Commissioner Jones and Covered California are on the same side when it comes to Obamacare.\u003c/p>\n\u003cp>But they disagree big time on whether Prop. 45 would help health reform or undermine it.\u003c/p>\n\u003cp>Jones says Prop. 45 is the missing piece of the Affordable Care Act; Kennedy says the timing is all wrong, and that the measure would interfere with Covered California’s ability to do its job.\u003c/p>\n\u003cp>“It would be one thing if we were to vote for Prop. 45 before we had begun implementing Obamacare, but I just don’t see how it’s possible to inject an entirely different system into an existing one and not expect it to cause chaos, delay, and cost,” she says.\u003c/p>\n\u003cp>Covered California has its own power to negotiate with insurers who want to sell health plans through the state’s individual and small business marketplace. The agency keeps an eye to cost already, but Kennedy says that’s not its only priority.\u003c/p>\n\u003cp>“For the last hundred years, health care reform has been about controlling the cost of health care. And, we want to improve quality of care and the outcomes of health care as opposed to just the cost,” she says. “Those are sometimes very conflicting goals.”\u003c/p>\n\u003cp>In the Hollywood version of this debate, one side self-implodes, or pulls out a dirty trick to throw the others’ credibility into question. But in real life in Sacramento, this is where the debate spirals into a long he-said-she-said and ends with Dave Jones swearing it can all work out and everyone can work together.\u003c/p>\n\u003cp>“The Department of Insurance, which has had over 25 years’ experience with rate regulation for all these other insurance products has reviewed Prop. 45 and concluded that Prop. 45 can be implemented consistent with Covered California,” he says.\u003c/p>\n\u003cp>Polls show support for the measure is slipping, with a third of voters still undecided.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So I guess by my own metaphor, this makes me journalist Zoe Barnes, a comparison I do not appreciate, thank you very much. I assure you there were no shady deals in the making if this story. Though I’m pretty sure Dave Jones and Susan Kennedy will not be responding to my texts for a while.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21973\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/miles.jpg\">\u003cimg class=\"size-large wp-image-21973\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/miles-640x427.jpg\" alt=\"Miles Alva, 28, says getting insured is not a priority and would rather deal with the penalty. (Heidi de Marco/KHN).\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Miles Alva, 28, says getting insured is not a priority and would rather deal with the penalty. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman and Julie Appleby,\u003c/strong> \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2014/October/07/Obamacare-Enrollment-Second-Year-An-Even-Tougher-Challenge.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2014/October/07/Obamacare-Enrollment-Second-Year-An-Even-Tougher-Challenge.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>As states gear up for round two of Obamacare enrollment next month, they have their sights set on people like Miles Alva.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Covered California seeks to renew 1.2 million members -- and enroll 500,000 new people. \u003c/aside>\n\u003cp>Alva, 28, works part-time at a video store and is about to graduate from Cal State Northridge. Getting insured is about the last thing on his mind.\u003c/p>\n\u003cp>\"It's not a priority,\" the television and cinema arts student said. \"I am not interested in paying for health insurance right now.\"\u003c/p>\n\u003cp>The second round of enrollment under the nation's Affordable Care Act promises to be tougher than the first. Many of those eager to get covered already did, including those with health conditions that had prevented them from getting insurance in the past.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>About 30 million to 40 million people remain uninsured in the United States, according to various surveys.\u003c/p>\n\u003cp>\"When you look at those who remain uninsured, they are in many ways harder to reach,\" said Anne Filipic, president of Enroll America, a nonprofit group that signs up consumers for new health coverage. \"This is really about doubling down and reaching those folks who didn’t get the message the first time.\"\u003c/p>\n\u003cp>During the inaugural round, computer glitches and other missteps delayed sign-ups and created a political backlash, nationally. California's website and overall enrollment went more smoothly than the federally-run healthcare.gov. Yet more than 7.3 million people purchased health plans through new insurance marketplaces and nearly 8 million low-income people enrolled in Medicaid. The massive effort helped to bring the nation's uninsured rate down to its lowest level since 2008.\u003c/p>\n\u003cp>This time, states and the federal government aim to renew the people they signed up last year as well as add about 6 million currently uninsured residents to the exchanges and 4 million to the Medicaid rolls, \u003ca title=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2014-04-ACAtables2.pdf\" href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2014-04-ACAtables2.pdf\" target=\"_blank\">according to estimates\u003c/a> from the Congressional Budget Office.\u003c/p>\n\u003cp>And there's a time crunch –- the second round of open enrollment lasts only three months, about half the time as before.\u003c/p>\n\u003cp>Health and Human Services Secretary Sylvia Burwell said last week that the government is facing \"deadlines every day” so it will be ready for the Nov. 15 start date. Officials are testing the site to ensure it can handle the demand, she said.\u003c/p>\n\u003cp>Health officials and advocates plan to adjust their pitch. Last time, they persuaded many to sign up by extolling the benefits of insurance. This time, they plan to focus more on the financial assistance available to consumers as well as on the penalty for not having coverage. In year two, those without insurance face a fine of $325 per person or 2 percent of their income, whichever is larger.\u003c/p>\n\u003cp>\"People dismissed the penalty a little bit last year,\" said Michael Marchand, director of communications for the Washington Health Benefit Exchange, which enrolled 164,000 in health plans last year. This year, higher fines could prompt an “awakening” and change people’s minds, he said.\u003c/p>\n\u003cp>\u003cstrong>Sticker Shock\u003c/strong>\u003c/p>\n\u003cp>But for many, whether to enroll in a plan has nothing to do with the penalty. In fact, a large portion of uninsured people were unaware of it, polls show. What troubles them is the price.\u003c/p>\n\u003cp>Alva, for example, makes about $10 an hour in his video job, working 25 to 30 hours a week during school –- not enough, he said, to afford insurance. He has heard about the penalty but doesn’t know how much it is for him. \"I guess I will deal with that when it comes,\" he said.\u003c/p>\n\u003cp>Barb Hill, 54, who lives outside Chicago, supports Obamacare but chose not to sign up last year. Even with a subsidy, she said, insurance would have cost her $200 each month.\u003c/p>\n\u003cp>\"I really don't go to the doctor that much so I didn't know if it was worth spending that,\" said Hill, an X-ray technician at a private health care office.\u003c/p>\n\u003cp>This year, however, she is reducing her cell phone bill and giving up monthly massages that ease her back pain so she might be able to afford a plan. Then again, if the premium has increased, she said, \"I am going to have to really think about it.\"\u003c/p>\n\u003cp>Among consumers still uninsured as of June, nearly 60 percent said they couldn’t afford coverage, \u003ca title=\"http://hrms.urban.org/briefs/who-are-the-remaining-uninsured-as-of-june-2014.html\" href=\"http://hrms.urban.org/briefs/who-are-the-remaining-uninsured-as-of-june-2014.html\" target=\"_blank\">according to a recent analysis\u003c/a> by the Urban Institute.\u003c/p>\n\u003cp>But many consumers weren't aware they might be eligible for subsidies. \"A lot of people don’t know what the costs are,\" said Sharon Long, senior fellow at the Institute. \"They just assume it is going to be high or they are afraid it is going to be high.\"\u003c/p>\n\u003cp>Long said the states and federal government need to do a better job of educating potential consumers about their options.\u003c/p>\n\u003cp>That’s what Sheila Chilson and her team at Moses Lake Community Health Center in Washington are trying to do –- teach patients how insurance works and help them figure out how to afford it. \"We have a year's experience under our belt, but we are preparing ourselves for the same level of volume and potential frustration,\" she said.\u003c/p>\n\u003cp>\u003cstrong>A Coverage Gap\u003c/strong>\u003c/p>\n\u003cp>Although uninsured residents are scattered throughout the U.S., nearly half live in the South and many are concentrated in the two dozen states that chose not to expand their Medicaid programs, according to the Urban Institute analysis. The health law expanded Medicaid to more low-income adults, but a Supreme Court ruling made that provision optional for states.\u003c/p>\n\u003cp>As a result, nearly 5 million uninsured adults fall into a \"coverage gap\" –- they make too much to qualify for the existing Medicaid program but too little to get financial help purchasing a plan through the marketplaces, according to the Kaiser Family Foundation.\u003c/p>\n\u003cp>Greg Morris, 46, is one of about 300,000 Missouri residents in that gap. Morris, a single father, lives in Osage County and works part-time at a miniature golf course. \"The only option I have is to pay more than I can afford,\" he said.\u003c/p>\n\u003cp>Morris plans to check his options again in November, but he is not hopeful. \"I wish they would go ahead and expand the Medicaid the way the law was designed,\" he said.\u003c/p>\n\u003cp>Missouri wants to add 100,000 more people to the approximately 150,000 who signed up for coverage through the federal exchange last year, said Ryan Barker, vice president of health policy with the Missouri Health Foundation. Even more ambitious is the foundation’s goal of cutting the state’s uninsured rate from 15.5 percent to below 5 percent within five years.\u003c/p>\n\u003cp>\"We can’t do it unless the state expands Medicaid,\" Barker said.\u003c/p>\n\u003cp>\u003cstrong>Need For 'Personal Contact'\u003c/strong>\u003c/p>\n\u003cp>Nationwide, among the most difficult populations to reach are Latinos. About 6 million people in the United States, many of them Latino, are uninsured and ineligible for coverage because they are undocumented, according to the Kaiser Family Foundation. But even among eligible Latinos, enrollment has been impaired by a fear of calling attention to undocumented family members, a lack of timely Spanish-language information and a shortage of bilingual enrollment workers.\u003c/p>\n\u003cp>Nevertheless, the percentage of uninsured Latinos across the nation decreased from 36 to 23 percent by June 2014, according \u003ca title=\"http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2014/sep/1775_doty_catching_up_latino_hlt_coverage_aca_tb_v3.pdf\" href=\"http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2014/sep/1775_doty_catching_up_latino_hlt_coverage_aca_tb_v3.pdf\" target=\"_blank\">a September report\u003c/a> from the Commonwealth Fund. Coverage gains were greatest in the states that expanded Medicaid eligibility.\u003c/p>\n\u003cp>Advocates found that in-person help worked best, as did partnerships with trusted groups, advertising on buses serving Latino neighborhoods and the use of health counselors, called promotoras.\u003c/p>\n\u003cp>\"Latinos really like personal contact, they don’t like to make decisions about health care over the Internet,\" said Commonwealth report author Michelle Doty.\u003c/p>\n\u003cp>In California, about half of previously uninsured Latinos gained coverage during the first round of open enrollment, according to the analysis.\u003c/p>\n\u003cp>In addition to having enough bilingual staff and investing enough in community groups, the enrollment process needs to be much smoother than last year, said Xavier Morales, executive director of Latino Coalition for a Healthy California. \"Any hiccup ... may mean that they may not come back.\"\u003c/p>\n\u003cp>Covered California \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/15/covered-california-launches-2015-outreach-campaign/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/15/covered-california-launches-2015-outreach-campaign/\" target=\"_blank\">launched its new outreach effort \u003c/a>this month, including an ad campaign featuring consumers who have benefited from health insurance. The state hopes to renew 1.2 million marketplace consumers and enroll about 500,000 new people. They also plan to renew 2 million Medicaid beneficiaries and take in several hundred thousand new applicants.\u003c/p>\n\u003cp>The marketplace plans to make a targeted push among Latinos and African Americans, said spokesman Dana Howard. “We need to do a heavier lift in making sure they get the information about Covered California.”\u003c/p>\n\u003cp>Nationwide, more than 600,000 Asian Americans, Native Hawaiians and Pacific Islanders enrolled in coverage, primarily through community groups, but about 1.3 million remain uninsured, according to the Asian & Pacific Islander American Health Forum.\u003c/p>\n\u003cp>To reach them, the marketplaces need to invest more in outreach and education, through libraries, ethnic grocery stores and faith-based institutions, said Bonnie Kwon, a program manager at the forum. \"If they are coming from a country that has a completely different system, they don’t understand co-pays, they don’t understand deductibles,\" she said.\u003c/p>\n\u003cp>New enrollees can sign up anytime between Nov. 15 and Feb. 15. But those already enrolled will have from Nov. 15 to Dec. 15 to re-enroll and switch plans for coverage that starts in the New Year. Those who don’t will be automatically re-enrolled in existing coverage.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We’re going to have up to 8 million people who need to get this done in 30 days: Holy smokes,\" said Robert Laszewski, a Maryland-based consultant to the insurance industry.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21973\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/miles.jpg\">\u003cimg class=\"size-large wp-image-21973\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/miles-640x427.jpg\" alt=\"Miles Alva, 28, says getting insured is not a priority and would rather deal with the penalty. (Heidi de Marco/KHN).\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Miles Alva, 28, says getting insured is not a priority and would rather deal with the penalty. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman and Julie Appleby,\u003c/strong> \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2014/October/07/Obamacare-Enrollment-Second-Year-An-Even-Tougher-Challenge.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2014/October/07/Obamacare-Enrollment-Second-Year-An-Even-Tougher-Challenge.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>As states gear up for round two of Obamacare enrollment next month, they have their sights set on people like Miles Alva.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Covered California seeks to renew 1.2 million members -- and enroll 500,000 new people. \u003c/aside>\n\u003cp>Alva, 28, works part-time at a video store and is about to graduate from Cal State Northridge. Getting insured is about the last thing on his mind.\u003c/p>\n\u003cp>\"It's not a priority,\" the television and cinema arts student said. \"I am not interested in paying for health insurance right now.\"\u003c/p>\n\u003cp>The second round of enrollment under the nation's Affordable Care Act promises to be tougher than the first. Many of those eager to get covered already did, including those with health conditions that had prevented them from getting insurance in the past.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>About 30 million to 40 million people remain uninsured in the United States, according to various surveys.\u003c/p>\n\u003cp>\"When you look at those who remain uninsured, they are in many ways harder to reach,\" said Anne Filipic, president of Enroll America, a nonprofit group that signs up consumers for new health coverage. \"This is really about doubling down and reaching those folks who didn’t get the message the first time.