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"disqusTitle": "Will California Smokers Pay More Under the Health Care Overhaul?",
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"content": "\u003cp>By Stephanie O'Neill, KPCC\u003c/p>\n\u003cfigure id=\"attachment_12073\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/11/will-california-smokers-pay-more-under-the-health-care-overhaul/4331208353_0f48ff56f5_b/\" rel=\"attachment wp-att-12073\">\u003cimg class=\"size-medium wp-image-12073\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/4331208353_0f48ff56f5_b-300x225.jpg\" alt=\"(Dale M. Moore/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Dale M. Moore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Perhaps the most popular provision of President Obama’s federal health law is that people cannot be turned down or charged a lot more because they are sick. Obamacare also reduces how much more older people can be charged for insurance.\u003c/p>\n\u003cp>But the president's health law permits one group to be charged more -- a lot more: smokers. States can allow health plans to charge tobacco users up to 50 percent more for their health insurance premiums.\u003c/p>\n\u003cp>The provision allowing for a \"tobacco surcharge\" was designed in part to encourage smokers to quit a habit that often leads to major illness.\u003c/p>\n\u003cp>The Centers for Disease Control puts the nation’s annual price tag for smoking at more than $190 billion in both medical care and lost productivity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It’s that price tag that prompts some to support higher health care premiums for smokers. Micah Weinberg is a senior fellow with the Bay Area Council, which researches public policy issues that affect businesses and the local economy. While he says caution is needed to avoid premiums so high that they are unaffordable to smokers, \"I think that we need to make sure that there is a strong financial disincentive for people to smoke.\"\u003c!--more-->\u003c/p>\n\u003cp>But critics say the smokers' surcharge is discriminatory and goes against the spirit of federal health reform.\u003c/p>\n\u003cp>It can also negate the benefits of subsidies offered under the federal health care law, says Karen Pollitz, a senior fellow with the Kaiser Family Foundation .\u003c/p>\n\u003cp>For example, a low-income person buying a $6,000 policy who qualified for a subsidy might see the price of the annual policy drop to $3,000, Pollitz says. But \"the tobacco surcharge would knock it back up to $6,000 again.\"\u003c/p>\n\u003cp>That was the finding of a \u003ca href=\"http://www.ihps.org/pubs/Tobacco_Rating_Issue_Brief_21June2012.pdf\">study published last summer\u003c/a> by the Institute for Health Policy Solutions in Washington, D.C. Smoking rates both in California and nationally are highest among lower-income people –- who often must juggle several jobs to support themselves and their families. The resulting stress, Rick Curtis, president of IHPS says, makes breaking the tobacco addiction even harder.\u003c/p>\n\u003cp>\"For somebody who is totally hooked after many years, and older – and those kinds of people often do need more medical care, they have emphysema and so forth – they have two bad choices: go without health insurance and be impoverished that way, or get health insurance and be impoverished,\" he said.\u003c/p>\n\u003cp>That argument resonates in Sacramento where Assemblyman Richard Pan (D-Sacramento) has written legislation that would make California among the first states to ban higher premiums for smokers under the Affordable Care Act. He believes providing smokers with affordable health insurance is a better way to help them kick the habit.\u003c/p>\n\u003cp>“It does not make sense to have smokers being uninsured,” says Pan, who is also a practicing pediatrician. \"We want smokers to actually have health care coverage. ... [T]hrough having health care coverage they’ll have access to smoking cessation treatment\" as well as health care in general.\u003c/p>\n\u003cp>Weinberg calls effort by California to ban higher premiums for smokers misguided, especially when based on findings that those smokers are disproportionately poor.\u003c/p>\n\u003cp>“We have this very paternalistic attitude about lower-income folks that I think is inappropriate and particularly inappropriate in this context,” he says. “Because if we eliminate the financial incentive not to smoke we’re going to create an environment in which more people do smoke.“\u003c/p>\n\u003cp>Weinberg's concerns aside, Pan’s bill faces little opposition –- not from cigarette companies, anti-smoking groups or anti-cancer advocates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Officials at the American Lung Association's California branch said in a statement that because smoking is so hard to quit, it’s essential to provide tobacco users with affordable health insurance, rather than make them pay more for it.\u003c/p>\n\n",
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"excerpt": "Perhaps the most popular provision of President Obama’s federal health law is that people cannot be turned down or charged a lot more because they are sick. Obamacare also reduces how much more older people can be charged for insurance.\r\n\r\nBut the president's health law permits one group to be charged more -- a lot more: smokers. States can allow health plans to charge tobacco users up to 50 percent more for their health insurance premiums. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Stephanie O'Neill, KPCC\u003c/p>\n\u003cfigure id=\"attachment_12073\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/11/will-california-smokers-pay-more-under-the-health-care-overhaul/4331208353_0f48ff56f5_b/\" rel=\"attachment wp-att-12073\">\u003cimg class=\"size-medium wp-image-12073\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/4331208353_0f48ff56f5_b-300x225.jpg\" alt=\"(Dale M. Moore/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Dale M. Moore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Perhaps the most popular provision of President Obama’s federal health law is that people cannot be turned down or charged a lot more because they are sick. Obamacare also reduces how much more older people can be charged for insurance.\u003c/p>\n\u003cp>But the president's health law permits one group to be charged more -- a lot more: smokers. States can allow health plans to charge tobacco users up to 50 percent more for their health insurance premiums.\u003c/p>\n\u003cp>The provision allowing for a \"tobacco surcharge\" was designed in part to encourage smokers to quit a habit that often leads to major illness.\u003c/p>\n\u003cp>The Centers for Disease Control puts the nation’s annual price tag for smoking at more than $190 billion in both medical care and lost productivity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s that price tag that prompts some to support higher health care premiums for smokers. Micah Weinberg is a senior fellow with the Bay Area Council, which researches public policy issues that affect businesses and the local economy. While he says caution is needed to avoid premiums so high that they are unaffordable to smokers, \"I think that we need to make sure that there is a strong financial disincentive for people to smoke.\"\u003c!--more-->\u003c/p>\n\u003cp>But critics say the smokers' surcharge is discriminatory and goes against the spirit of federal health reform.\u003c/p>\n\u003cp>It can also negate the benefits of subsidies offered under the federal health care law, says Karen Pollitz, a senior fellow with the Kaiser Family Foundation .\u003c/p>\n\u003cp>For example, a low-income person buying a $6,000 policy who qualified for a subsidy might see the price of the annual policy drop to $3,000, Pollitz says. But \"the tobacco surcharge would knock it back up to $6,000 again.\"\u003c/p>\n\u003cp>That was the finding of a \u003ca href=\"http://www.ihps.org/pubs/Tobacco_Rating_Issue_Brief_21June2012.pdf\">study published last summer\u003c/a> by the Institute for Health Policy Solutions in Washington, D.C. Smoking rates both in California and nationally are highest among lower-income people –- who often must juggle several jobs to support themselves and their families. The resulting stress, Rick Curtis, president of IHPS says, makes breaking the tobacco addiction even harder.\u003c/p>\n\u003cp>\"For somebody who is totally hooked after many years, and older – and those kinds of people often do need more medical care, they have emphysema and so forth – they have two bad choices: go without health insurance and be impoverished that way, or get health insurance and be impoverished,\" he said.