\"\u003c/p>\n\u003cp>During the inaugural round, computer glitches and other missteps delayed sign-ups and created a political backlash, nationally. California's website and overall enrollment went more smoothly than the federally-run healthcare.gov. Yet more than 7.3 million people purchased health plans through new insurance marketplaces and nearly 8 million low-income people enrolled in Medicaid. The massive effort helped to bring the nation's uninsured rate down to its lowest level since 2008.\u003c/p>\n\u003cp>This time, states and the federal government aim to renew the people they signed up last year as well as add about 6 million currently uninsured residents to the exchanges and 4 million to the Medicaid rolls, \u003ca title=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2014-04-ACAtables2.pdf\" href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2014-04-ACAtables2.pdf\" target=\"_blank\">according to estimates\u003c/a> from the Congressional Budget Office.\u003c/p>\n\u003cp>And there's a time crunch –- the second round of open enrollment lasts only three months, about half the time as before.\u003c/p>\n\u003cp>Health and Human Services Secretary Sylvia Burwell said last week that the government is facing \"deadlines every day” so it will be ready for the Nov. 15 start date. Officials are testing the site to ensure it can handle the demand, she said.\u003c/p>\n\u003cp>Health officials and advocates plan to adjust their pitch. Last time, they persuaded many to sign up by extolling the benefits of insurance. This time, they plan to focus more on the financial assistance available to consumers as well as on the penalty for not having coverage. In year two, those without insurance face a fine of $325 per person or 2 percent of their income, whichever is larger.\u003c/p>\n\u003cp>\"People dismissed the penalty a little bit last year,\" said Michael Marchand, director of communications for the Washington Health Benefit Exchange, which enrolled 164,000 in health plans last year. This year, higher fines could prompt an “awakening” and change people’s minds, he said.\u003c/p>\n\u003cp>\u003cstrong>Sticker Shock\u003c/strong>\u003c/p>\n\u003cp>But for many, whether to enroll in a plan has nothing to do with the penalty. In fact, a large portion of uninsured people were unaware of it, polls show. What troubles them is the price.\u003c/p>\n\u003cp>Alva, for example, makes about $10 an hour in his video job, working 25 to 30 hours a week during school –- not enough, he said, to afford insurance. He has heard about the penalty but doesn’t know how much it is for him. \"I guess I will deal with that when it comes,\" he said.\u003c/p>\n\u003cp>Barb Hill, 54, who lives outside Chicago, supports Obamacare but chose not to sign up last year. Even with a subsidy, she said, insurance would have cost her $200 each month.\u003c/p>\n\u003cp>\"I really don't go to the doctor that much so I didn't know if it was worth spending that,\" said Hill, an X-ray technician at a private health care office.\u003c/p>\n\u003cp>This year, however, she is reducing her cell phone bill and giving up monthly massages that ease her back pain so she might be able to afford a plan. Then again, if the premium has increased, she said, \"I am going to have to really think about it.\"\u003c/p>\n\u003cp>Among consumers still uninsured as of June, nearly 60 percent said they couldn’t afford coverage, \u003ca title=\"http://hrms.urban.org/briefs/who-are-the-remaining-uninsured-as-of-june-2014.html\" href=\"http://hrms.urban.org/briefs/who-are-the-remaining-uninsured-as-of-june-2014.html\" target=\"_blank\">according to a recent analysis\u003c/a> by the Urban Institute.\u003c/p>\n\u003cp>But many consumers weren't aware they might be eligible for subsidies. \"A lot of people don’t know what the costs are,\" said Sharon Long, senior fellow at the Institute. \"They just assume it is going to be high or they are afraid it is going to be high.\"\u003c/p>\n\u003cp>Long said the states and federal government need to do a better job of educating potential consumers about their options.\u003c/p>\n\u003cp>That’s what Sheila Chilson and her team at Moses Lake Community Health Center in Washington are trying to do –- teach patients how insurance works and help them figure out how to afford it. \"We have a year's experience under our belt, but we are preparing ourselves for the same level of volume and potential frustration,\" she said.\u003c/p>\n\u003cp>\u003cstrong>A Coverage Gap\u003c/strong>\u003c/p>\n\u003cp>Although uninsured residents are scattered throughout the U.S., nearly half live in the South and many are concentrated in the two dozen states that chose not to expand their Medicaid programs, according to the Urban Institute analysis. The health law expanded Medicaid to more low-income adults, but a Supreme Court ruling made that provision optional for states.\u003c/p>\n\u003cp>As a result, nearly 5 million uninsured adults fall into a \"coverage gap\" –- they make too much to qualify for the existing Medicaid program but too little to get financial help purchasing a plan through the marketplaces, according to the Kaiser Family Foundation.\u003c/p>\n\u003cp>Greg Morris, 46, is one of about 300,000 Missouri residents in that gap. Morris, a single father, lives in Osage County and works part-time at a miniature golf course. \"The only option I have is to pay more than I can afford,\" he said.\u003c/p>\n\u003cp>Morris plans to check his options again in November, but he is not hopeful. \"I wish they would go ahead and expand the Medicaid the way the law was designed,\" he said.\u003c/p>\n\u003cp>Missouri wants to add 100,000 more people to the approximately 150,000 who signed up for coverage through the federal exchange last year, said Ryan Barker, vice president of health policy with the Missouri Health Foundation. Even more ambitious is the foundation’s goal of cutting the state’s uninsured rate from 15.5 percent to below 5 percent within five years.\u003c/p>\n\u003cp>\"We can’t do it unless the state expands Medicaid,\" Barker said.\u003c/p>\n\u003cp>\u003cstrong>Need For 'Personal Contact'\u003c/strong>\u003c/p>\n\u003cp>Nationwide, among the most difficult populations to reach are Latinos. About 6 million people in the United States, many of them Latino, are uninsured and ineligible for coverage because they are undocumented, according to the Kaiser Family Foundation. But even among eligible Latinos, enrollment has been impaired by a fear of calling attention to undocumented family members, a lack of timely Spanish-language information and a shortage of bilingual enrollment workers.\u003c/p>\n\u003cp>Nevertheless, the percentage of uninsured Latinos across the nation decreased from 36 to 23 percent by June 2014, according \u003ca title=\"http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2014/sep/1775_doty_catching_up_latino_hlt_coverage_aca_tb_v3.pdf\" href=\"http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2014/sep/1775_doty_catching_up_latino_hlt_coverage_aca_tb_v3.pdf\" target=\"_blank\">a September report\u003c/a> from the Commonwealth Fund. Coverage gains were greatest in the states that expanded Medicaid eligibility.\u003c/p>\n\u003cp>Advocates found that in-person help worked best, as did partnerships with trusted groups, advertising on buses serving Latino neighborhoods and the use of health counselors, called promotoras.\u003c/p>\n\u003cp>\"Latinos really like personal contact, they don’t like to make decisions about health care over the Internet,\" said Commonwealth report author Michelle Doty.\u003c/p>\n\u003cp>In California, about half of previously uninsured Latinos gained coverage during the first round of open enrollment, according to the analysis.\u003c/p>\n\u003cp>In addition to having enough bilingual staff and investing enough in community groups, the enrollment process needs to be much smoother than last year, said Xavier Morales, executive director of Latino Coalition for a Healthy California. \"Any hiccup ... may mean that they may not come back.\"\u003c/p>\n\u003cp>Covered California \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/15/covered-california-launches-2015-outreach-campaign/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/15/covered-california-launches-2015-outreach-campaign/\" target=\"_blank\">launched its new outreach effort \u003c/a>this month, including an ad campaign featuring consumers who have benefited from health insurance. The state hopes to renew 1.2 million marketplace consumers and enroll about 500,000 new people. They also plan to renew 2 million Medicaid beneficiaries and take in several hundred thousand new applicants.\u003c/p>\n\u003cp>The marketplace plans to make a targeted push among Latinos and African Americans, said spokesman Dana Howard. “We need to do a heavier lift in making sure they get the information about Covered California.”\u003c/p>\n\u003cp>Nationwide, more than 600,000 Asian Americans, Native Hawaiians and Pacific Islanders enrolled in coverage, primarily through community groups, but about 1.3 million remain uninsured, according to the Asian & Pacific Islander American Health Forum.\u003c/p>\n\u003cp>To reach them, the marketplaces need to invest more in outreach and education, through libraries, ethnic grocery stores and faith-based institutions, said Bonnie Kwon, a program manager at the forum. \"If they are coming from a country that has a completely different system, they don’t understand co-pays, they don’t understand deductibles,\" she said.\u003c/p>\n\u003cp>New enrollees can sign up anytime between Nov. 15 and Feb. 15. But those already enrolled will have from Nov. 15 to Dec. 15 to re-enroll and switch plans for coverage that starts in the New Year. Those who don’t will be automatically re-enrolled in existing coverage.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We’re going to have up to 8 million people who need to get this done in 30 days: Holy smokes,\" said Robert Laszewski, a Maryland-based consultant to the insurance industry.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Screen shot from the Spanish-language version of the Covered California website.)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Daniela Hernandez,\u003c/strong> \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2014/September/29/Scrambling-To-Prove-Hes-Eligible-For-Obamacare.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2014/September/29/Scrambling-To-Prove-Hes-Eligible-For-Obamacare.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>When Fabrizio Mancinelli applied for health insurance through California’s online marketplace nine months ago, he ran into a frustrating snag.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The deadline is midnight, Tuesday, for those who were notified to provide documents proving their legal status.\u003c/aside>\n\u003cp>An Italian composer and self-described computer geek, Mancinelli said he was surprised to find there wasn’t a clear way to upload a copy of his O-1 visa. The document, which grants temporary residency status to people with extraordinary talents in the sciences and arts, was part of his proof to the government that he was eligible for coverage.\u003c/p>\n\u003cp>So, the 35-year-old Sherman Oaks resident wrote in his application that he’d be happy to send along any further documentation.\u003c!--more-->\u003c/p>\n\u003cp>Months went by without word from the state. Then last week he came home from vacation to find a notice telling him he was at risk of losing the Anthem Blue Cross plan he’d purchased.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On Sept. 4 -- five months after the end of open enrollment -- Covered California sent out notices in English and Spanish to 98,000 families who bought plans on the exchange alerting them that their legal status could not be verified. As many as 50,000 households still remain unverified and must meet a Tuesday deadline at midnight to prove that they are citizens or legal U.S. residents, or risk losing coverage.\u003c/p>\n\u003cp>If deemed ineligible, the letters said, applicants could be liable to repay the tax credits they received, plus interest.\u003c/p>\n\u003cp>By the time Mancinelli got his letter, he had only days to comply.\u003c/p>\n\u003cp>“It’s more and more pressure,” said Mancinelli. “I understand they have lots of applications to process, but on the other end, if a document is missing, the computer should have a red flag. …Don’t wait nine months.”\u003c/p>\n\u003cp>\u003cstrong>What Documents are Needed\u003c/strong>\u003c/p>\n\u003cp>Each person in a household needs to \u003ca title=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" href=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" target=\"_blank\">submit proof, s\u003c/a>uch as copies of a U.S. passport, a certificate of naturalization, a U.S birth certificate plus a driver’s license, or a state-issued identification card. Nonpermanent residents like Mancinelli have to submit certain immigration documents.\u003c/p>\n\u003cp>In some cases, the problem was not missing documents but something as simple as using a nickname instead of a full name or inverting the first and last names on an application, according to Covered California spokesman James Scullary. When it came time to match those names to information in federal databases, inconsistencies arose.\u003c/p>\n\u003cp>Other applicants reported technical problems uploading documents or lacked scanners to make digital copies.\u003c/p>\n\u003cp>Glitches exist at the other end of the verification process as well. When officials have gone to confirm an applicant’s information by comparing it with records in government databases, they’ve received vague messages about why verification was not possible, consumer advocates say. It can be unclear whether the problem is the result of inconsistencies or because a database is down, according to advocates.\u003c/p>\n\u003cp>“This is such a difficult situation for consumers to be put in,” said Sonal Ambegaokar, a senior attorney at the National Health Law Program, a national health advocacy group.\u003c/p>\n\u003cp>For immigrant families, this could add to language and cultural barriers that have complicated enrollment, advocates said. Many fear the information they provide Covered California could be used by immigration officials to deport relatives, even though the state has repeatedly said that is not the case.\u003c/p>\n\u003cp>Other applicants are baffled as to why they need to resubmit documents they claim they have already provided Covered California, don’t understand what documents are required or simply don’t yet have them in hand. In some cases, it can take months to get a lost Social Security card or permanent residency card replaced.\u003c/p>\n\u003cp>Scullary said he couldn’t say yet how many applicants had been deemed ineligible for coverage because Covered California is still looking through documents and helping people through the process.\u003c/p>\n\u003cp>Covered California has added a \u003ca title=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" href=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" target=\"_blank\">Frequently Asked Questions Web page\u003c/a> to help people better understand the process. The page includes information on what documents they can submit and who is eligible, namely U.S citizens, permanent residents, refugees and lawful temporary residents.\u003c/p>\n\u003cp>In addition to the written notices, “customers would have also received an email reminder that went out this week to impart on them that this is something they need to be aware of and take care of,” Scullary, the Covered California spokesman, said.\u003c/p>\n\u003cp>Mancinelli says he never received one.\u003c/p>\n\u003cp>\u003cstrong>Advocacy Groups Helping Notify Their Communities\u003c/strong>\u003c/p>\n\u003cp>Some nonprofit and advocacy organizations are translating the notices to other languages, like Korean and Vietnamese, or sending out notices of their own asking people if they received a notice from Covered California and informing them where they can seek help.\u003c/p>\n\u003cp>“There are efforts to try to get as much information out to the community as we can,” said Cary Sanders, the director of the Having Our Say Coalition in Oakland.\u003c/p>\n\u003cp>Covered California is allowing consumers to submit documents after the Sept. 30 deadline, but there is no guarantee these can be processed in time to avoid losing coverage after Oct. 31.\u003c/p>\n\u003cp>“Certainly if someone is able to prove they’re lawful but they’re unable to do it until after (the) 30th, we’d work with them and their insurance company to see what we could do to keep them covered, but they do run the risk of having some sort of gap in their coverage,” Scullary said.\u003c/p>\n\u003cp>People deemed ineligible can contest the decision, though that process has not been finalized, according to Scullary.