\u003c/p>\n\u003cp>That argument resonates in Sacramento where Assemblyman Richard Pan (D-Sacramento) has written legislation that would make California among the first states to ban higher premiums for smokers under the Affordable Care Act. He believes providing smokers with affordable health insurance is a better way to help them kick the habit.\u003c/p>\n\u003cp>“It does not make sense to have smokers being uninsured,” says Pan, who is also a practicing pediatrician. \"We want smokers to actually have health care coverage. ... [T]hrough having health care coverage they’ll have access to smoking cessation treatment\" as well as health care in general.\u003c/p>\n\u003cp>Weinberg calls effort by California to ban higher premiums for smokers misguided, especially when based on findings that those smokers are disproportionately poor.\u003c/p>\n\u003cp>“We have this very paternalistic attitude about lower-income folks that I think is inappropriate and particularly inappropriate in this context,” he says. “Because if we eliminate the financial incentive not to smoke we’re going to create an environment in which more people do smoke.“\u003c/p>\n\u003cp>Weinberg's concerns aside, Pan’s bill faces little opposition –- not from cigarette companies, anti-smoking groups or anti-cancer advocates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Officials at the American Lung Association's California branch said in a statement that because smoking is so hard to quit, it’s essential to provide tobacco users with affordable health insurance, rather than make them pay more for it.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Nearly 3 Million Californians Will Be Eligible for Obamacare Tax Credits, Study Says",
"title": "Nearly 3 Million Californians Will Be Eligible for Obamacare Tax Credits, Study Says",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Stephanie O'Neill, \u003ca href=\"http://www.scpr.org/news/2013/04/09/36759/nearly-3-million-californians-will-be-eligible-for/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+893KpccSouthernCaliforniaNews+%28KPCC%3A+News%29&utm_content=Google+Reader\" target=\"_blank\">KPCC\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_5472\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/27/steps-toward-lower-cost-higher-quality-health-care/doctor-greating-patient-2/\" rel=\"attachment wp-att-5472\">\u003cimg class=\"size-medium wp-image-5472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/CalPERS_DoctorPatient_Vic_Flickr-300x200.jpg\" alt=\"(Vic: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Vic: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Federal tax credits designed to make health insurance more affordable, starting next year, will help nearly 3 million Californians buy health insurance, according to a study issued Tuesday.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.familiesusa.org/help-is-at-hand/california/\" target=\"_blank\">report commissioned by Families USA\u003c/a> -- a supporter of President Obama’s health care reforms -- says that more than 85 percent of all Californians who qualify for the federal tax credits live in families with at least one full- or part-time worker who doesn't receive employer-sponsored health insurance.\u003c/p>\n\u003cp>It also finds that 52 percent of Californians expected to qualify for the sliding-scale tax credits will come from middle-class families who earn up to $95,000 a year.\u003c!--more-->\u003c/p>\n\u003cp>The biggest block of recipients -- about a million people -- live in Los Angeles County. About 100,000 people in Santa Clara County are expected to receive subsidies and about 75,000 people in Fresno County. (You can look up other counties in \u003ca href=\"http://familiesusa2.org/assets/pdfs/premium-tax-credits/California.pdf\" target=\"_blank\">the report, on page 7\u003c/a>. [PDF])\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The report estimates that Latinos will make up half the eligible Californians; whites will make up about 30 percent; blacks about 5 percent, with the remainder comprising mostly Asians and Pacific Islanders.\u003c/p>\n\u003cp>The tax credits will be “advanceable,” meaning they will be applied as an upfront discount at the time enrollment in California's new health insurance marketplace, called \"Covered California.\"\u003c/p>\n\u003cp>\"People won't have to ... pay the full premium and then try to get a reimbursement for it,\" said Rep. Henry A. Waxman (D-CA) in a Tuesday morning conference call with reporters after the report's release. \"They’ll simply enter their income information, shop for coverage and then get an automatic discount of hundreds or even thousands of dollars.\"\u003c/p>\n\u003cp>California’s health insurance marketplace is scheduled to open for enrollment this October, with coverage beginning on Jan. 1, 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Covered California has a \u003ca href=\"http://www.coveredca.com/calculating_the_cost.html\" target=\"_blank\">subsidy calculator\u003c/a> where consumers can quickly get an estimate.\u003c/p>\n\n",
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"excerpt": "Federal tax credits designed to make health insurance more affordable, starting next year, will help nearly 3 million Californians buy health insurance, according to a study issued Tuesday.\r\n\r\nThe report commissioned by Families USA -- a supporter of President Obama’s health care reforms -- says that more than 85 percent of all Californians who qualify for the federal tax credits live in families with at least one full- or part-time worker who doesn't receive employer-sponsored health insurance.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Stephanie O'Neill, \u003ca href=\"http://www.scpr.org/news/2013/04/09/36759/nearly-3-million-californians-will-be-eligible-for/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+893KpccSouthernCaliforniaNews+%28KPCC%3A+News%29&utm_content=Google+Reader\" target=\"_blank\">KPCC\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_5472\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/27/steps-toward-lower-cost-higher-quality-health-care/doctor-greating-patient-2/\" rel=\"attachment wp-att-5472\">\u003cimg class=\"size-medium wp-image-5472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/CalPERS_DoctorPatient_Vic_Flickr-300x200.jpg\" alt=\"(Vic: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Vic: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Federal tax credits designed to make health insurance more affordable, starting next year, will help nearly 3 million Californians buy health insurance, according to a study issued Tuesday.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.familiesusa.org/help-is-at-hand/california/\" target=\"_blank\">report commissioned by Families USA\u003c/a> -- a supporter of President Obama’s health care reforms -- says that more than 85 percent of all Californians who qualify for the federal tax credits live in families with at least one full- or part-time worker who doesn't receive employer-sponsored health insurance.\u003c/p>\n\u003cp>It also finds that 52 percent of Californians expected to qualify for the sliding-scale tax credits will come from middle-class families who earn up to $95,000 a year.\u003c!--more-->\u003c/p>\n\u003cp>The biggest block of recipients -- about a million people -- live in Los Angeles County. About 100,000 people in Santa Clara County are expected to receive subsidies and about 75,000 people in Fresno County. (You can look up other counties in \u003ca href=\"http://familiesusa2.org/assets/pdfs/premium-tax-credits/California.pdf\" target=\"_blank\">the report, on page 7\u003c/a>. [PDF])\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The report estimates that Latinos will make up half the eligible Californians; whites will make up about 30 percent; blacks about 5 percent, with the remainder comprising mostly Asians and Pacific Islanders.\u003c/p>\n\u003cp>The tax credits will be “advanceable,” meaning they will be applied as an upfront discount at the time enrollment in California's new health insurance marketplace, called \"Covered California.\"\u003c/p>\n\u003cp>\"People won't have to ... pay the full premium and then try to get a reimbursement for it,\" said Rep. Henry A. Waxman (D-CA) in a Tuesday morning conference call with reporters after the report's release. \"They’ll simply enter their income information, shop for coverage and then get an automatic discount of hundreds or even thousands of dollars.\"\u003c/p>\n\u003cp>California’s health insurance marketplace is scheduled to open for enrollment this October, with coverage beginning on Jan. 1, 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Covered California has a \u003ca href=\"http://www.coveredca.com/calculating_the_cost.html\" target=\"_blank\">subsidy calculator\u003c/a> where consumers can quickly get an estimate.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State Hires Consumer Group To Help Review Health Insurance Rates",