\u003c/p>\n\u003cp>The state has dedicated a service center in Fresno to verifying documents. All the call centers have been trained to take questions from customers regarding the verification process, Scullary said.\u003c/p>\n\u003cp>But telephone wait times can be upward of an hour. Chat volume went up more than 40 percent in August, probably due to consumer concern over the verification process, according to documents from Covered California. Nearly two-thirds of calls were abandoned in August, compared with a third the previous month. Up to 15 percent of callers got a busy signal.\u003c/p>\n\u003cp>Mancinelli tried calling several times. Once he got through he was ultimately directed elsewhere, to the nonprofit Health Consumer Alliance, for help. Rather than wait on the phone again, he waded through the information on the Covered California website himself. Finally, he found a clause saying he could upload any documents not listed on the site under the module for U.S. passport – which he immediately did.\u003c/p>\n\u003cp>He said he simply wants to do the right thing.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is 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>\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Screen shot from the Spanish-language version of the Covered California website.)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Daniela Hernandez,\u003c/strong> \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2014/September/29/Scrambling-To-Prove-Hes-Eligible-For-Obamacare.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2014/September/29/Scrambling-To-Prove-Hes-Eligible-For-Obamacare.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>When Fabrizio Mancinelli applied for health insurance through California’s online marketplace nine months ago, he ran into a frustrating snag.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The deadline is midnight, Tuesday, for those who were notified to provide documents proving their legal status.\u003c/aside>\n\u003cp>An Italian composer and self-described computer geek, Mancinelli said he was surprised to find there wasn’t a clear way to upload a copy of his O-1 visa. The document, which grants temporary residency status to people with extraordinary talents in the sciences and arts, was part of his proof to the government that he was eligible for coverage.\u003c/p>\n\u003cp>So, the 35-year-old Sherman Oaks resident wrote in his application that he’d be happy to send along any further documentation.\u003c!--more-->\u003c/p>\n\u003cp>Months went by without word from the state. Then last week he came home from vacation to find a notice telling him he was at risk of losing the Anthem Blue Cross plan he’d purchased.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On Sept. 4 -- five months after the end of open enrollment -- Covered California sent out notices in English and Spanish to 98,000 families who bought plans on the exchange alerting them that their legal status could not be verified. As many as 50,000 households still remain unverified and must meet a Tuesday deadline at midnight to prove that they are citizens or legal U.S. residents, or risk losing coverage.\u003c/p>\n\u003cp>If deemed ineligible, the letters said, applicants could be liable to repay the tax credits they received, plus interest.\u003c/p>\n\u003cp>By the time Mancinelli got his letter, he had only days to comply.\u003c/p>\n\u003cp>“It’s more and more pressure,” said Mancinelli. “I understand they have lots of applications to process, but on the other end, if a document is missing, the computer should have a red flag. …Don’t wait nine months.”\u003c/p>\n\u003cp>\u003cstrong>What Documents are Needed\u003c/strong>\u003c/p>\n\u003cp>Each person in a household needs to \u003ca title=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" href=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" target=\"_blank\">submit proof, s\u003c/a>uch as copies of a U.S. passport, a certificate of naturalization, a U.S birth certificate plus a driver’s license, or a state-issued identification card. Nonpermanent residents like Mancinelli have to submit certain immigration documents.\u003c/p>\n\u003cp>In some cases, the problem was not missing documents but something as simple as using a nickname instead of a full name or inverting the first and last names on an application, according to Covered California spokesman James Scullary. When it came time to match those names to information in federal databases, inconsistencies arose.\u003c/p>\n\u003cp>Other applicants reported technical problems uploading documents or lacked scanners to make digital copies.\u003c/p>\n\u003cp>Glitches exist at the other end of the verification process as well. When officials have gone to confirm an applicant’s information by comparing it with records in government databases, they’ve received vague messages about why verification was not possible, consumer advocates say. It can be unclear whether the problem is the result of inconsistencies or because a database is down, according to advocates.\u003c/p>\n\u003cp>“This is such a difficult situation for consumers to be put in,” said Sonal Ambegaokar, a senior attorney at the National Health Law Program, a national health advocacy group.\u003c/p>\n\u003cp>For immigrant families, this could add to language and cultural barriers that have complicated enrollment, advocates said. Many fear the information they provide Covered California could be used by immigration officials to deport relatives, even though the state has repeatedly said that is not the case.\u003c/p>\n\u003cp>Other applicants are baffled as to why they need to resubmit documents they claim they have already provided Covered California, don’t understand what documents are required or simply don’t yet have them in hand. In some cases, it can take months to get a lost Social Security card or permanent residency card replaced.\u003c/p>\n\u003cp>Scullary said he couldn’t say yet how many applicants had been deemed ineligible for coverage because Covered California is still looking through documents and helping people through the process.\u003c/p>\n\u003cp>Covered California has added a \u003ca title=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" href=\"http://www.coveredca.com/faqs/Request-for-Verification-CLP/PDFs/Document-List.pdf\" target=\"_blank\">Frequently Asked Questions Web page\u003c/a> to help people better understand the process. The page includes information on what documents they can submit and who is eligible, namely U.S citizens, permanent residents, refugees and lawful temporary residents.\u003c/p>\n\u003cp>In addition to the written notices, “customers would have also received an email reminder that went out this week to impart on them that this is something they need to be aware of and take care of,” Scullary, the Covered California spokesman, said.\u003c/p>\n\u003cp>Mancinelli says he never received one.\u003c/p>\n\u003cp>\u003cstrong>Advocacy Groups Helping Notify Their Communities\u003c/strong>\u003c/p>\n\u003cp>Some nonprofit and advocacy organizations are translating the notices to other languages, like Korean and Vietnamese, or sending out notices of their own asking people if they received a notice from Covered California and informing them where they can seek help.\u003c/p>\n\u003cp>“There are efforts to try to get as much information out to the community as we can,” said Cary Sanders, the director of the Having Our Say Coalition in Oakland.\u003c/p>\n\u003cp>Covered California is allowing consumers to submit documents after the Sept. 30 deadline, but there is no guarantee these can be processed in time to avoid losing coverage after Oct. 31.\u003c/p>\n\u003cp>“Certainly if someone is able to prove they’re lawful but they’re unable to do it until after (the) 30th, we’d work with them and their insurance company to see what we could do to keep them covered, but they do run the risk of having some sort of gap in their coverage,” Scullary said.\u003c/p>\n\u003cp>People deemed ineligible can contest the decision, though that process has not been finalized, according to Scullary.\u003c/p>\n\u003cp>The state has dedicated a service center in Fresno to verifying documents. All the call centers have been trained to take questions from customers regarding the verification process, Scullary said.\u003c/p>\n\u003cp>But telephone wait times can be upward of an hour. Chat volume went up more than 40 percent in August, probably due to consumer concern over the verification process, according to documents from Covered California. Nearly two-thirds of calls were abandoned in August, compared with a third the previous month. Up to 15 percent of callers got a busy signal.\u003c/p>\n\u003cp>Mancinelli tried calling several times. Once he got through he was ultimately directed elsewhere, to the nonprofit Health Consumer Alliance, for help. Rather than wait on the phone again, he waded through the information on the Covered California website himself. Finally, he found a clause saying he could upload any documents not listed on the site under the module for U.S. passport – which he immediately did.\u003c/p>\n\u003cp>He said he simply wants to do the right thing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Covered California Launches 2015 Outreach Campaign",
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"content": "\u003cfigure id=\"attachment_19598\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/187909352.jpg\">\u003cimg class=\"size-large wp-image-19598\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/187909352-640x426.jpg\" alt=\"Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California, the state's health insurance exchange, kicked off its marketing and outreach campaign Monday for the upcoming 2015 open enrollment period. Officials say they forecast enrolling 1.7 million people, about 500,000 more than are presently signed up.\u003c/p>\n\u003cp>Peter Lee, the agency's executive director, acknowledged the work ahead. \"It won't be easy,\" he said. \"In many ways, it will be harder than last year.\"\u003c/p>\n\u003cp>For starters, the next open enrollment runs three months compared to last year's six month period when more than three million people signed up either for Covered California or to Medi-Cal, the state's version of Medicaid.\u003c!--more-->\u003c/p>\n\u003cp>But analysts had long presumed at least a portion of those people were informed about health insurance and the benefits of the Affordable Care Act. Lee said of those uninsured today and eligible for subsidies, 56 percent have been uninsured for at least two years, and 15 percent have never had insurance.\u003c/p>\n\u003cp>Those individuals have dealt with a \"culture of coping,\" he said. \"We want that to be a culture of coverage.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Covered California announced \u003ca title=\"Certified Enrollment Entities\" href=\"http://hbex.coveredca.com/enrollment-entities/\" target=\"_blank\">$14.6 million in new grants \u003c/a>to community groups \"that have a track record,\" Lee said, of direct outreach to diverse groups, in multiple languages. An additional $33.4 million had previously been awarded.\u003c/p>\n\u003cp>Officials also announced a $46 million statewide advertising campaign rolling out this week, in specific markets. The total budget for outreach and marketing is $94 million.\u003c/p>\n\u003cp>Lee spoke of lessons learned from the first open enrollment, including that many people prefer face-to-face counseling, as opposed to signing up online. \"There's no such thing as one touch and done,\" he said. \"It's going to take multiple conversations.\"\u003c/p>\n\u003cp>Covered California is also adding more staff at its three call centers. Spokesman Roy Kennedy said that at the end of the last open enrollment, there were 709 service center representatives. Kennedy said that Covered California \"hope(s) to have 950 in place for the beginning of the upcoming open enrollment\" which starts Nov. 15.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Call center wait times were often quite long during last year's open enrollment. \"Knock on wood, we'll have fast answer time,\" Lee said. \"We were swamped last year.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19598\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/187909352.jpg\">\u003cimg class=\"size-large wp-image-19598\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/187909352-640x426.jpg\" alt=\"Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California, the state's health insurance exchange, kicked off its marketing and outreach campaign Monday for the upcoming 2015 open enrollment period. Officials say they forecast enrolling 1.7 million people, about 500,000 more than are presently signed up.\u003c/p>\n\u003cp>Peter Lee, the agency's executive director, acknowledged the work ahead. \"It won't be easy,\" he said. \"In many ways, it will be harder than last year.\"\u003c/p>\n\u003cp>For starters, the next open enrollment runs three months compared to last year's six month period when more than three million people signed up either for Covered California or to Medi-Cal, the state's version of Medicaid.\u003c!--more-->\u003c/p>\n\u003cp>But analysts had long presumed at least a portion of those people were informed about health insurance and the benefits of the Affordable Care Act. Lee said of those uninsured today and eligible for subsidies, 56 percent have been uninsured for at least two years, and 15 percent have never had insurance.\u003c/p>\n\u003cp>Those individuals have dealt with a \"culture of coping,\" he said. \"We want that to be a culture of coverage.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Covered California announced \u003ca title=\"Certified Enrollment Entities\" href=\"http://hbex.coveredca.com/enrollment-entities/\" target=\"_blank\">$14.6 million in new grants \u003c/a>to community groups \"that have a track record,\" Lee said, of direct outreach to diverse groups, in multiple languages. An additional $33.4 million had previously been awarded.\u003c/p>\n\u003cp>Officials also announced a $46 million statewide advertising campaign rolling out this week, in specific markets. The total budget for outreach and marketing is $94 million.\u003c/p>\n\u003cp>Lee spoke of lessons learned from the first open enrollment, including that many people prefer face-to-face counseling, as opposed to signing up online. \"There's no such thing as one touch and done,\" he said. \"It's going to take multiple conversations.\"\u003c/p>\n\u003cp>Covered California is also adding more staff at its three call centers. Spokesman Roy Kennedy said that at the end of the last open enrollment, there were 709 service center representatives. Kennedy said that Covered California \"hope(s) to have 950 in place for the beginning of the upcoming open enrollment\" which starts Nov. 15.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Call center wait times were often quite long during last year's open enrollment. \"Knock on wood, we'll have fast answer time,\" Lee said. \"We were swamped last year.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_21524\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/LeaburnAlexander-e1410531393794.jpg\">\u003cimg class=\"size-large wp-image-21524\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/LeaburnAlexander-640x427.jpg\" alt=\"Leaburn Alexander works two jobs and does not have health insurance. Here, he is on the start of his 3-hour commute home from the job he works as an overnight hotel janitor. (Lisa Morehouse/KQED)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Leaburn Alexander works two jobs and does not have health insurance. Here, he is on the start of his 3-hour commute home from the job he works as an overnight hotel janitor. (Lisa Morehouse/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lisa Morehouse\u003c/strong>\u003c/p>\n\u003cp>When the Affordable Care Act rolled out last fall, Californians enrolled in both Covered California and expanded Medi-Cal\u003ca title=\"Obamacare: More than 3.3 Million Californians Signed Up\" href=\"http://ww2.kqed.org/stateofhealth/2014/04/17/final-obamacare-open-enrollment-more-than-3-3-million-californians-signed-up/\" target=\"_blank\"> in high numbers\u003c/a>. But there are still millions in the state without health insurance. Undocumented people don’t qualify for Obamacare benefits. Many others still find coverage too expensive, or face other obstacles in enrolling.\u003c/p>\n\u003cp>One of those people is Leaburn Alexander. I meet up with him at 6 a.m. as he is finishing his shift as the night janitor at a hotel near the San Francisco Airport. He clocks out just in time to catch the hotel's shuttle back to SFO, where he will catch a bus.\u003c/p>\n\u003cp>\"Right now I’m on the beginning of my commute,\" he tells me. \"After an eight hour shift, my commute is like 2 and a half hours.