"title": "State Hires Consumer Group To Help Review Health Insurance Rates",
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"content": "\u003cp>California Insurance Commissioner Dave Jones has irritated the insurance industry and surprised public-policy analysts by hiring Consumer Watchdog, a vocal insurance industry critic, to assist in reviewing health insurance rate increases, the\u003ca href=\"http://www.latimes.com/business/la-fi-0403-insurance-critic-hired-20130403,0,5476273.story\" target=\"_blank\"> Los Angeles Times\u003c/a> reports.\u003c/p>\n\u003cp>In a one-year contract worth up to $88,000, Consumer Watchdog will supplement the rate review process already done by the insurance department.\u003c/p>\n\u003cp>From the Los Angeles Times:\u003c/p>\n\u003cdiv>\n\u003cblockquote>\u003cp>The insurance industry expressed dismay that the state enlisted its longtime nemesis to help review rate increases, and some experts questioned whether it's necessary to further antagonize insurers at a time when state officials are trying to work closely with the industry to implement a massive healthcare expansion.\u003c/p>\n\u003cp>Public-policy experts also scoffed at the arrangement.\u003c!--more-->\u003c/p>\n\u003cp>\"Their very aggressive stance against insurance companies raises serious questions about a conflict of interest,\" said Jessica Levinson, a Loyola Law School professor and expert on government ethics. \"You want an independent researcher.\"\u003c/p>\n\u003cp>Patrick Johnston, president of the insurance trade group California Assn. of Health Plans, said, \"Any review of health plan rates should be conducted by independent, impartial consumer groups that do not have political conflicts of interest and financial motivations.\" ...\u003c/p>\n\u003cp>(I)n an interview, Jones defended using grant money from the federal healthcare law to hire Consumer Watchdog.\u003c/p>\n\u003cp>\"I think it's important to have the consumer perspective, but at the end of the day we make our own determination,\" Jones said. \"This grant funding is a drop in the bucket compared to the hundreds of millions of dollars health insurers and HMOs have on their side. I think ordinary Californians know the deck is stacked against them.\"\u003c/p>\n\u003cp>Jamie Court, president of Consumer Watchdog, said the group's proven track record in challenging insurance company practices made it an ideal choice for the state. ...\u003c/p>\n\u003cp>\"We are the foremost expert on health insurance rates,\" Court said. \"This grant allows us to pull back the curtain and show how the wizards at Anthem and other companies are manipulating Oz. We want to prove that rates are too high.\"\u003c/p>\n\u003cp>That approach by Consumer Watchdog troubled some observers.\u003c/p>\n\u003cp>\"It's like asking one of the Dodgers to umpire a big game for the \u003ca title=\"San Francisco Giants\" href=\"http://www.latimes.com/topic/sports/baseball/san-francisco-giants-ORSPT000025.topic\">San Francisco Giants\u003c/a>,\" said Dan Schnur, director of the Jesse M. Unruh Institute of Politics at USC. \"Consumer Watchdog is a very well-respected organization, but the commissioner is clearly going out of his way to predetermine the outcome.\"\u003c/p>\u003c/blockquote>\n\u003cdiv>\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "California Insurance Commissioner Dave Jones has irritated the insurance industry and surprised public-policy analysts by hiring Consumer Watchdog, a vocal insurance industry critic, to assist in reviewing health insurance rate increases, the Los Angeles Times reports.\r\n\r\nIn a one-year contract worth up to $88,000, Consumer Watchdog will supplement rate review by the insurance department.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Insurance Commissioner Dave Jones has irritated the insurance industry and surprised public-policy analysts by hiring Consumer Watchdog, a vocal insurance industry critic, to assist in reviewing health insurance rate increases, the\u003ca href=\"http://www.latimes.com/business/la-fi-0403-insurance-critic-hired-20130403,0,5476273.story\" target=\"_blank\"> Los Angeles Times\u003c/a> reports.\u003c/p>\n\u003cp>In a one-year contract worth up to $88,000, Consumer Watchdog will supplement the rate review process already done by the insurance department.\u003c/p>\n\u003cp>From the Los Angeles Times:\u003c/p>\n\u003cdiv>\n\u003cblockquote>\u003cp>The insurance industry expressed dismay that the state enlisted its longtime nemesis to help review rate increases, and some experts questioned whether it's necessary to further antagonize insurers at a time when state officials are trying to work closely with the industry to implement a massive healthcare expansion.\u003c/p>\n\u003cp>Public-policy experts also scoffed at the arrangement.\u003c!--more-->\u003c/p>\n\u003cp>\"Their very aggressive stance against insurance companies raises serious questions about a conflict of interest,\" said Jessica Levinson, a Loyola Law School professor and expert on government ethics. \"You want an independent researcher.\"\u003c/p>\n\u003cp>Patrick Johnston, president of the insurance trade group California Assn. of Health Plans, said, \"Any review of health plan rates should be conducted by independent, impartial consumer groups that do not have political conflicts of interest and financial motivations.\" ...\u003c/p>\n\u003cp>(I)n an interview, Jones defended using grant money from the federal healthcare law to hire Consumer Watchdog.\u003c/p>\n\u003cp>\"I think it's important to have the consumer perspective, but at the end of the day we make our own determination,\" Jones said. \"This grant funding is a drop in the bucket compared to the hundreds of millions of dollars health insurers and HMOs have on their side. I think ordinary Californians know the deck is stacked against them.\"\u003c/p>\n\u003cp>Jamie Court, president of Consumer Watchdog, said the group's proven track record in challenging insurance company practices made it an ideal choice for the state. ...\u003c/p>\n\u003cp>\"We are the foremost expert on health insurance rates,\" Court said. \"This grant allows us to pull back the curtain and show how the wizards at Anthem and other companies are manipulating Oz. We want to prove that rates are too high.\"\u003c/p>\n\u003cp>That approach by Consumer Watchdog troubled some observers.\u003c/p>\n\u003cp>\"It's like asking one of the Dodgers to umpire a big game for the \u003ca title=\"San Francisco Giants\" href=\"http://www.latimes.com/topic/sports/baseball/san-francisco-giants-ORSPT000025.topic\">San Francisco Giants\u003c/a>,\" said Dan Schnur, director of the Jesse M. Unruh Institute of Politics at USC. \"Consumer Watchdog is a very well-respected organization, but the commissioner is clearly going out of his way to predetermine the outcome.\"\u003c/p>\u003c/blockquote>\n\u003cdiv>\u003c/div>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "No 'Rate Shock' in Vermont, First State with Proposed 2014 Premiums",
"title": "No 'Rate Shock' in Vermont, First State with Proposed 2014 Premiums",
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"content": "\u003cp>By Phil Galewitz, \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2013/04/no-rate-shock-seen-in-proposed-2014-premiums-in-vermont/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11871\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/02/no-rate-shock-in-vermont-first-state-with-proposed-2014-premiums/vermontsign_-flickr_herzogb/\" rel=\"attachment wp-att-11871\">\u003cimg class=\"size-medium wp-image-11871\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/VermontSign_-Flickr_herzogb-300x223.jpg\" alt=\"Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)\" width=\"300\" height=\"223\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>After years of anticipation, Vermont became the first state Monday \u003ca href=\"http://www.dfr.vermont.gov/sites/default/files/Filed%20QHP%20rates.pdf\">to publish proposed 2014 individual health \u003c/a>insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>That state may not be the best barometer of the impact of the heath overhaul on premiums, however, because it already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Unlike California, Vermont already prohibits insurers from using health status to determine an individual’s premiums.\u003c/aside>\n\u003cp>California does not currently have community rating regulations.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/28/health-care-overhaul-to-dramatically-reduce-premiums-for-many-individuals-study-finds/\" target=\"_blank\"> A major study last week \u003c/a>concluded that individual premiums will likely go down substantially for many Californians and up for others on the individual market, once the new online marketplace for health insurance opens later this year. Premiums are expected to be announced for California in several weeks.\u003c/p>\n\u003cp>Vermont also requires prices to be the same regardless of person’s age. Two of the health law’s biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->California is expected to implement both these provisions.\u003c/p>\n\u003cp>Blue Cross and Blue Shield of Vermont and MVP Health Care submitted plans to state regulators with monthly premiums that range from an average of $265 for catastrophic coverage for young adults to $609 for platinum coverage, which has the lowest cost-sharing among four categories of plans.\u003c/p>\n\u003cp>“We think this is a positive development for folks who were worried about what rates would look like in 2014,” said Kevin Goddard, spokesman for Blue Cross and Blue Shield of Vermont, which is the state’s dominant commercial carrier, controlling about two-thirds of the market. He confirmed rates are similar to what the company now offers.\u003c/p>\n\u003cp>“These rates are comparable to what’s on the market today and that’s good news,” said Robin Lunge, director of health reform in the Vermont governor’s office. She said it’s difficult to do an apples-to-apples comparison because of the many benefit changes required under President Barack Obama’s health overhaul. These changes, which take effect Jan. 1, include an end to annual lifetime limits in policies and a prohibition on denying coverage to people with medical problems.\u003c/p>\n\u003cp>Insurance industry predictions of rate shock are more likely in the majority of states that currently allow insurers to set premiums based on an individual’s health status, Goddard said.\u003c/p>\n\u003cp>Starting Oct. 1, individual and small group coverage in the state will be sold on a new online health insurance \u003ca href=\"http://healthconnect.vermont.gov/\">marketplace\u003c/a> as required under the Affordable Care Act. Health insurers nationwide have just begun submitting their pricing and benefit information to states and the federal government for policies which will be sold in \u003ca href=\"http://www.healthcare.gov/marketplace\">the marketplaces\u003c/a>, or exchanges. Most people who buy on the new marketplaces are expected to be eligible for government subsidies.\u003c/p>\n\u003cp>Vermont insurance regulators still must approve the insurers’ proposed rates. In January 2013, the state approved about a 10 percent rate increase on the individual market after carriers asked for about a 13 percent increase, Lunge said.\u003c/p>\n\u003cp>All the health plans in the new marketplaces are standardized into platinum, gold, silver and bronze categories depending on their actuarial value so consumers have an easier time comparing.\u003c/p>\n\u003cp>The Vermont 2014 annual premiums for bronze plans range from $4,200 to $4,440, compared to a Congressional Budget Office estimate of $4,500 for an individual, according to Carolyn Pearson of consulting firm Avalere Health.\u003c/p>\n\u003cp>Mary Eversole, executive director of the Vermont Insurance Agents Association, said she was surprised the rate increases were not higher. At first blush, she said the 2014 proposed rates appear to be about 10 percent higher than this year. Premiums for the gold and platinum policies appear lower than similar products, but silver and bronze policies are higher.\u003c/p>\n\u003cp>Officials from MVP were not available for immediate comment.\u003c/p>\n\u003cp>Learn more:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.washingtonpost.com/blogs/wonkblog/wp/2013/04/02/the-confused-debate-over-obamacare-and-insurance-premiums/\" target=\"_blank\">The Confused Debate Over Obamacare and Insurance Premiums\u003c/a> (Ezra Klein, Washington Post)\u003c/p>\n\n",
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"excerpt": "After years of anticipation, Vermont became the first state Monday to publish proposed 2014 individual health insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives.\r\n\r\nThat state may not be the best barometer of the impact of the heath overhaul on premiums, however, because it already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Phil Galewitz, \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2013/04/no-rate-shock-seen-in-proposed-2014-premiums-in-vermont/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11871\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/02/no-rate-shock-in-vermont-first-state-with-proposed-2014-premiums/vermontsign_-flickr_herzogb/\" rel=\"attachment wp-att-11871\">\u003cimg class=\"size-medium wp-image-11871\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/VermontSign_-Flickr_herzogb-300x223.jpg\" alt=\"Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)\" width=\"300\" height=\"223\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>After years of anticipation, Vermont became the first state Monday \u003ca href=\"http://www.dfr.vermont.gov/sites/default/files/Filed%20QHP%20rates.pdf\">to publish proposed 2014 individual health \u003c/a>insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>That state may not be the best barometer of the impact of the heath overhaul on premiums, however, because it already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Unlike California, Vermont already prohibits insurers from using health status to determine an individual’s premiums.\u003c/aside>\n\u003cp>California does not currently have community rating regulations.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/28/health-care-overhaul-to-dramatically-reduce-premiums-for-many-individuals-study-finds/\" target=\"_blank\"> A major study last week \u003c/a>concluded that individual premiums will likely go down substantially for many Californians and up for others on the individual market, once the new online marketplace for health insurance opens later this year. Premiums are expected to be announced for California in several weeks.\u003c/p>\n\u003cp>Vermont also requires prices to be the same regardless of person’s age. Two of the health law’s biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->California is expected to implement both these provisions.\u003c/p>\n\u003cp>Blue Cross and Blue Shield of Vermont and MVP Health Care submitted plans to state regulators with monthly premiums that range from an average of $265 for catastrophic coverage for young adults to $609 for platinum coverage, which has the lowest cost-sharing among four categories of plans.\u003c/p>\n\u003cp>“We think this is a positive development for folks who were worried about what rates would look like in 2014,” said Kevin Goddard, spokesman for Blue Cross and Blue Shield of Vermont, which is the state’s dominant commercial carrier, controlling about two-thirds of the market. He confirmed rates are similar to what the company now offers.\u003c/p>\n\u003cp>“These rates are comparable to what’s on the market today and that’s good news,” said Robin Lunge, director of health reform in the Vermont governor’s office. She said it’s difficult to do an apples-to-apples comparison because of the many benefit changes required under President Barack Obama’s health overhaul. These changes, which take effect Jan. 1, include an end to annual lifetime limits in policies and a prohibition on denying coverage to people with medical problems.\u003c/p>\n\u003cp>Insurance industry predictions of rate shock are more likely in the majority of states that currently allow insurers to set premiums based on an individual’s health status, Goddard said.\u003c/p>\n\u003cp>Starting Oct. 1, individual and small group coverage in the state will be sold on a new online health insurance \u003ca href=\"http://healthconnect.vermont.gov/\">marketplace\u003c/a> as required under the Affordable Care Act. Health insurers nationwide have just begun submitting their pricing and benefit information to states and the federal government for policies which will be sold in \u003ca href=\"http://www.healthcare.gov/marketplace\">the marketplaces\u003c/a>, or exchanges. Most people who buy on the new marketplaces are expected to be eligible for government subsidies.\u003c/p>\n\u003cp>Vermont insurance regulators still must approve the insurers’ proposed rates. In January 2013, the state approved about a 10 percent rate increase on the individual market after carriers asked for about a 13 percent increase, Lunge said.\u003c/p>\n\u003cp>All the health plans in the new marketplaces are standardized into platinum, gold, silver and bronze categories depending on their actuarial value so consumers have an easier time comparing.\u003c/p>\n\u003cp>The Vermont 2014 annual premiums for bronze plans range from $4,200 to $4,440, compared to a Congressional Budget Office estimate of $4,500 for an individual, according to Carolyn Pearson of consulting firm Avalere Health.\u003c/p>\n\u003cp>Mary Eversole, executive director of the Vermont Insurance Agents Association, said she was surprised the rate increases were not higher. At first blush, she said the 2014 proposed rates appear to be about 10 percent higher than this year. Premiums for the gold and platinum policies appear lower than similar products, but silver and bronze policies are higher.\u003c/p>\n\u003cp>Officials from MVP were not available for immediate comment.\u003c/p>\n\u003cp>Learn more:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.washingtonpost.com/blogs/wonkblog/wp/2013/04/02/the-confused-debate-over-obamacare-and-insurance-premiums/\" target=\"_blank\">The Confused Debate Over Obamacare and Insurance Premiums\u003c/a> (Ezra Klein, Washington Post)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Health Care Overhaul to Dramatically Reduce Premiums for Many Individuals, Study Finds",