\"\u003c/p>\n\u003cp>I accompany Alexander on his commute to East Palo Alto, about 20 miles south. It actually takes three hours, on the hotel shuttle plus three more buses. He does this commute 5 days a week.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Alexander doesn't have a car. The train would be faster, but cost three times as much. Alexander has no wiggle room in his budget.\u003c/p>\n\u003cp>He says he makes just under $11 an hour, and after taxes, child support and other expenses, he brings home just enough to cover rent. And all the other bills? He has a second job to cover those. His wife has been looking for work for over a year, and his oldest daughter is in college. Alexander doesn’t have health insurance.\u003c/p>\n\u003cp>\"When I first got this job,\" he says, of his night janitor position, \"they informed me about different employee packages, different benefits and all that.\u003c/p>\n\u003cp>But Alexander says he can’t afford the employee portion of the health insurance premium. Many people who are working lower wage jobs may qualify for Medi-Cal, California's version of Medicaid, if their incomes are low enough. But because Alexander had been turned down for Medi-Cal in the past, he presumed he still wouldn’t qualify, even under Obamacare.\u003c/p>\n\u003cp>Earlier this year, he went to get a physical at a community clinic, and they tried to sign him up for a county program. But even the $20 a month payment was too steep for his budget.\u003c/p>\n\u003cp>While he'd like to be insured, Alexander, 53, says he feels pretty healthy.\u003c/p>\n\u003cp>\"I mean, there’s times where I’d be tired from fatigue and my age, a little arthritis, but I still feel pretty good,\" he says. \"But what might be going on inside of me is a different story.\"\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167433325&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>Alexander’s blood pressure is high. He got free pills free from a clinic and plans to return when he runs out.\u003c/p>\n\u003cp>The only time in his adult life when he had health care was when he was incarcerated. He had substance abuse issues and was involved in a bank robbery. He says he had tried recovery programs, but didn't succeed, until he became a born-again Christian.\u003c/p>\n\u003cp>\"That was divine intervention. It really happened,\" he says. \"I been clean and sober since July, 2011.\"\u003c/p>\n\u003cp>And so he’s grateful for what he’s got. He just doesn’t know how he’d get insurance right now.\u003c/p>\n\u003cp>\u003cstrong>The Remaining Uninsured\u003c/strong>\u003c/p>\n\u003cp>Uninsured Californians fall into a few categories, says Laurel Lucia with the U.C. Berkeley Labor Center. One is called the \"family glitch.\"\u003c/p>\n\u003cp>\"Basically spouses and children who can get coverage through a family member’s employer but it’s too expensive,\" she says.\u003c/p>\n\u003cp>Sometimes the employee part of the premium is affordable, but the family coverage is much higher. But because the employer made an offer of insurance to family members, \"(w)hen they go to Covered California they’re told they’re ineligible for subsidies,\" Lucia says. It's part of federal policy.\u003c/p>\n\u003cp>A second uninsured group is Californians who are eligible for subsidies through Covered California -- but still find the premiums unaffordable.\u003c/p>\n\u003cp>Finally, Lucia says there may be nearly one million Californians who are eligible for Medi-Cal but don’t know it, or have had difficulties enrolling.\u003c/p>\n\u003cp>It's unclear exactly which category Alexander may fit into.\u003c/p>\n\u003cp>\u003cstrong>The Enrollment Counselor's Perspective\u003c/strong>\u003c/p>\n\u003cp>Over in East Palo Alto, Irais Bazan is an enrollment and eligibility manager at the Ravenswood Family Health Clinic. Bazan has met people in all of those uninsured categories -- and more.\u003c/p>\n\u003cp>\"Situations can change at any minute,\" she said. \"So we’re adamant with clients, any changes, as little as you may think\" must be reported right away. Things like adding a dependent -- or subtracting one, if you are no longer declaring a child as a dependent on your taxes. Or even small changes in income may make a difference.\u003c/p>\n\u003cp>\"You have to come back, let us know,\" she says. \"Sometimes these rules for these programs change.\"\u003c/p>\n\u003cp>And someone who thought they weren’t eligible for Medi-Cal or Covered California subsidies before may be eligible now. That may describe Leaburn Alexander. But while coming back to the clinic sounds like a minor hassle, for him, it's a big barrier.\u003c/p>\n\u003cp>\"Scheduling time to do that, an appointment. It’s kind of rough, kind of hard right now,\" Alexander says.\u003c/p>\n\u003cp>Just as Alexander has no wiggle room in his budget, he has precious little wiggle room in his schedule. After he wraps his overnight janitor job, he heads to a second job, washing dishes at a Stanford dining hall. He says he gets his sleep in 20 and 30 minute naps on his hours-long daily commute.\u003c/p>\n\u003cp>He has one full morning off each week, the only time he could meet with an enrollment counselor to update his family status, present income verification for himself and his wife, and see if he qualifies for health coverage. But that time is taken up with other needs of daily life.\u003c/p>\n\u003cp>\"Come Wednesday,\" he says, about his morning off, \"that’s when my pastor comes and gets us and takes us grocery shopping.\"\u003c/p>\n\u003cp>Alexander remains optimistic that his situation will improve.\u003c/p>\n\u003cp>\"I’m hopeful that through prayer that God will bless me with a better paying job,\" he told me. \"I got a feeling, that’s coming. Because He knows my situation.\"\u003c/p>\n\u003cp>Alexander hopes that job will be closer to home, and that he’ll have the time and money to get health coverage.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Lisa Morehouse produced this story while participating in \u003ca title=\"Health Journalism Fellowships\" href=\"http://www.reportingonhealth.org/fellowships/seminars\" target=\"_blank\">The California Endowment Health Journalism Fellowships\u003c/a>, a program of USC's Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21524\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/LeaburnAlexander-e1410531393794.jpg\">\u003cimg class=\"size-large wp-image-21524\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/LeaburnAlexander-640x427.jpg\" alt=\"Leaburn Alexander works two jobs and does not have health insurance. Here, he is on the start of his 3-hour commute home from the job he works as an overnight hotel janitor. (Lisa Morehouse/KQED)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Leaburn Alexander works two jobs and does not have health insurance. Here, he is on the start of his 3-hour commute home from the job he works as an overnight hotel janitor. (Lisa Morehouse/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lisa Morehouse\u003c/strong>\u003c/p>\n\u003cp>When the Affordable Care Act rolled out last fall, Californians enrolled in both Covered California and expanded Medi-Cal\u003ca title=\"Obamacare: More than 3.3 Million Californians Signed Up\" href=\"http://ww2.kqed.org/stateofhealth/2014/04/17/final-obamacare-open-enrollment-more-than-3-3-million-californians-signed-up/\" target=\"_blank\"> in high numbers\u003c/a>. But there are still millions in the state without health insurance. Undocumented people don’t qualify for Obamacare benefits. Many others still find coverage too expensive, or face other obstacles in enrolling.\u003c/p>\n\u003cp>One of those people is Leaburn Alexander. I meet up with him at 6 a.m. as he is finishing his shift as the night janitor at a hotel near the San Francisco Airport. He clocks out just in time to catch the hotel's shuttle back to SFO, where he will catch a bus.\u003c/p>\n\u003cp>\"Right now I’m on the beginning of my commute,\" he tells me. \"After an eight hour shift, my commute is like 2 and a half hours.\"\u003c/p>\n\u003cp>I accompany Alexander on his commute to East Palo Alto, about 20 miles south. It actually takes three hours, on the hotel shuttle plus three more buses. He does this commute 5 days a week.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Alexander doesn't have a car. The train would be faster, but cost three times as much. Alexander has no wiggle room in his budget.\u003c/p>\n\u003cp>He says he makes just under $11 an hour, and after taxes, child support and other expenses, he brings home just enough to cover rent. And all the other bills? He has a second job to cover those. His wife has been looking for work for over a year, and his oldest daughter is in college. Alexander doesn’t have health insurance.\u003c/p>\n\u003cp>\"When I first got this job,\" he says, of his night janitor position, \"they informed me about different employee packages, different benefits and all that.\u003c/p>\n\u003cp>But Alexander says he can’t afford the employee portion of the health insurance premium. Many people who are working lower wage jobs may qualify for Medi-Cal, California's version of Medicaid, if their incomes are low enough. But because Alexander had been turned down for Medi-Cal in the past, he presumed he still wouldn’t qualify, even under Obamacare.\u003c/p>\n\u003cp>Earlier this year, he went to get a physical at a community clinic, and they tried to sign him up for a county program. But even the $20 a month payment was too steep for his budget.\u003c/p>\n\u003cp>While he'd like to be insured, Alexander, 53, says he feels pretty healthy.\u003c/p>\n\u003cp>\"I mean, there’s times where I’d be tired from fatigue and my age, a little arthritis, but I still feel pretty good,\" he says. \"But what might be going on inside of me is a different story.\"\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167433325&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>Alexander’s blood pressure is high. He got free pills free from a clinic and plans to return when he runs out.\u003c/p>\n\u003cp>The only time in his adult life when he had health care was when he was incarcerated. He had substance abuse issues and was involved in a bank robbery. He says he had tried recovery programs, but didn't succeed, until he became a born-again Christian.\u003c/p>\n\u003cp>\"That was divine intervention. It really happened,\" he says. \"I been clean and sober since July, 2011.\"\u003c/p>\n\u003cp>And so he’s grateful for what he’s got. He just doesn’t know how he’d get insurance right now.\u003c/p>\n\u003cp>\u003cstrong>The Remaining Uninsured\u003c/strong>\u003c/p>\n\u003cp>Uninsured Californians fall into a few categories, says Laurel Lucia with the U.C. Berkeley Labor Center. One is called the \"family glitch.\"\u003c/p>\n\u003cp>\"Basically spouses and children who can get coverage through a family member’s employer but it’s too expensive,\" she says.\u003c/p>\n\u003cp>Sometimes the employee part of the premium is affordable, but the family coverage is much higher. But because the employer made an offer of insurance to family members, \"(w)hen they go to Covered California they’re told they’re ineligible for subsidies,\" Lucia says. It's part of federal policy.\u003c/p>\n\u003cp>A second uninsured group is Californians who are eligible for subsidies through Covered California -- but still find the premiums unaffordable.\u003c/p>\n\u003cp>Finally, Lucia says there may be nearly one million Californians who are eligible for Medi-Cal but don’t know it, or have had difficulties enrolling.\u003c/p>\n\u003cp>It's unclear exactly which category Alexander may fit into.\u003c/p>\n\u003cp>\u003cstrong>The Enrollment Counselor's Perspective\u003c/strong>\u003c/p>\n\u003cp>Over in East Palo Alto, Irais Bazan is an enrollment and eligibility manager at the Ravenswood Family Health Clinic. Bazan has met people in all of those uninsured categories -- and more.\u003c/p>\n\u003cp>\"Situations can change at any minute,\" she said. \"So we’re adamant with clients, any changes, as little as you may think\" must be reported right away. Things like adding a dependent -- or subtracting one, if you are no longer declaring a child as a dependent on your taxes. Or even small changes in income may make a difference.\u003c/p>\n\u003cp>\"You have to come back, let us know,\" she says. \"Sometimes these rules for these programs change.\"\u003c/p>\n\u003cp>And someone who thought they weren’t eligible for Medi-Cal or Covered California subsidies before may be eligible now. That may describe Leaburn Alexander. But while coming back to the clinic sounds like a minor hassle, for him, it's a big barrier.\u003c/p>\n\u003cp>\"Scheduling time to do that, an appointment. It’s kind of rough, kind of hard right now,\" Alexander says.\u003c/p>\n\u003cp>Just as Alexander has no wiggle room in his budget, he has precious little wiggle room in his schedule. After he wraps his overnight janitor job, he heads to a second job, washing dishes at a Stanford dining hall. He says he gets his sleep in 20 and 30 minute naps on his hours-long daily commute.\u003c/p>\n\u003cp>He has one full morning off each week, the only time he could meet with an enrollment counselor to update his family status, present income verification for himself and his wife, and see if he qualifies for health coverage. But that time is taken up with other needs of daily life.\u003c/p>\n\u003cp>\"Come Wednesday,\" he says, about his morning off, \"that’s when my pastor comes and gets us and takes us grocery shopping.\"\u003c/p>\n\u003cp>Alexander remains optimistic that his situation will improve.\u003c/p>\n\u003cp>\"I’m hopeful that through prayer that God will bless me with a better paying job,\" he told me. \"I got a feeling, that’s coming. Because He knows my situation.\"\u003c/p>\n\u003cp>Alexander hopes that job will be closer to home, and that he’ll have the time and money to get health coverage.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Lisa Morehouse produced this story while participating in \u003ca title=\"Health Journalism Fellowships\" href=\"http://www.reportingonhealth.org/fellowships/seminars\" target=\"_blank\">The California Endowment Health Journalism Fellowships\u003c/a>, a program of USC's Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Income Verifications Lead to Canceled Coverage",
"title": "Covered California Income Verifications Lead to Canceled Coverage",