"title": "Health Care Overhaul to Dramatically Reduce Premiums for Many Individuals, Study Finds",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5398\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-5398\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatient_Caroline_1_Flickr_04252012-300x200.jpg\" alt=\"(Caroline_1: Flickr)\" width=\"300\" height=\"200\">\u003cfigcaption class=\"wp-caption-text\">(Caroline_1: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new analysis shows that hundreds of thousands of Californians will see their monthly insurance premiums fall an average 47 percent under President Obama's health care overhaul, in large part due to tax credits and subsidies. It is the first detailed look at how health insurance premiums could change under President Obama's Affordable Care Act, which goes into effect on Jan. 1, 2014.\u003c/p>\n\u003cp>Covered California, the agency charged with creating the state's new health insurance marketplace, commissioned t\u003ca href=\"http://www.healthexchange.ca.gov/Documents/Factors%20Affecting%20Individual%20Premiums%20FINAL%203-28-2013.pdf\" target=\"_blank\">he analysis\u003c/a>. The report looked at the individual market only and did not examine the small or large group market.\u003c/p>\n\u003cp>Under the ACA people with incomes up to four times the federal poverty level (about $94,000 for a family of four; $46,000 for an individual) will be eligible for subsidies from the federal government. That's about 570,000 people, Covered California said.\u003c/p>\n\u003cp>Major findings from the study include:\u003c/p>\n\u003cul>\n\u003cli>Individuals with incomes less than four times the poverty level are \"likely to pay\" 47 to 84 percent less for their monthly premium compared to this year\u003c/li>\n\u003cli>Premiums would have increased 9 percent in 2014 because of health care inflation, even without the ACA\u003c!--more-->\u003c/li>\n\u003c/ul>\n\u003cp>The analysis was conducted by Milliman, a large actuarial firm.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to the non-partisan Kaiser Family Foundation, just over 2 million Californians buy insurance on the individual market. About 50 percent of Californians get insurance from their employer. Larry Levitt, senior vice president of the foundation, called the report a \"complete and well done analysis.\"\u003c/p>\n\u003cp>\"Probably the most important thing this analysis did,\" Levitt said, \"was to help people understand that not everyone is going to be faced with higher premiums as a result of the Affordable Care Act.\"\u003c/p>\n\u003cp>Still, some people will see higher premiums, in particular, people with incomes above 400 percent of the poverty level. More than a million of these middle and upper-income earners will likely experience an increase of 20 percent, the report found.\u003c/p>\n\u003cp>The Milliman analysis comes on the heels of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/\" target=\"_blank\">another actuarial review \u003c/a>completed this week. That one, from the Society of Actuaries, concluded costs would go up 32 percent under the ACA. But Levitt said that report was flawed, in part because it did not look across the ACA as a whole -- or at the two primary ways people pay for health care: through premiums and through direct out-or-pocket costs such as deductibles and co-pays.\u003c/p>\n\u003cp>The Milliman report looked at both these fees to consumers. Because of anticipated benefits of the ACA, increased premium rates that some will pay could be partially offset by reduced out-of-pocket costs for health care, the study found.\u003c/p>\n\u003cp>In a release, Covered California Executive Director Peter Lee called the study \"an important step in determining strategies to help protect\" individuals from cost increases.\u003c/p>\n\u003cp>In California, people buying insurance on the individual market have experienced dramatic premium rate hikes over the last several years.\u003c/p>\n\u003cp>\"Our top priority is to provide Californians with affordable health insurance options,\" Lee said. \"We are pleased that most individuals will pay lower rates and receive better coverage.\"\u003c/p>\n\u003cp>The report also found that people in their 20s are likely to experience the biggest increase in monthly premiums (roughly 25 percent higher than the average increase for all ages), but in its release Covered California said many of these younger Californians are likely to be eligible for subsidies.\u003c/p>\n\u003cp>Levitt credited the study for estimating cost reductions due to competition expected under the Affordable Care Act. Right now on the individual market in California, it is very difficult for consumers to comparison shop. Often they cannot even find out what their premium will be until they fill out a detailed health questionnaire, Levitt said. The goal of the new insurance marketplace is to allow a more straightforward comparison of health insurance plans.\u003c/p>\n\u003cp>\"Insurers will respond to that price competition by changing their cost structure,\" Levitt said. The analysis found that this competition should bring costs down an average 6 percent.\u003c/p>\n\u003cp>The California Association of Health Plans reiterated the group's overall support for the Affordable Care Act, but acknowledged the new competitive marketplace coming.\u003c/p>\n\u003cp>\"These are completely different products in the individual market than what is sold today,\" said Charles Bacchi, vice president of the group told KQED's Mina Kim. \"Health plans are going through the process of changing the way they provide coverage to this portion of the population, all on top of trying to price the products, deal with underlying health care costs and still remain competitive in the marketplace.\"\u003c/p>\n\u003cp>Insurance companies are expected to submit plans to Covered California next month, to determine eligibility for the marketplace. Plans -- and premiums -- will be announced this summer. But this study is well-timed, Levitt said.\u003c/p>\n\u003cp>\"People are forming impressions now about how this law will work and what it means to them,\" he said. \"So having accurate information out there about how people may be affected is really important.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new health insurance marketplace is scheduled to open to consumers on Oct. 1. Individuals will be able to shop for insurance that will take effect Jan. 1, 2014.\u003c/p>\n\n",
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"excerpt": "A major new analysis shows that hundreds of thousands of Californians will see their monthly insurance premiums fall an average 47 percent under President Obama's health care overhaul, in large part due to tax credits and subsidies. It is the first detailed look at how health insurance premiums could change under the president's health law, the Affordable Care Act, which goes into effect on January 1, 2014.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to the non-partisan Kaiser Family Foundation, just over 2 million Californians buy insurance on the individual market. About 50 percent of Californians get insurance from their employer. Larry Levitt, senior vice president of the foundation, called the report a \"complete and well done analysis.\"\u003c/p>\n\u003cp>\"Probably the most important thing this analysis did,\" Levitt said, \"was to help people understand that not everyone is going to be faced with higher premiums as a result of the Affordable Care Act.\"\u003c/p>\n\u003cp>Still, some people will see higher premiums, in particular, people with incomes above 400 percent of the poverty level. More than a million of these middle and upper-income earners will likely experience an increase of 20 percent, the report found.\u003c/p>\n\u003cp>The Milliman analysis comes on the heels of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/\" target=\"_blank\">another actuarial review \u003c/a>completed this week. That one, from the Society of Actuaries, concluded costs would go up 32 percent under the ACA. But Levitt said that report was flawed, in part because it did not look across the ACA as a whole -- or at the two primary ways people pay for health care: through premiums and through direct out-or-pocket costs such as deductibles and co-pays.\u003c/p>\n\u003cp>The Milliman report looked at both these fees to consumers. Because of anticipated benefits of the ACA, increased premium rates that some will pay could be partially offset by reduced out-of-pocket costs for health care, the study found.\u003c/p>\n\u003cp>In a release, Covered California Executive Director Peter Lee called the study \"an important step in determining strategies to help protect\" individuals from cost increases.\u003c/p>\n\u003cp>In California, people buying insurance on the individual market have experienced dramatic premium rate hikes over the last several years.\u003c/p>\n\u003cp>\"Our top priority is to provide Californians with affordable health insurance options,\" Lee said. \"We are pleased that most individuals will pay lower rates and receive better coverage.\"\u003c/p>\n\u003cp>The report also found that people in their 20s are likely to experience the biggest increase in monthly premiums (roughly 25 percent higher than the average increase for all ages), but in its release Covered California said many of these younger Californians are likely to be eligible for subsidies.\u003c/p>\n\u003cp>Levitt credited the study for estimating cost reductions due to competition expected under the Affordable Care Act. Right now on the individual market in California, it is very difficult for consumers to comparison shop. Often they cannot even find out what their premium will be until they fill out a detailed health questionnaire, Levitt said. The goal of the new insurance marketplace is to allow a more straightforward comparison of health insurance plans.\u003c/p>\n\u003cp>\"Insurers will respond to that price competition by changing their cost structure,\" Levitt said. The analysis found that this competition should bring costs down an average 6 percent.\u003c/p>\n\u003cp>The California Association of Health Plans reiterated the group's overall support for the Affordable Care Act, but acknowledged the new competitive marketplace coming.\u003c/p>\n\u003cp>\"These are completely different products in the individual market than what is sold today,\" said Charles Bacchi, vice president of the group told KQED's Mina Kim. \"Health plans are going through the process of changing the way they provide coverage to this portion of the population, all on top of trying to price the products, deal with underlying health care costs and still remain competitive in the marketplace.\"\u003c/p>\n\u003cp>Insurance companies are expected to submit plans to Covered California next month, to determine eligibility for the marketplace. Plans -- and premiums -- will be announced this summer. But this study is well-timed, Levitt said.\u003c/p>\n\u003cp>\"People are forming impressions now about how this law will work and what it means to them,\" he said. \"So having accurate information out there about how people may be affected is really important.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new health insurance marketplace is scheduled to open to consumers on Oct. 1. Individuals will be able to shop for insurance that will take effect Jan. 1, 2014.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Health Care Overhaul: Study Say Costs Could Go Up 32 Percent",
"title": "Health Care Overhaul: Study Say Costs Could Go Up 32 Percent",
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"content": "\u003cfigure id=\"attachment_11745\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/rs2147_stackof100dollarbills/\" rel=\"attachment wp-att-11745\">\u003cimg class=\"size-medium wp-image-11745\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-300x225.jpg\" alt=\"(401(k)2012/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(401(k)2012/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Now the actuaries are weighing in.\u003c/p>\n\u003cp>In a \u003ca href=\"http://cdn-files.soa.org/web/research-cost-aca-report.pdf\" target=\"_blank\">new analysis,\u003c/a> the Society of Actuaries says insurance companies will pay an average 32 percent more for medical claims under the health care overhaul.\u003c/p>\n\u003cp>That means premiums could go up, especially in the individual market.\u003c/p>\n\u003cp>The Obama Administration isn't convinced, though, saying the report didn't consider all the ways in which the administration says the Affordable Care Act will reduce costs.\u003c/p>\n\u003cp>More from the AP:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Actuaries are financial risk professionals who conduct long-range cost estimates for pension plans, insurance companies and government programs.\u003c/p>\n\u003cp>The study says claims costs will go up largely because sicker people will join the insurance pool. That's because the law forbids insurers from turning down those with pre-existing medical problems, effective Jan. 1. Everyone gets sick sooner or later, but sicker people also use more health care services.\u003c/p>\n\u003cp>\"Claims cost is the most important driver of health care premiums,\" said Kristi Bohn, an actuary who worked on the study. Spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program, said the report.\u003c/p>\n\u003cp>The Obama administration challenged the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.\u003c/p>\n\u003cp>The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live Oct. 1, administration officials said.\u003c/p>\n\u003cp>At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can't be compared to the comprehensive coverage available under the law. \"Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus,\" she said. \"They're really mortgage protection, not health insurance.\"\u003c/p>\n\u003cp>Sebelius said the picture on premiums won't start coming into focus until insurers submit their bids. Those results may not be publicly known until late summer. ...\u003c/p>\n\u003cp>A prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does \"a credible job\" of estimating potential enrollment and costs under the law, \"without trying to tilt the answers in any particular direction.\"\u003c/p>\n\u003cp>\"Having said that,\" Foster added, \"actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully.\" Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.\u003c/p>\u003c/blockquote>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "A new study finds that insurance companies will have to pay out an average of 32 percent more for medical claims under President Barack Obama's health care overhaul.\r\n\r\nWhat does that mean for you?\r\n\r\nIt could increase premiums for at least some Americans.\r\n\r\nIf you are uninsured, or you buy your policy directly from an insurance company, you should pay attention.",
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"description": "A new study finds that insurance companies will have to pay out an average of 32 percent more for medical claims under President Barack Obama's health care overhaul.\r\n\r\nWhat does that mean for you?\r\n\r\nIt could increase premiums for at least some Americans.\r\n\r\nIf you are uninsured, or you buy your policy directly from an insurance company, you should pay attention.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_11745\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/rs2147_stackof100dollarbills/\" rel=\"attachment wp-att-11745\">\u003cimg class=\"size-medium wp-image-11745\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS2147_Stackof100DollarBIlls-300x225.jpg\" alt=\"(401(k)2012/Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(401(k)2012/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Now the actuaries are weighing in.\u003c/p>\n\u003cp>In a \u003ca href=\"http://cdn-files.soa.org/web/research-cost-aca-report.pdf\" target=\"_blank\">new analysis,\u003c/a> the Society of Actuaries says insurance companies will pay an average 32 percent more for medical claims under the health care overhaul.\u003c/p>\n\u003cp>That means premiums could go up, especially in the individual market.\u003c/p>\n\u003cp>The Obama Administration isn't convinced, though, saying the report didn't consider all the ways in which the administration says the Affordable Care Act will reduce costs.\u003c/p>\n\u003cp>More from the AP:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Actuaries are financial risk professionals who conduct long-range cost estimates for pension plans, insurance companies and government programs.