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"content": "\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Judy Lin, Associated Press\u003c/strong>\u003c/p>\n\u003cp>Some Californians who purchased individual health coverage through the state's insurance exchange are suddenly being dropped or transferred to Medi-Cal, the state Medicaid program for the poor that fewer doctors and providers accept.\u003c/p>\n\u003cp>Covered California, which is responsible for determining and directing Californians to an appropriate health plan, has no estimate of how many people are affected, saying only that the changes are occurring as incomes are checked to verify the policyholders can purchase insurance through the exchange.\u003c/p>\n\u003cp>Since the shifts often happen without warning, there's confusion and anger among policyholders.\u003c/p>\n\u003cp>Glendale resident Andrea Beckum learned last month that she and her husband had been shunted to Medi-Cal only after getting a call from their insurance broker telling them their Anthem Blue Cross policy had been canceled.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It's a mystery because they make above the $21,707 threshold for two people to qualify for Medi-Cal, she said.\u003c/p>\n\u003cp>When the couple met with Los Angeles County social service workers, they were told they make too much to qualify for Medi-Cal. Now they are uninsured and considering an appeal.\u003c/p>\n\u003cp>\"That's the crazy part,\" said Beckum, 35, a part-time neuropsychology researcher. \"Even if we were in Medi-Cal, we don't qualify for Medi-Cal.\"\u003c/p>\n\u003cp>Covered California launched the online marketplace in October 2013 as part of the state's implementation of the federal Affordable Care Act. The exchange offers sliding-scale subsidies for private coverage to lower-income and middle-class people with no access to health insurance on the job, and directs the poor to county social service offices for Medi-Cal.\u003c/p>\n\u003cp>Assemblyman Richard Pan, D-Sacramento, who chairs the Assembly Health Committee, said he will hold a hearing on Sept. 23 and look, among other things, at why people are losing coverage and what can be done to reduce interruptions.\u003c/p>\n\u003cp>\"Implementing the Affordable Care Act, clearly it's not something that just stops at the end of open enrollment,\" Pan said. \"There are ongoing issues.\"\u003c/p>\n\u003cp>Officials at Covered California acknowledged that a number of people are being shifted around during income checks and eligibility updates.\u003c/p>\n\u003cp>\"It will happen continually,\" spokesman Dana Howard said.\u003c/p>\n\u003cp>This year, he said, the exchange adjusted its income eligibility scale when the federal government updated the poverty scale. As a result, Howard said, people near the thresholds are sometimes moved between private health plans and Medi-Cal. The checks might also determine that some people make too much money to receive a subsidy.\u003c/p>\n\u003cp>Covered California said the goal is to make sure that the 1.2 million people who were determined to be eligible for a subsidy receive the appropriate amount. Overall, 1.4 million people are enrolled with a health plan through the exchange.\u003c/p>\n\u003cp>The exchange could not provide an estimate of how much in subsidies Californians have qualified for this year.\u003c/p>\n\u003cp>Officials say they are researching the Beckums' case.\u003c/p>\n\u003cp>\"I don't have the complete picture yet to share,\" said Larry Hicks, another spokesman.\u003c/p>\n\u003cp>During the past few weeks, Beckum has been on a frustration-filled journey marked by long trips to the welfare office and extended telephone calls with Covered California. She believes the cancellation of their coverage stems from a mistake by a Covered California service representative who entered the wrong income, and she has been unable to get the exchange to resolve her case.\u003c/p>\n\u003cp>\"It's one of the worst things I've ever dealt with,\" she said. \"It's total incompetence.\"\u003c/p>\n\u003cp>The Beckums are now stuck with a $519 bill for a mammogram she had after they lost coverage.\u003c/p>\n\u003cp>Evette Tsang, a Sacramento insurance agent, said some of her clients unexpectedly received Medi-Cal cards even though they were content with the plan they purchased through the exchange.\u003c/p>\n\u003cp>\"There's a lot of people who have never been on Medi-Cal, and they don't want to. You hear the service is not as good, providers are not easy to find,\" Tsang said.\u003c/p>\n\u003cp>Tsang said she has had mixed results trying to fix her clients' problems. She was able to help one small business owner keep her health plan after Covered California entered her roughly $42,000 household income as $70,000. Another client became pregnant and was shifted to Medi-Cal.\u003c/p>\n\u003cp>\"I told her, `I cannot help you,' \" said Tsang, \u003ca title='Center for Health Reporting \"Ask Emily\" Column' href=\"http://centerforhealthreporting.org/article/does-covered-california-really-have-you-covered\" target=\"_blank\">who first raised concerns to Emily Bazar\u003c/a>, a senior writer at the California HealthCare Foundation's Center for Health Reporting.\u003c/p>\n\u003cp>Covered California's Facebook page is filled with people expressing anger about policy cancellations, unfixed errors and poor customer service.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I know that Covered California is working on that but we need ... to be sure that people don't have interruption in their coverage,\" Pan said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Judy Lin, Associated Press\u003c/strong>\u003c/p>\n\u003cp>Some Californians who purchased individual health coverage through the state's insurance exchange are suddenly being dropped or transferred to Medi-Cal, the state Medicaid program for the poor that fewer doctors and providers accept.\u003c/p>\n\u003cp>Covered California, which is responsible for determining and directing Californians to an appropriate health plan, has no estimate of how many people are affected, saying only that the changes are occurring as incomes are checked to verify the policyholders can purchase insurance through the exchange.\u003c/p>\n\u003cp>Since the shifts often happen without warning, there's confusion and anger among policyholders.\u003c/p>\n\u003cp>Glendale resident Andrea Beckum learned last month that she and her husband had been shunted to Medi-Cal only after getting a call from their insurance broker telling them their Anthem Blue Cross policy had been canceled.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It's a mystery because they make above the $21,707 threshold for two people to qualify for Medi-Cal, she said.\u003c/p>\n\u003cp>When the couple met with Los Angeles County social service workers, they were told they make too much to qualify for Medi-Cal. Now they are uninsured and considering an appeal.\u003c/p>\n\u003cp>\"That's the crazy part,\" said Beckum, 35, a part-time neuropsychology researcher. \"Even if we were in Medi-Cal, we don't qualify for Medi-Cal.\"\u003c/p>\n\u003cp>Covered California launched the online marketplace in October 2013 as part of the state's implementation of the federal Affordable Care Act. The exchange offers sliding-scale subsidies for private coverage to lower-income and middle-class people with no access to health insurance on the job, and directs the poor to county social service offices for Medi-Cal.\u003c/p>\n\u003cp>Assemblyman Richard Pan, D-Sacramento, who chairs the Assembly Health Committee, said he will hold a hearing on Sept. 23 and look, among other things, at why people are losing coverage and what can be done to reduce interruptions.\u003c/p>\n\u003cp>\"Implementing the Affordable Care Act, clearly it's not something that just stops at the end of open enrollment,\" Pan said. \"There are ongoing issues.\"\u003c/p>\n\u003cp>Officials at Covered California acknowledged that a number of people are being shifted around during income checks and eligibility updates.\u003c/p>\n\u003cp>\"It will happen continually,\" spokesman Dana Howard said.\u003c/p>\n\u003cp>This year, he said, the exchange adjusted its income eligibility scale when the federal government updated the poverty scale. As a result, Howard said, people near the thresholds are sometimes moved between private health plans and Medi-Cal. The checks might also determine that some people make too much money to receive a subsidy.\u003c/p>\n\u003cp>Covered California said the goal is to make sure that the 1.2 million people who were determined to be eligible for a subsidy receive the appropriate amount. Overall, 1.4 million people are enrolled with a health plan through the exchange.\u003c/p>\n\u003cp>The exchange could not provide an estimate of how much in subsidies Californians have qualified for this year.\u003c/p>\n\u003cp>Officials say they are researching the Beckums' case.\u003c/p>\n\u003cp>\"I don't have the complete picture yet to share,\" said Larry Hicks, another spokesman.\u003c/p>\n\u003cp>During the past few weeks, Beckum has been on a frustration-filled journey marked by long trips to the welfare office and extended telephone calls with Covered California. She believes the cancellation of their coverage stems from a mistake by a Covered California service representative who entered the wrong income, and she has been unable to get the exchange to resolve her case.\u003c/p>\n\u003cp>\"It's one of the worst things I've ever dealt with,\" she said. \"It's total incompetence.\"\u003c/p>\n\u003cp>The Beckums are now stuck with a $519 bill for a mammogram she had after they lost coverage.\u003c/p>\n\u003cp>Evette Tsang, a Sacramento insurance agent, said some of her clients unexpectedly received Medi-Cal cards even though they were content with the plan they purchased through the exchange.\u003c/p>\n\u003cp>\"There's a lot of people who have never been on Medi-Cal, and they don't want to. You hear the service is not as good, providers are not easy to find,\" Tsang said.\u003c/p>\n\u003cp>Tsang said she has had mixed results trying to fix her clients' problems. She was able to help one small business owner keep her health plan after Covered California entered her roughly $42,000 household income as $70,000. Another client became pregnant and was shifted to Medi-Cal.\u003c/p>\n\u003cp>\"I told her, `I cannot help you,' \" said Tsang, \u003ca title='Center for Health Reporting \"Ask Emily\" Column' href=\"http://centerforhealthreporting.org/article/does-covered-california-really-have-you-covered\" target=\"_blank\">who first raised concerns to Emily Bazar\u003c/a>, a senior writer at the California HealthCare Foundation's Center for Health Reporting.\u003c/p>\n\u003cp>Covered California's Facebook page is filled with people expressing anger about policy cancellations, unfixed errors and poor customer service.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I know that Covered California is working on that but we need ... to be sure that people don't have interruption in their coverage,\" Pan said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>by Mark Sherman\u003cbr>\nAssociated Press\u003c/strong>\u003c/p>\n\u003cp>The federal appeals court in Washington threw out a ruling Thursday that called into question the subsidies that help millions of low- and middle-income people afford their premiums under the president's health care law.\u003c/p>\n\u003cfigure id=\"attachment_15375\" class=\"wp-caption alignleft\" style=\"max-width: 275px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/6865_transform.jpg\">\u003cimg class=\" wp-image-15375\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/6865_transform.jpg\" alt=\"A woman looks at the HealthCare.gov insurance exchange on October 1, 2013 in Washington, DC. (Karen Bleier/AFP/Getty Images)\" width=\"275\" height=\"155\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/6865_transform.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/6865_transform-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/6865_transform-320x180.jpg 320w\" sizes=\"(max-width: 275px) 100vw, 275px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A woman looks at the HealthCare.gov insurance exchange on October 1, 2013 in Washington, DC. (Karen Bleier/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The U.S. Circuit Court of Appeals for the District of Columbia granted an Obama administration request to have its full complement of judges re-hear a challenge to regulations that allow health insurance tax credits under the Affordable Care Act for consumers in all 50 states.\u003c/p>\n\u003cp>The announcement diminishes the prospect of Supreme Court review of the issue in the near term. The initial 2-1 appeals court ruling in Washington came out the same day that a panel of appellate judges in Richmond, Virginia, unanimously sided with the administration on the same issue.\u003c/p>\n\u003cp>The health law's opponents had hoped that the split rulings would lead the high court to take up the issue soon.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, the argument in the federal courthouse just a few blocks from the Supreme Court will take place on December 17.\u003c/p>\n\u003cp>If the full court comes out in favor of the administration, the prospect of Supreme Court involvement would be greatly reduced. On the other hand, if the full Washington court essentially reinstates the original decision, then the Supreme Court would almost certainly weigh in. Under that scenario, the justices probably would not render a decision until the spring of 2016.\u003c/p>\n\u003cp>In the first appellate ruling on July 22, two Republican-appointed judges ruled against the administration, with a Democratic appointee dissenting. They said that under the law, financial aid can be provided only in states that have set up their own insurance markets, or exchanges. The unanimous Richmond panel that upheld the law's financing was made up of three Democrats.\u003c/p>\n\u003cp>The Washington court that will hear the case has seven judges appointed by Democratic presidents, including four by Obama, and four by Republican presidents. Two senior judges on the initial panel, one Democrat and one Republican, also may choose to weigh in, under appeals court rules.\u003c/p>\n\u003cp>The fight over subsidies is part of a long-running political and legal campaign to overturn Obama's signature domestic legislation by Republicans and other opponents of the law.\u003c/p>\n\u003cp>In the Washington case, Halbig v. Burwell, a group of small business owners argued that the law authorizes subsidies only for people who buy insurance through markets established by the states — not by the federal government, which runs the markets, or exchanges, in 36 states.\u003c/p>\n\u003cp>If the challengers succeed, more than half the 8 million Americans who have purchased taxpayer-subsidized private insurance under the law could face hefty increases in their insurance premiums.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For those federal exchange consumers, it would result in an average premium increase of 76 percent. Customers now pay $82 on average on total monthly premiums averaging $346. The federal subsidy of $264 a month makes up the rest of the premium.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>by Mark Sherman\u003cbr>\nAssociated Press\u003c/strong>\u003c/p>\n\u003cp>The federal appeals court in Washington threw out a ruling Thursday that called into question the subsidies that help millions of low- and middle-income people afford their premiums under the president's health care law.\u003c/p>\n\u003cfigure id=\"attachment_15375\" class=\"wp-caption alignleft\" style=\"max-width: 275px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/6865_transform.jpg\">\u003cimg class=\" wp-image-15375\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/6865_transform.jpg\" alt=\"A woman looks at the HealthCare.gov insurance exchange on October 1, 2013 in Washington, DC. (Karen Bleier/AFP/Getty Images)\" width=\"275\" height=\"155\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/6865_transform.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/6865_transform-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/6865_transform-320x180.jpg 320w\" sizes=\"(max-width: 275px) 100vw, 275px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A woman looks at the HealthCare.gov insurance exchange on October 1, 2013 in Washington, DC. (Karen Bleier/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The U.S. Circuit Court of Appeals for the District of Columbia granted an Obama administration request to have its full complement of judges re-hear a challenge to regulations that allow health insurance tax credits under the Affordable Care Act for consumers in all 50 states.\u003c/p>\n\u003cp>The announcement diminishes the prospect of Supreme Court review of the issue in the near term. The initial 2-1 appeals court ruling in Washington came out the same day that a panel of appellate judges in Richmond, Virginia, unanimously sided with the administration on the same issue.\u003c/p>\n\u003cp>The health law's opponents had hoped that the split rulings would lead the high court to take up the issue soon.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, the argument in the federal courthouse just a few blocks from the Supreme Court will take place on December 17.\u003c/p>\n\u003cp>If the full court comes out in favor of the administration, the prospect of Supreme Court involvement would be greatly reduced. On the other hand, if the full Washington court essentially reinstates the original decision, then the Supreme Court would almost certainly weigh in. Under that scenario, the justices probably would not render a decision until the spring of 2016.\u003c/p>\n\u003cp>In the first appellate ruling on July 22, two Republican-appointed judges ruled against the administration, with a Democratic appointee dissenting. They said that under the law, financial aid can be provided only in states that have set up their own insurance markets, or exchanges. The unanimous Richmond panel that upheld the law's financing was made up of three Democrats.\u003c/p>\n\u003cp>The Washington court that will hear the case has seven judges appointed by Democratic presidents, including four by Obama, and four by Republican presidents. Two senior judges on the initial panel, one Democrat and one Republican, also may choose to weigh in, under appeals court rules.\u003c/p>\n\u003cp>The fight over subsidies is part of a long-running political and legal campaign to overturn Obama's signature domestic legislation by Republicans and other opponents of the law.\u003c/p>\n\u003cp>In the Washington case, Halbig v. Burwell, a group of small business owners argued that the law authorizes subsidies only for people who buy insurance through markets established by the states — not by the federal government, which runs the markets, or exchanges, in 36 states.\u003c/p>\n\u003cp>If the challengers succeed, more than half the 8 million Americans who have purchased taxpayer-subsidized private insurance under the law could face hefty increases in their insurance premiums.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For those federal exchange consumers, it would result in an average premium increase of 76 percent. Customers now pay $82 on average on total monthly premiums averaging $346. The federal subsidy of $264 a month makes up the rest of the premium.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "People Found Ineligible for Obamacare Coverage Must Repay Subsidies",
"title": "People Found Ineligible for Obamacare Coverage Must Repay Subsidies",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The rule primarily affects immigrants. Many people have not provided sufficient documentation to prove lawful presence or citizenship in California.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Appleby\u003c/strong>\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/August/29/treasury-department-obamacare-insurance-subsidies.aspx\" target=\"_blank\">, Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Consumers getting government subsidies for health insurance who are later found ineligible for those payments will owe the government, but not necessarily the full amount, according to the Treasury Department.\u003c/p>\n\u003caside class=\"pullquote alignleft\">100,000 Californians must provide proof of legal residency or lose eligibility for subsidies. \u003c/aside>\n\u003cp>The clarified rule could affect some of the 300,000 people enrolled in a health plan through healthcare.gov. They face a Sept. 5 deadline to submit additional documents to confirm their citizenship or immigration status, and also apply broadly to anyone ultimately deemed ineligible for subsidies.\u003c/p>\n\u003cp>California runs its own exchange and is on a different timeline. Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/29/people-found-ineligible-for-obamacare-coverage-must-repay-subsidies/\" target=\"_blank\">will send notices\u003c/a> starting next week to 100,000 people affected. They have until September 30 to respond. \u003c!--more-->\u003c/p>\n\u003cp>First reported by the newsletter\u003ca href=\"http://www.insidehealthpolicy.com/login-redirect-no-cookie?n=78396&destination=node/78396\" target=\"_blank\"> Inside Health Policy on Thursday\u003c/a>, the clarification \u003ca href=\"http://ccf.georgetown.edu/all/help-us-spread-the-word-deadline-one-week-away-for-immigrant-communities-needing-to-verify-marketplace-eligibility/\" target=\"_blank\">worries immigration advocates\u003c/a>, who say many residents don’t know about the requirement. If people do not provide the necessary information, they could be deemed ineligible for subsidies and lose their coverage.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If found ineligible, residents could owe thousands of dollars.\u003c/p>\n\u003cp>Under the health law, people who earn between 100 percent and 400 percent of the federal poverty level, about $11,670 to $46,680 for an individual this year, \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/july/24/interview-with-cathy-livingston-on-how-to-apply-for-tax-credit-subsidies-for-premiums.aspx\" target=\"_blank\">are eligible for premium subsidies\u003c/a> to help them purchase coverage if they buy through the new state and federal marketplaces, such as healthcare.gov.\u003c/p>\n\u003cp>Some exceptions apply. For example, undocumented immigrants cannot enroll in coverage through the new marketplaces. And people with job-based insurance that meets the law’s requirements are not allowed to get a subsidy, no matter their income.\u003c/p>\n\u003cp>A Treasury official said an enrollee who gets such an advance tax credit, but is later found ineligible to have received it, would have to pay those amounts back, generally through a tax refund reduction.\u003c/p>\n\u003cp>Such a rule would not just affect the 300,000 immigrants who have received notices requesting additional information. It could also apply to someone who had job-based insurance, for example, but was approved incorrectly for a subsidy through the new marketplaces. If later found ineligible because of that job-based coverage, that person would also owe the government what was paid to insurers on his behalf.\u003c/p>\n\u003cp>What’s less clear is how much an ineligible person would have to pay.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The health law caps repayments for subsidy-eligible lower income residents to between $300 and $2,500, depending on family size and income, \u003ca href=\"http://www.irs.gov/uac/Newsroom/IRS-Now-is-the-Time-for-a-Mid-Year-Premium-Tax-Credit-Checkup\" target=\"_blank\">according to the Internal Revenue Service\u003c/a>. But people who earn more than four times the federal poverty rate must pay any subsidies received back in full, with no cap. Whether those caps apply to people who received subsidies but were later deemed ineligible is not clear.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The rule primarily affects immigrants. Many people have not provided sufficient documentation to prove lawful presence or citizenship in California.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Appleby\u003c/strong>\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/August/29/treasury-department-obamacare-insurance-subsidies.aspx\" target=\"_blank\">, Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Consumers getting government subsidies for health insurance who are later found ineligible for those payments will owe the government, but not necessarily the full amount, according to the Treasury Department.\u003c/p>\n\u003caside class=\"pullquote alignleft\">100,000 Californians must provide proof of legal residency or lose eligibility for subsidies. \u003c/aside>\n\u003cp>The clarified rule could affect some of the 300,000 people enrolled in a health plan through healthcare.gov. They face a Sept. 5 deadline to submit additional documents to confirm their citizenship or immigration status, and also apply broadly to anyone ultimately deemed ineligible for subsidies.\u003c/p>\n\u003cp>California runs its own exchange and is on a different timeline. Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/29/people-found-ineligible-for-obamacare-coverage-must-repay-subsidies/\" target=\"_blank\">will send notices\u003c/a> starting next week to 100,000 people affected. They have until September 30 to respond. \u003c!--more-->\u003c/p>\n\u003cp>First reported by the newsletter\u003ca href=\"http://www.insidehealthpolicy.com/login-redirect-no-cookie?n=78396&destination=node/78396\" target=\"_blank\"> Inside Health Policy on Thursday\u003c/a>, the clarification \u003ca href=\"http://ccf.georgetown.edu/all/help-us-spread-the-word-deadline-one-week-away-for-immigrant-communities-needing-to-verify-marketplace-eligibility/\" target=\"_blank\">worries immigration advocates\u003c/a>, who say many residents don’t know about the requirement. If people do not provide the necessary information, they could be deemed ineligible for subsidies and lose their coverage.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If found ineligible, residents could owe thousands of dollars.\u003c/p>\n\u003cp>Under the health law, people who earn between 100 percent and 400 percent of the federal poverty level, about $11,670 to $46,680 for an individual this year, \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/july/24/interview-with-cathy-livingston-on-how-to-apply-for-tax-credit-subsidies-for-premiums.aspx\" target=\"_blank\">are eligible for premium subsidies\u003c/a> to help them purchase coverage if they buy through the new state and federal marketplaces, such as healthcare.gov.\u003c/p>\n\u003cp>Some exceptions apply. For example, undocumented immigrants cannot enroll in coverage through the new marketplaces. And people with job-based insurance that meets the law’s requirements are not allowed to get a subsidy, no matter their income.\u003c/p>\n\u003cp>A Treasury official said an enrollee who gets such an advance tax credit, but is later found ineligible to have received it, would have to pay those amounts back, generally through a tax refund reduction.\u003c/p>\n\u003cp>Such a rule would not just affect the 300,000 immigrants who have received notices requesting additional information. It could also apply to someone who had job-based insurance, for example, but was approved incorrectly for a subsidy through the new marketplaces. If later found ineligible because of that job-based coverage, that person would also owe the government what was paid to insurers on his behalf.\u003c/p>\n\u003cp>What’s less clear is how much an ineligible person would have to pay.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The health law caps repayments for subsidy-eligible lower income residents to between $300 and $2,500, depending on family size and income, \u003ca href=\"http://www.irs.gov/uac/Newsroom/IRS-Now-is-the-Time-for-a-Mid-Year-Premium-Tax-Credit-Checkup\" target=\"_blank\">according to the Internal Revenue Service\u003c/a>. But people who earn more than four times the federal poverty rate must pay any subsidies received back in full, with no cap. Whether those caps apply to people who received subsidies but were later deemed ineligible is not clear.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California to Request Evidence of Lawful Presence in U.S. ",
"title": "Covered California to Request Evidence of Lawful Presence in U.S. ",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16890\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"wp-image-16890 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS8056_L1006917-lpr-300x200.jpg\" alt=\"CCHP enrollment counselor Kristen Chow explains Covered California and federal subsidies to a Chinese-language caller. Currently, more than 90 percent of the HMO's members are ethnically Chinese. (Marcus Teply/KQED)\" width=\"300\" height=\"200\">\u003cfigcaption class=\"wp-caption-text\">CCHP enrollment counselor explains Covered California and federal subsidies to a caller. (Marcus Teply/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Some enrollees who get their health insurance through Covered California, the state's Obamacare exchange, will be getting notices in the next few weeks requesting evidence that they are lawfully in the country.\u003c/p>\n\u003cp>Yesterday, many news outlets \u003ca href=\"http://online.wsj.com/articles/health-plans-to-end-without-proof-of-citizenship-1407870402\" target=\"_blank\">reported\u003c/a> on the Obama administration's announcement that it was sending letters to about 310,000 people who have signed up for insurance through the Affordable Care Act, but whose documentation of citizenship or legal immigration status was at odds with government records. From the \u003ca href=\"http://online.wsj.com/articles/health-plans-to-end-without-proof-of-citizenship-1407870402\" target=\"_blank\">Wall Street Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The Obama administration moved Tuesday to cut off health insurance for up to 310,000 people who signed up through the \u003cspan class=\"mandelbrot_refrag\">\u003ca class=\"mandelbrot_refrag\" style=\"color: #115b8f\" href=\"https://www.healthcare.gov/\" target=\"_blank\" rel=\"nofollow\">HealthCare.gov\u003c/a>\u003c/span> system unless they can provide documents in the next few weeks showing they are U.S. citizens or legal residents.\u003c/p>\n\u003cp>Those individuals have until Sept. 5 to send in additional information that could confirm they are in the U.S. legally, a condition of using the online insurance exchanges to obtain coverage.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->The Sept. 5 deadline, however, affects only those enrollees in states that rely on the federal exchange, as opposed to state exchanges like Covered California. Fourteen states run their own exchanges; the remaining 36 declined to create their own online insurance marketplaces due mostly to Republican opposition, leaving the federal government to service residents in those states.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Some enrollees will have 30 days to submit their documentation or risk having their insurance canceled.\u003c/aside>\n\u003cp>Covered California spokesman Roy Kennedy says the notices will go out in late August to \"consumers identified as not having provided sufficient evidence of lawful presence.\" These individuals will have 30 days to submit their documentation or risk having their insurance canceled.\u003c/p>\n\u003cp>The state doesn't know yet how many enrollees will need to submit such verification.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kennedy said those receiving the notices can upload the required documents, such as a permanent residence card, at the\u003ca href=\"https://www.coveredca.com/\" target=\"_blank\"> Covered California website\u003c/a> or work on their submissions through their insurance agent or enrollment counselor.\u003c/p>\n\u003cp>In addition to cancellation of their insurance, those who do not respond to the notices may also be required to pay back any federal subsidies they have received through the exchange, Kennedy said.\u003c/p>\n\u003cp>In July, the \u003cspan style=\"color: #000000\">Department of Health and Human Services Office of the Inspector General issued two reports stating the \u003ca href=\"http://www.reuters.com/article/2014/07/01/usa-healthcare-subsidies-idUSL2N0PC1M520140701\" target=\"_blank\">federal government did not properly verify eligibility\u003c/a> for receiving insurance through the federal exchange. \u003c/span>\u003c/p>\n\u003cp>One of the reports said California's exchange was deficient in not always verifying citizenship and lawful presence through the Department of Homeland Security.\u003c/p>\n\u003cp>You can \u003ca href=\"http://oig.hhs.gov/oas/reports/region9/91401000.pdf\" target=\"_blank\">read that report here\u003c/a>.\u003c/p>\n\u003cp>Here is yesterday's AP story on the notifications going out to those who use the federal exchange:\u003c/p>\n\u003cp>(AP) The clock is ticking for hundreds of thousands of people who have unresolved issues affecting their coverage under the new health care law.\u003c/p>\n\u003cp>The Obama administration said Tuesday that letters are going out to about 310,000 people whose citizenship or immigration details don't match what the government has on file.\u003c/p>\n\u003cp>These consumers need to send in their documentation by Sept. 5. Otherwise their coverage will end Sept. 30.\u003c/p>\n\u003cp>Of the 8 million people who signed up for private coverage through President Barack Obama's law, more than 2 million at one point had discrepancies of some sort that affected their eligibility. That number has been greatly reduced — but the remaining cases are proving difficult to resolve.\u003c/p>\n\u003cp>People living in the country illegally are not allowed to get coverage. Officials at the Health and Human Services Department said the letters will notify consumers with unresolved citizenship and immigration issues that they can upload their documents to the HealthCare.gov website or mail them in.\u003c/p>\n\u003cp>Most haven't responded to repeated outreach efforts, officials said. Hispanics, who historically have lagged in health insurance coverage, may account for a big share of the group.\u003c/p>\n\u003cp>Indeed, two states with large Latino populations top the list of unresolved cases. Florida has 93,800 cases, while Texas has 52,700. Georgia, Virginia and Pennsylvania round out the top five. The letters are being sent in English and Spanish.\u003c/p>\n\u003cp>The next five states are North Carolina, Illinois, Michigan, New Jersey and Louisiana.\u003c/p>\n\u003cp>The new policy affects the 36 states where the federal government has taken the lead in running online insurance markets created by the law. It's unclear how it will apply in places like California and New York, which are running their own insurance exchanges.\u003c/p>\n\u003cp>Some supporters of the law worried that eligible consumers might lose coverage due to record-keeping problems on the government's part, or because of something as mundane as letters getting lost in the mail.\u003c/p>\n\u003cp>\"Many of these people have issues because government files are incomplete,\" said Ron Pollack, executive director of the advocacy group Families USA. \"Many may feel that they have fully complied with what is necessary to get health coverage.\"\u003c/p>\n\u003cp>The number of problem cases was a lot larger only a few months ago, prompting criticism from congressional Republicans that the administration was signing up people ineligible under the law.\u003c/p>\n\u003cp>In May, there were nearly 970,000 people with citizenship or immigration problems. About half those cases have now been closed, officials said, and another 20 percent are being worked on actively. Officials have previously said that the overwhelming majority of cases are resolved in favor of the enrollee.\u003c/p>\n\u003cp>Consumers who have unresolved discrepancies over their incomes will get notices at a later date.