\u003c/p>\n\u003cp>The study says claims costs will go up largely because sicker people will join the insurance pool. That's because the law forbids insurers from turning down those with pre-existing medical problems, effective Jan. 1. Everyone gets sick sooner or later, but sicker people also use more health care services.\u003c/p>\n\u003cp>\"Claims cost is the most important driver of health care premiums,\" said Kristi Bohn, an actuary who worked on the study. Spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program, said the report.\u003c/p>\n\u003cp>The Obama administration challenged the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.\u003c/p>\n\u003cp>The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live Oct. 1, administration officials said.\u003c/p>\n\u003cp>At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can't be compared to the comprehensive coverage available under the law. \"Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus,\" she said. \"They're really mortgage protection, not health insurance.\"\u003c/p>\n\u003cp>Sebelius said the picture on premiums won't start coming into focus until insurers submit their bids. Those results may not be publicly known until late summer. ...\u003c/p>\n\u003cp>A prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does \"a credible job\" of estimating potential enrollment and costs under the law, \"without trying to tilt the answers in any particular direction.\"\u003c/p>\n\u003cp>\"Having said that,\" Foster added, \"actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully.\" Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.\u003c/p>\u003c/blockquote>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>By John M. Gonzales, \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11636\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/24/immigration-reform-maybe-but-long-wait-for-health-access-by-the-undocumented/fred-bauermeister_laurenwhaley_chcfctrforhealthrptg_032013/\" rel=\"attachment wp-att-11636\">\u003cimg class=\"size-medium wp-image-11636\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Fred-Bauermeister_LaurenWhaley_CHCFctrforHealthRptg_032013-300x198.jpg\" alt=\"Fred Bauermeister is executive director of the Free Clinic of Simi Valley, which has been providing health care to undocumented immigrants for years. (Lauren Whaley/CHCF Center for Health Reporting)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Fred Bauermeister is executive director of the Free Clinic of Simi Valley, a health care provider to undocumented immigrants for years. (Lauren Whaley/CHCF Center for Health Reporting) \u003ccite>(Lauren Whaley/CHCF Center for Health Reporting)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Clinic director Fred Bauermeister has watched them pass through his doors for decades: chronically ill, uninsured men, women and children, who have delayed medical care because they are in the country illegally.\u003c/p>\n\u003cp>Now, immigration reform may bring health benefits to millions of formerly undocumented people -- although there may still be a years-long wait after they attain legal residency.\u003c/p>\n\u003cp>But first -- the immigration reform piece: a bandwagon of \u003ca href=\"http://politicalticker.blogs.cnn.com/2013/03/19/rubio-praises-paul-on-immigration/\">endorsements last week\u003c/a> by Congressional Republicans have aligned with vows by President Obama and Senate Democrats to establish comprehensive immigration reform. A road to citizenship for people who entered the country illegally seems more assured by the day, but what is less clear is how the health care landscape of California, and the nation, would also change.\u003c/p>\n\u003cp>Would California’s estimated 2.5 million undocumented immigrants become eligible for health benefits? How would an already burdened health care system absorb them?\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We’re very interested -- and very concerned – with how this is all going to work out,” said Bauermeister, executive director of the Free Clinic of Simi Valley, a California provider that seeks to keep immigrants out of expensive modes of care like the emergency room.\u003c/p>\n\u003cp>Obama’s commitment to move an estimated 11 million undocumented immigrants nationally “out of the shadows” would not end there. Under current law, it would also slowly open the door for them to qualify for public programs, including the health care overhaul’s massive coverage expansions.\u003c/p>\n\u003cp>Obama’s plan would have immigrants wait at least eight years before they qualify for health benefits. A Congressional plan spearheaded by Republican senators Marco Rubio and John McCain pushes the wait to at least 10 years.\u003c/p>\n\u003cp>Some experts believe both scenarios would create an interim period in which even wider gaps will develop between the haves and have-nots of health care.\u003c/p>\n\u003cp>If health reform works as intended, there will not only be a boost in the number of new people covered, but a steady improvement in their health. Meanwhile, undocumented immigrants sit on the sidelines for, give or take, at least a decade.\u003c/p>\n\u003cp>“We’re going to create a two-tiered system of health, as well as perpetuate disparities in health,” said Ignatious Bau, a San Francisco-based health policy consultant whose clients include insurance giant Kaiser Permanente.\u003c/p>\n\u003cp>“People who are in the system are going to get better quality and efficiency,” said Bau. “But [undocumented] people who aren’t in the system are going to go to the ER.”\u003c/p>\n\u003cp>The haves, incidentally, will continue to be stuck with the bill for the health care have-nots, Bau said.\u003c/p>\n\u003cp>There is a push by several groups, \u003ca href=\"http://www.youtube.com/watch?v=sK6IG67IuLI\">including the California Endowment\u003c/a>, to win immediate health reform benefits for undocumented immigrants.\u003c/p>\n\u003cp>But so far neither President Obama, nor Congress, has shown any interest.\u003c/p>\n\u003cp>Some health providers believe that the gradual approach proposed by Washington is the only way to accommodate the undocumented population, particularly in immigrant-heavy states like California.\u003c/p>\n\u003cp>Health reform, which comes fully online in 2014, consists of two enormous coverage methods.\u003c/p>\n\u003cp>One is the Medicaid safety net, called Medi-Cal in California, from which undocumented immigrants are generally excluded.\u003c/p>\n\u003cp>The other is the government-subsidized insurance marketplace,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/\" target=\"_blank\"> Covered California\u003c/a>, designed to help consumers find affordable health plans of their own choosing. Undocumented immigrants cannot participate in Covered California either.\u003c/p>\n\u003cp>The exclusions frustrate many health experts. They say that including currently ineligible immigrants in reform would slash the ranks of the uninsured.\u003c/p>\n\u003cp>According \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/Two-Thirds%20of%20California%E2%80%99s%20Seven%20Million%20Uninsured%20May%20Obtain%20Coverage%20Under%20Health%20Care%20Reform.pdf\">to a 2011 study\u003c/a> by the UCLA Center for Health Policy Research, 84 percent of California’s 7 million uninsured will qualify for health reform coverage as it currently stands.\u003c/p>\n\u003cp>If undocumented immigrants were added to the health reform mix, 100 percent of the state’s uninsured would then be eligible for some form of coverage. Still, experts say, because of language barriers and personal choice, it is unlikely every qualified immigrant would apply.\u003c/p>\n\u003cp>Nationally, the Congressional Budget Office reported in 2010 that more than 90 percent of U.S. residents could eventually be insured with the boost provided by health reform, leaving about 23 million uncovered. If undocumented immigrants were granted coverage, the uninsured would be slashed by an additional third.\u003c/p>\n\u003cp>Health experts rarely dispute the long-term fiscal benefits of covering more people.\u003c/p>\n\u003cp>Studies like \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=185561\">Health Care Reform in Transition,\u003c/a> in the Journal of the American Medical Association, find the larger the population in an insurance pool, the more stable the premiums.\u003c/p>\n\u003cp>“The healthy subsidize the sick,” the 2010 study found.\u003c/p>\n\u003cp>Scholars also cite studies showing that immigrants are generally younger, and healthier, than the U.S.-born population when they first arrive. As they stay in the United States longer, their health begins to decline and look like that of their U.S.-born counterparts, studies find.\u003c/p>\n\u003cp>Nevertheless, Obama cites the Personal Responsibility and Work Opportunity Act of 1996, which bans green card holders from public benefits for five years, and his own ideas, as the timetable for immigrant access to health reform.