\u003c/p>\n\u003cp>The new health law provides subsidized coverage to people with no access to health insurance on the job. More than 80 percent of those signed up are getting subsidies to help with their premiums and, in some cases, their copays and deductibles as well.\u003c/p>\n\u003cp>But those taxpayer subsidies are contingent on meeting a host of requirements. The amount of a consumer's premium tax credit can vary by income, family size, hometown and other factors. That can make getting covered through the law feel somewhat like doing your taxes.\u003c/p>\n\u003cp>The letters that started going out Tuesday won't be the final attempt to reach those with unresolved issues. HHS will try to contact each consumer two more times by phone and once via email. The administration is also working with local organizations to try to reach people directly in their homes.\u003c/p>\n\u003cp>Consumers can also contact HealthCare.gov's call center at 800-318-2596 to see what documents they need to submit and see whether their information has been received.\u003c/p>\n\u003cp>The notices affect this year's coverage only.\u003c/p>\n\u003cp>The open enrollment period for this year is over. Open enrollment season for 2015 coverage doesn't start until Nov. 15. At that point, consumers will be able to renew or make changes in their coverage, and new customers can find out whether there's a plan that's right for them.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Under the law, most Americans are required to have health insurance or risk fines.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16890\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"wp-image-16890 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS8056_L1006917-lpr-300x200.jpg\" alt=\"CCHP enrollment counselor Kristen Chow explains Covered California and federal subsidies to a Chinese-language caller. Currently, more than 90 percent of the HMO's members are ethnically Chinese. (Marcus Teply/KQED)\" width=\"300\" height=\"200\">\u003cfigcaption class=\"wp-caption-text\">CCHP enrollment counselor explains Covered California and federal subsidies to a caller. (Marcus Teply/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Some enrollees who get their health insurance through Covered California, the state's Obamacare exchange, will be getting notices in the next few weeks requesting evidence that they are lawfully in the country.\u003c/p>\n\u003cp>Yesterday, many news outlets \u003ca href=\"http://online.wsj.com/articles/health-plans-to-end-without-proof-of-citizenship-1407870402\" target=\"_blank\">reported\u003c/a> on the Obama administration's announcement that it was sending letters to about 310,000 people who have signed up for insurance through the Affordable Care Act, but whose documentation of citizenship or legal immigration status was at odds with government records. From the \u003ca href=\"http://online.wsj.com/articles/health-plans-to-end-without-proof-of-citizenship-1407870402\" target=\"_blank\">Wall Street Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The Obama administration moved Tuesday to cut off health insurance for up to 310,000 people who signed up through the \u003cspan class=\"mandelbrot_refrag\">\u003ca class=\"mandelbrot_refrag\" style=\"color: #115b8f\" href=\"https://www.healthcare.gov/\" target=\"_blank\" rel=\"nofollow\">HealthCare.gov\u003c/a>\u003c/span> system unless they can provide documents in the next few weeks showing they are U.S. citizens or legal residents.\u003c/p>\n\u003cp>Those individuals have until Sept. 5 to send in additional information that could confirm they are in the U.S. legally, a condition of using the online insurance exchanges to obtain coverage.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->The Sept. 5 deadline, however, affects only those enrollees in states that rely on the federal exchange, as opposed to state exchanges like Covered California. Fourteen states run their own exchanges; the remaining 36 declined to create their own online insurance marketplaces due mostly to Republican opposition, leaving the federal government to service residents in those states.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Some enrollees will have 30 days to submit their documentation or risk having their insurance canceled.\u003c/aside>\n\u003cp>Covered California spokesman Roy Kennedy says the notices will go out in late August to \"consumers identified as not having provided sufficient evidence of lawful presence.\" These individuals will have 30 days to submit their documentation or risk having their insurance canceled.\u003c/p>\n\u003cp>The state doesn't know yet how many enrollees will need to submit such verification.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kennedy said those receiving the notices can upload the required documents, such as a permanent residence card, at the\u003ca href=\"https://www.coveredca.com/\" target=\"_blank\"> Covered California website\u003c/a> or work on their submissions through their insurance agent or enrollment counselor.\u003c/p>\n\u003cp>In addition to cancellation of their insurance, those who do not respond to the notices may also be required to pay back any federal subsidies they have received through the exchange, Kennedy said.\u003c/p>\n\u003cp>In July, the \u003cspan style=\"color: #000000\">Department of Health and Human Services Office of the Inspector General issued two reports stating the \u003ca href=\"http://www.reuters.com/article/2014/07/01/usa-healthcare-subsidies-idUSL2N0PC1M520140701\" target=\"_blank\">federal government did not properly verify eligibility\u003c/a> for receiving insurance through the federal exchange. \u003c/span>\u003c/p>\n\u003cp>One of the reports said California's exchange was deficient in not always verifying citizenship and lawful presence through the Department of Homeland Security.\u003c/p>\n\u003cp>You can \u003ca href=\"http://oig.hhs.gov/oas/reports/region9/91401000.pdf\" target=\"_blank\">read that report here\u003c/a>.\u003c/p>\n\u003cp>Here is yesterday's AP story on the notifications going out to those who use the federal exchange:\u003c/p>\n\u003cp>(AP) The clock is ticking for hundreds of thousands of people who have unresolved issues affecting their coverage under the new health care law.\u003c/p>\n\u003cp>The Obama administration said Tuesday that letters are going out to about 310,000 people whose citizenship or immigration details don't match what the government has on file.\u003c/p>\n\u003cp>These consumers need to send in their documentation by Sept. 5. Otherwise their coverage will end Sept. 30.\u003c/p>\n\u003cp>Of the 8 million people who signed up for private coverage through President Barack Obama's law, more than 2 million at one point had discrepancies of some sort that affected their eligibility. That number has been greatly reduced — but the remaining cases are proving difficult to resolve.\u003c/p>\n\u003cp>People living in the country illegally are not allowed to get coverage. Officials at the Health and Human Services Department said the letters will notify consumers with unresolved citizenship and immigration issues that they can upload their documents to the HealthCare.gov website or mail them in.\u003c/p>\n\u003cp>Most haven't responded to repeated outreach efforts, officials said. Hispanics, who historically have lagged in health insurance coverage, may account for a big share of the group.\u003c/p>\n\u003cp>Indeed, two states with large Latino populations top the list of unresolved cases. Florida has 93,800 cases, while Texas has 52,700. Georgia, Virginia and Pennsylvania round out the top five. The letters are being sent in English and Spanish.\u003c/p>\n\u003cp>The next five states are North Carolina, Illinois, Michigan, New Jersey and Louisiana.\u003c/p>\n\u003cp>The new policy affects the 36 states where the federal government has taken the lead in running online insurance markets created by the law. It's unclear how it will apply in places like California and New York, which are running their own insurance exchanges.\u003c/p>\n\u003cp>Some supporters of the law worried that eligible consumers might lose coverage due to record-keeping problems on the government's part, or because of something as mundane as letters getting lost in the mail.\u003c/p>\n\u003cp>\"Many of these people have issues because government files are incomplete,\" said Ron Pollack, executive director of the advocacy group Families USA. \"Many may feel that they have fully complied with what is necessary to get health coverage.\"\u003c/p>\n\u003cp>The number of problem cases was a lot larger only a few months ago, prompting criticism from congressional Republicans that the administration was signing up people ineligible under the law.\u003c/p>\n\u003cp>In May, there were nearly 970,000 people with citizenship or immigration problems. About half those cases have now been closed, officials said, and another 20 percent are being worked on actively. Officials have previously said that the overwhelming majority of cases are resolved in favor of the enrollee.\u003c/p>\n\u003cp>Consumers who have unresolved discrepancies over their incomes will get notices at a later date.\u003c/p>\n\u003cp>The new health law provides subsidized coverage to people with no access to health insurance on the job. More than 80 percent of those signed up are getting subsidies to help with their premiums and, in some cases, their copays and deductibles as well.\u003c/p>\n\u003cp>But those taxpayer subsidies are contingent on meeting a host of requirements. The amount of a consumer's premium tax credit can vary by income, family size, hometown and other factors. That can make getting covered through the law feel somewhat like doing your taxes.\u003c/p>\n\u003cp>The letters that started going out Tuesday won't be the final attempt to reach those with unresolved issues. HHS will try to contact each consumer two more times by phone and once via email. The administration is also working with local organizations to try to reach people directly in their homes.\u003c/p>\n\u003cp>Consumers can also contact HealthCare.gov's call center at 800-318-2596 to see what documents they need to submit and see whether their information has been received.\u003c/p>\n\u003cp>The notices affect this year's coverage only.\u003c/p>\n\u003cp>The open enrollment period for this year is over. Open enrollment season for 2015 coverage doesn't start until Nov. 15. At that point, consumers will be able to renew or make changes in their coverage, and new customers can find out whether there's a plan that's right for them.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Obamacare: With One-Third of Californians Now on Medi-Cal, Can State Manage?",
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"content": "\u003cp>\u003cstrong>By Anna Gorman, \u003c/strong>\u003ca href=\"http://www.kaiserhealthnews.org/stories/2014/august/14/california-enrollment-success-is-its--greatest-challenge.aspx?referrer=search\" target=\"_blank\">\u003cstrong>Kaiser Health News\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>California is coming face to face with the reality of one of its biggest Obamacare successes: the explosion in Medi-Cal enrollment.\u003c/p>\n\u003cdiv class=\"nosyndication\" style=\"color: #000000\">\n\u003cdiv class=\"inlineImage300\">\u003cimg class=\"alignleft\" src=\"http://www.kaiserhealthnews.org/~/media/Images/KHN%20Features/2014/August/11%2015/medi%20cal%20line%20300.jpg\" alt=\"\" width=\"300\" height=\"199\">\u003c/div>\n\u003c/div>\n\u003cp>The numbers — 2.2 million enrollees since January — surprised health care experts and created unforeseen challenges for state officials. Altogether, there are now about 11 million Medi-Cal beneficiaries, constituting nearly 30 percent of the state's population.\u003c/p>\n\u003cp>That has pushed the public insurance program into the spotlight, after nearly 50 years as a quiet mainstay of the state's health care system, and it has raised concerns about California's ability to meet the increased demand for health care.\u003c/p>\n\u003cp>Even as sign-ups continue, state health officials are struggling to figure out how to serve a staggering number of Medi-Cal beneficiaries while also improving their health and keeping costs down. Many are chronically ill and have gone without insurance or regular care for years, and some new enrollees have higher expectations than in the past. \u003c!--more-->\u003c/p>\n\u003caside class=\"pullquote alignleft\">Does California have the health care infrastructure to cover so many more people?\u003c/aside>\n\u003cp>Medi-Cal is the largest version of the nation's Medicaid program for low-income and disabled people. Created as an anti-poverty program in 1965, Medicaid for years primarily served families, seniors and people with disabilities. Now, in the states that chose to expand their programs, the coverage is available to single adults without children and to those who make slightly higher incomes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Real questions remain, however, about whether California is up to the task of covering so many more people and about whether it has the health care infrastructure to handle the needs of the new enrollees. The costs to the state will be significant.\u003c/p>\n\u003cp>Under the Affordable Care Act, the federal government pays 100 percent of the costs for newly eligible Medi-Cal enrollees for the first three years. But the state is responsible for 50 percent of the costs for those who qualified for the program before the Obamacare expansion, even if they hadn't previously enrolled. Publicity and outreach about the health care law brought hundreds of thousands of people forward who were previously eligible but hadn't signed up.\u003c/p>\n\u003cp>Gov. Jerry Brown said the higher-than-expected number of enrollees will cost the state an additional $1.2 billion this year, bringing the state's total share of the costs for the program to $17 billion a year.\u003c/p>\n\u003cp>In some ways, the state is building on a thin foundation. California pays less per beneficiary than almost any other state, and its compensation to doctors is among the lowest in the nation. Brown won a legal fight to make additional cuts to doctors, pharmacists and other providers, and he has refused recent pleas to restore the funds.\u003c/p>\n\u003cp>That may help control costs, but it also makes finding health care more difficult for Medi-Cal recipients, since many health care providers won't accept them as patients. Despite efforts to boost the number of primary care providers and to stretch the reach of specialists in the Medi-Cal program, there are areas of the state in which patients have little or no access.\u003c/p>\n\u003cp style=\"color: #000000\">\n\u003caside class=\"pullquote alignleft\">California's compensation to doctors is among the lowest in the nation. The state also has a huge application backlog.\u003c/aside>\n\u003c/p>\u003cp>With payments of $18 to $24 a visit, “doctors can't continue to accept new patients and keep their doors open,” said Molly Weedn, a spokeswoman for the California Medical Association. Without enough doctors, Medi-Cal patients could continue landing in costly emergency rooms — the opposite of Obamacare's aims.\u003c/p>\n\u003cp>Another problem rests with the state bureaucracy. California has an application backlog of about 490,000 people, which underscores the need to modernize and streamline the technology used for enrollment. The state is making progress in reducing the number of people waiting, but consumer advocates recently asked the federal government for help.\u003c/p>\n\u003cp>“As a result of the continued technical problems … the Medi-Cal system is failing on several levels,” a coalition of advocates wrote in a letter to the federal Centers for Medicare & Medicaid Services.\u003c/p>\n\u003cp>Meanwhile, many applicants have received no information about the status of their applications. Dylan Roby, an assistant professor at the UCLA Fielding School of Public Health, said that the state needs to improve its customer service.\u003c/p>\n\u003cp>With nearly a third of the state now enrolled in Medi-Cal, the political stakes are higher, and the state will increasingly face pressure to make the program more efficient and less burdensome.\u003c/p>\n\u003cp>Over the last several years, California has increasingly transferred responsibility for coordinating the care of Medi-Cal patients to managed-care companies, which get paid a fixed amount per patient to provide comprehensive care. The plans cover 70 percent of the Medi-Cal population, which helps keep the state's costs predictable.\u003c/p>\n\u003cp style=\"color: #000000\">But the expansion has come so quickly that advocates are concerned about whether the state is adequately monitoring the companies to ensure they are providing high-quality care and timely access to services. Initiatives to track access are underway, and Democratic state Sen. Ed Hernandez has proposed a bill that would require the state to conduct annual reviews of managed-care plans.\u003c/p>\n\u003cp>Medi-Cal managed care hasn't always received high marks. One evaluation last year by the California HealthCare Foundation showed that California ranked below the national average on “consumer experience” — such as communication with doctors and getting treatment quickly — although the quality of care was generally on par with the nation.\u003c/p>\n\u003cp>Another foundation report recently warned that oversight needs to be strengthened to ensure that patients don't suffer as “dramatic changes” to Medi-Cal unfold.\u003c/p>\n\u003cp>California has already demonstrated to the rest of the country that it can dramatically cut its rate of uninsured, largely by increasing the size of Medi-Cal. Now it needs to show that its public insurance program can actually deliver the care its new enrollees are counting on.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.kff.org/\">\u003cstrong style=\"font-style: inherit\">\u003cem style=\"font-weight: bold\">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>\u003cstrong>By Anna Gorman, \u003c/strong>\u003ca href=\"http://www.kaiserhealthnews.org/stories/2014/august/14/california-enrollment-success-is-its--greatest-challenge.aspx?referrer=search\" target=\"_blank\">\u003cstrong>Kaiser Health News\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>California is coming face to face with the reality of one of its biggest Obamacare successes: the explosion in Medi-Cal enrollment.\u003c/p>\n\u003cdiv class=\"nosyndication\" style=\"color: #000000\">\n\u003cdiv class=\"inlineImage300\">\u003cimg class=\"alignleft\" src=\"http://www.kaiserhealthnews.org/~/media/Images/KHN%20Features/2014/August/11%2015/medi%20cal%20line%20300.jpg\" alt=\"\" width=\"300\" height=\"199\">\u003c/div>\n\u003c/div>\n\u003cp>The numbers — 2.2 million enrollees since January — surprised health care experts and created unforeseen challenges for state officials. Altogether, there are now about 11 million Medi-Cal beneficiaries, constituting nearly 30 percent of the state's population.\u003c/p>\n\u003cp>That has pushed the public insurance program into the spotlight, after nearly 50 years as a quiet mainstay of the state's health care system, and it has raised concerns about California's ability to meet the increased demand for health care.\u003c/p>\n\u003cp>Even as sign-ups continue, state health officials are struggling to figure out how to serve a staggering number of Medi-Cal beneficiaries while also improving their health and keeping costs down. Many are chronically ill and have gone without insurance or regular care for years, and some new enrollees have higher expectations than in the past. \u003c!--more-->\u003c/p>\n\u003caside class=\"pullquote alignleft\">Does California have the health care infrastructure to cover so many more people?\u003c/aside>\n\u003cp>Medi-Cal is the largest version of the nation's Medicaid program for low-income and disabled people. Created as an anti-poverty program in 1965, Medicaid for years primarily served families, seniors and people with disabilities. Now, in the states that chose to expand their programs, the coverage is available to single adults without children and to those who make slightly higher incomes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Real questions remain, however, about whether California is up to the task of covering so many more people and about whether it has the health care infrastructure to handle the needs of the new enrollees. The costs to the state will be significant.\u003c/p>\n\u003cp>Under the Affordable Care Act, the federal government pays 100 percent of the costs for newly eligible Medi-Cal enrollees for the first three years. But the state is responsible for 50 percent of the costs for those who qualified for the program before the Obamacare expansion, even if they hadn't previously enrolled. Publicity and outreach about the health care law brought hundreds of thousands of people forward who were previously eligible but hadn't signed up.\u003c/p>\n\u003cp>Gov. Jerry Brown said the higher-than-expected number of enrollees will cost the state an additional $1.2 billion this year, bringing the state's total share of the costs for the program to $17 billion a year.\u003c/p>\n\u003cp>In some ways, the state is building on a thin foundation. California pays less per beneficiary than almost any other state, and its compensation to doctors is among the lowest in the nation. Brown won a legal fight to make additional cuts to doctors, pharmacists and other providers, and he has refused recent pleas to restore the funds.\u003c/p>\n\u003cp>That may help control costs, but it also makes finding health care more difficult for Medi-Cal recipients, since many health care providers won't accept them as patients. Despite efforts to boost the number of primary care providers and to stretch the reach of specialists in the Medi-Cal program, there are areas of the state in which patients have little or no access.\u003c/p>\n\u003cp style=\"color: #000000\">\n\u003caside class=\"pullquote alignleft\">California's compensation to doctors is among the lowest in the nation. The state also has a huge application backlog.\u003c/aside>\n\u003c/p>\u003cp>With payments of $18 to $24 a visit, “doctors can't continue to accept new patients and keep their doors open,” said Molly Weedn, a spokeswoman for the California Medical Association. Without enough doctors, Medi-Cal patients could continue landing in costly emergency rooms — the opposite of Obamacare's aims.\u003c/p>\n\u003cp>Another problem rests with the state bureaucracy. California has an application backlog of about 490,000 people, which underscores the need to modernize and streamline the technology used for enrollment. The state is making progress in reducing the number of people waiting, but consumer advocates recently asked the federal government for help.\u003c/p>\n\u003cp>“As a result of the continued technical problems … the Medi-Cal system is failing on several levels,” a coalition of advocates wrote in a letter to the federal Centers for Medicare & Medicaid Services.\u003c/p>\n\u003cp>Meanwhile, many applicants have received no information about the status of their applications. Dylan Roby, an assistant professor at the UCLA Fielding School of Public Health, said that the state needs to improve its customer service.\u003c/p>\n\u003cp>With nearly a third of the state now enrolled in Medi-Cal, the political stakes are higher, and the state will increasingly face pressure to make the program more efficient and less burdensome.\u003c/p>\n\u003cp>Over the last several years, California has increasingly transferred responsibility for coordinating the care of Medi-Cal patients to managed-care companies, which get paid a fixed amount per patient to provide comprehensive care. The plans cover 70 percent of the Medi-Cal population, which helps keep the state's costs predictable.\u003c/p>\n\u003cp style=\"color: #000000\">But the expansion has come so quickly that advocates are concerned about whether the state is adequately monitoring the companies to ensure they are providing high-quality care and timely access to services. Initiatives to track access are underway, and Democratic state Sen. Ed Hernandez has proposed a bill that would require the state to conduct annual reviews of managed-care plans.\u003c/p>\n\u003cp>Medi-Cal managed care hasn't always received high marks. One evaluation last year by the California HealthCare Foundation showed that California ranked below the national average on “consumer experience” — such as communication with doctors and getting treatment quickly — although the quality of care was generally on par with the nation.\u003c/p>\n\u003cp>Another foundation report recently warned that oversight needs to be strengthened to ensure that patients don't suffer as “dramatic changes” to Medi-Cal unfold.\u003c/p>\n\u003cp>California has already demonstrated to the rest of the country that it can dramatically cut its rate of uninsured, largely by increasing the size of Medi-Cal. Now it needs to show that its public insurance program can actually deliver the care its new enrollees are counting on.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.kff.org/\">\u003cstrong style=\"font-style: inherit\">\u003cem style=\"font-weight: bold\">Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20683\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\">\u003cimg class=\"size-full wp-image-20683\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\" alt=\"Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\" width=\"640\" height=\"528\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/5371998566_179533eed7_z-400x330.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/5371998566_179533eed7_z-320x264.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>As all the other health insurers on California's Obamacare exchange raise their rates for next year, Kaiser Permanente plans to lower them.\u003c/p>\n\u003cp>The \u003cem>Los Angeles Times\u003c/em> \u003ca href=\"http://www.latimes.com/business/healthcare/la-fi-obamacare-california-rates-20140810-story.html\">reports\u003c/a> that a new analysis by Citigroup shows Kaiser's premiums dropping by 1.4 percent in 2015.\u003c/p>\n\u003cp>At the same time, the average premium across all plans on the Covered California exchange will rise 4.2 percent.\u003c/p>\n\u003cp>Citigroup health care analyst Carl McDonald told the \u003cem>Times\u003c/em> he thinks Kaiser's move is meant to draw customers:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Kaiser was among the most expensive health plans in 2014 and staggered to a fourth-place finish in exchange enrollment. Anthem Blue Cross was the leader statewide, followed by Blue Shield of California and Health Net Inc.\u003c/p>\n\u003cp>\"Kaiser doesn’t seem particularly happy with its exchange market share, as it is the only company reducing exchange premiums in 2015,\" McDonald said.\u003c/p>\u003c/blockquote>\n\u003cp>McDonald's report predicts premiums for the other Covered California plans will rise as follows:\u003c/p>\n\u003cul>\n\u003cul>Anthem Blue Cross: 4.6 percent\u003c/ul>\n\u003cul>Blue Shield: 6 percent\u003c/ul>\n\u003cp>Health Net: 4.9 percent\u003c/p>\u003c/ul>\n\u003cp>(Note that Kaiser's plans on the exchange are different from its employer-based plans and typically have deductibles.)\u003c/p>\n\u003caside class=\"pullquote alignleft\">These rate changes give us a glimpse of the market forces at work.\u003c/aside>\n\u003cp>Rates for Obamacare exchange plans are rising nationwide, too, but not to the level of the double-digit \"sticker shock\" forecast in Congressional debates last year, \u003ca href=\"http://thehill.com/policy/healthcare/214847-average-premium-under-obamacare-to-rise-75-percent\">reports\u003c/a> \u003cem>The Hill\u003c/em>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A new PricewaterhouseCoopers analysis shows the price of health plans on Obamacare exchanges will rise by an average of 7.5 percent next year.\u003c/p>\n\u003cp>It's significant to note that the exchanges were meant to create a new, more competitive market for health insurance. And these rate changes give us a glimpse of the market forces at work. \u003cem>The Hill\u003c/em> explains:\u003c/p>\n\u003cblockquote>\u003cp>The healthcare law's first enrollment period was a major test for the insurance industry, which set premium prices with little information about exactly who might sign up for coverage.\u003c/p>\n\u003cp>The 2015 rates shed light on how well their guesses panned out.\u003c/p>\n\u003cp>Companies are generally raising prices if their new customers are older, sicker or will use more medical care than projected.\u003c/p>\n\u003cp>Firms with a healthier pool, on the other hand, have an incentive to lower premiums.\u003c/p>\u003c/blockquote>\n\u003cp>State regulators still have to review and approve the California plan prices before enrollment opens on Nov. 15.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>California Healthline contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20683\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\">\u003cimg class=\"size-full wp-image-20683\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\" alt=\"Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\" width=\"640\" height=\"528\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/5371998566_179533eed7_z-400x330.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/5371998566_179533eed7_z-320x264.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>As all the other health insurers on California's Obamacare exchange raise their rates for next year, Kaiser Permanente plans to lower them.\u003c/p>\n\u003cp>The \u003cem>Los Angeles Times\u003c/em> \u003ca href=\"http://www.latimes.com/business/healthcare/la-fi-obamacare-california-rates-20140810-story.html\">reports\u003c/a> that a new analysis by Citigroup shows Kaiser's premiums dropping by 1.4 percent in 2015.\u003c/p>\n\u003cp>At the same time, the average premium across all plans on the Covered California exchange will rise 4.2 percent.\u003c/p>\n\u003cp>Citigroup health care analyst Carl McDonald told the \u003cem>Times\u003c/em> he thinks Kaiser's move is meant to draw customers:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Kaiser was among the most expensive health plans in 2014 and staggered to a fourth-place finish in exchange enrollment. Anthem Blue Cross was the leader statewide, followed by Blue Shield of California and Health Net Inc.\u003c/p>\n\u003cp>\"Kaiser doesn’t seem particularly happy with its exchange market share, as it is the only company reducing exchange premiums in 2015,\" McDonald said.\u003c/p>\u003c/blockquote>\n\u003cp>McDonald's report predicts premiums for the other Covered California plans will rise as follows:\u003c/p>\n\u003cul>\n\u003cul>Anthem Blue Cross: 4.6 percent\u003c/ul>\n\u003cul>Blue Shield: 6 percent\u003c/ul>\n\u003cp>Health Net: 4.9 percent\u003c/p>\u003c/ul>\n\u003cp>(Note that Kaiser's plans on the exchange are different from its employer-based plans and typically have deductibles.)\u003c/p>\n\u003caside class=\"pullquote alignleft\">These rate changes give us a glimpse of the market forces at work.\u003c/aside>\n\u003cp>Rates for Obamacare exchange plans are rising nationwide, too, but not to the level of the double-digit \"sticker shock\" forecast in Congressional debates last year, \u003ca href=\"http://thehill.com/policy/healthcare/214847-average-premium-under-obamacare-to-rise-75-percent\">reports\u003c/a> \u003cem>The Hill\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A new PricewaterhouseCoopers analysis shows the price of health plans on Obamacare exchanges will rise by an average of 7.5 percent next year.\u003c/p>\n\u003cp>It's significant to note that the exchanges were meant to create a new, more competitive market for health insurance. And these rate changes give us a glimpse of the market forces at work. \u003cem>The Hill\u003c/em> explains:\u003c/p>\n\u003cblockquote>\u003cp>The healthcare law's first enrollment period was a major test for the insurance industry, which set premium prices with little information about exactly who might sign up for coverage.\u003c/p>\n\u003cp>The 2015 rates shed light on how well their guesses panned out.\u003c/p>\n\u003cp>Companies are generally raising prices if their new customers are older, sicker or will use more medical care than projected.\u003c/p>\n\u003cp>Firms with a healthier pool, on the other hand, have an incentive to lower premiums.\u003c/p>\u003c/blockquote>\n\u003cp>State regulators still have to review and approve the California plan prices before enrollment opens on Nov. 15.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>California Healthline contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"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.",
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"mindshift": {
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"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>",
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"order": 12
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"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.",
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"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?",
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"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",
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"perspectives": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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