\u003c/p>\n\u003cp>According to a leaked copy of the President’s proposal, undocumented immigrants must get in the “back of the line” and petition to become a “Lawful Prospective Immigrant.” They must hold that newly created status for at least eight years.\u003c/p>\n\u003cp>From there, they can be declared a “Legal Permanent Resident” with a green card. But they must hold the green card for at least five years to qualify for public health benefits including the expanded version of Medicaid created by reform.\u003c/p>\n\u003cp>“If everybody else is covered,” Bauermeister said, “then the ones who aren’t are going to be our patients.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Learn more about \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/about\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>, \u003cem>an independent news organization reporting on health care issues.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Clinic director Fred Bauermeister has watched them pass through his doors for decades: chronically ill, uninsured men, women and children, who have delayed medical care because they are in the country illegally.\r\n\r\nNow, though, the prospect of a political deal over immigration reform may, after many years, bring health benefits to millions of undocumented people.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By John M. Gonzales, \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11636\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/24/immigration-reform-maybe-but-long-wait-for-health-access-by-the-undocumented/fred-bauermeister_laurenwhaley_chcfctrforhealthrptg_032013/\" rel=\"attachment wp-att-11636\">\u003cimg class=\"size-medium wp-image-11636\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Fred-Bauermeister_LaurenWhaley_CHCFctrforHealthRptg_032013-300x198.jpg\" alt=\"Fred Bauermeister is executive director of the Free Clinic of Simi Valley, which has been providing health care to undocumented immigrants for years. (Lauren Whaley/CHCF Center for Health Reporting)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Fred Bauermeister is executive director of the Free Clinic of Simi Valley, a health care provider to undocumented immigrants for years. (Lauren Whaley/CHCF Center for Health Reporting) \u003ccite>(Lauren Whaley/CHCF Center for Health Reporting)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Clinic director Fred Bauermeister has watched them pass through his doors for decades: chronically ill, uninsured men, women and children, who have delayed medical care because they are in the country illegally.\u003c/p>\n\u003cp>Now, immigration reform may bring health benefits to millions of formerly undocumented people -- although there may still be a years-long wait after they attain legal residency.\u003c/p>\n\u003cp>But first -- the immigration reform piece: a bandwagon of \u003ca href=\"http://politicalticker.blogs.cnn.com/2013/03/19/rubio-praises-paul-on-immigration/\">endorsements last week\u003c/a> by Congressional Republicans have aligned with vows by President Obama and Senate Democrats to establish comprehensive immigration reform. A road to citizenship for people who entered the country illegally seems more assured by the day, but what is less clear is how the health care landscape of California, and the nation, would also change.\u003c/p>\n\u003cp>Would California’s estimated 2.5 million undocumented immigrants become eligible for health benefits? How would an already burdened health care system absorb them?\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re very interested -- and very concerned – with how this is all going to work out,” said Bauermeister, executive director of the Free Clinic of Simi Valley, a California provider that seeks to keep immigrants out of expensive modes of care like the emergency room.\u003c/p>\n\u003cp>Obama’s commitment to move an estimated 11 million undocumented immigrants nationally “out of the shadows” would not end there. Under current law, it would also slowly open the door for them to qualify for public programs, including the health care overhaul’s massive coverage expansions.\u003c/p>\n\u003cp>Obama’s plan would have immigrants wait at least eight years before they qualify for health benefits. A Congressional plan spearheaded by Republican senators Marco Rubio and John McCain pushes the wait to at least 10 years.\u003c/p>\n\u003cp>Some experts believe both scenarios would create an interim period in which even wider gaps will develop between the haves and have-nots of health care.\u003c/p>\n\u003cp>If health reform works as intended, there will not only be a boost in the number of new people covered, but a steady improvement in their health. Meanwhile, undocumented immigrants sit on the sidelines for, give or take, at least a decade.\u003c/p>\n\u003cp>“We’re going to create a two-tiered system of health, as well as perpetuate disparities in health,” said Ignatious Bau, a San Francisco-based health policy consultant whose clients include insurance giant Kaiser Permanente.\u003c/p>\n\u003cp>“People who are in the system are going to get better quality and efficiency,” said Bau. “But [undocumented] people who aren’t in the system are going to go to the ER.”\u003c/p>\n\u003cp>The haves, incidentally, will continue to be stuck with the bill for the health care have-nots, Bau said.\u003c/p>\n\u003cp>There is a push by several groups, \u003ca href=\"http://www.youtube.com/watch?v=sK6IG67IuLI\">including the California Endowment\u003c/a>, to win immediate health reform benefits for undocumented immigrants.\u003c/p>\n\u003cp>But so far neither President Obama, nor Congress, has shown any interest.\u003c/p>\n\u003cp>Some health providers believe that the gradual approach proposed by Washington is the only way to accommodate the undocumented population, particularly in immigrant-heavy states like California.\u003c/p>\n\u003cp>Health reform, which comes fully online in 2014, consists of two enormous coverage methods.\u003c/p>\n\u003cp>One is the Medicaid safety net, called Medi-Cal in California, from which undocumented immigrants are generally excluded.\u003c/p>\n\u003cp>The other is the government-subsidized insurance marketplace,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/\" target=\"_blank\"> Covered California\u003c/a>, designed to help consumers find affordable health plans of their own choosing. Undocumented immigrants cannot participate in Covered California either.\u003c/p>\n\u003cp>The exclusions frustrate many health experts. They say that including currently ineligible immigrants in reform would slash the ranks of the uninsured.\u003c/p>\n\u003cp>According \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/Two-Thirds%20of%20California%E2%80%99s%20Seven%20Million%20Uninsured%20May%20Obtain%20Coverage%20Under%20Health%20Care%20Reform.pdf\">to a 2011 study\u003c/a> by the UCLA Center for Health Policy Research, 84 percent of California’s 7 million uninsured will qualify for health reform coverage as it currently stands.\u003c/p>\n\u003cp>If undocumented immigrants were added to the health reform mix, 100 percent of the state’s uninsured would then be eligible for some form of coverage. Still, experts say, because of language barriers and personal choice, it is unlikely every qualified immigrant would apply.\u003c/p>\n\u003cp>Nationally, the Congressional Budget Office reported in 2010 that more than 90 percent of U.S. residents could eventually be insured with the boost provided by health reform, leaving about 23 million uncovered. If undocumented immigrants were granted coverage, the uninsured would be slashed by an additional third.\u003c/p>\n\u003cp>Health experts rarely dispute the long-term fiscal benefits of covering more people.\u003c/p>\n\u003cp>Studies like \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=185561\">Health Care Reform in Transition,\u003c/a> in the Journal of the American Medical Association, find the larger the population in an insurance pool, the more stable the premiums.\u003c/p>\n\u003cp>“The healthy subsidize the sick,” the 2010 study found.\u003c/p>\n\u003cp>Scholars also cite studies showing that immigrants are generally younger, and healthier, than the U.S.-born population when they first arrive. As they stay in the United States longer, their health begins to decline and look like that of their U.S.-born counterparts, studies find.\u003c/p>\n\u003cp>Nevertheless, Obama cites the Personal Responsibility and Work Opportunity Act of 1996, which bans green card holders from public benefits for five years, and his own ideas, as the timetable for immigrant access to health reform.\u003c/p>\n\u003cp>According to a leaked copy of the President’s proposal, undocumented immigrants must get in the “back of the line” and petition to become a “Lawful Prospective Immigrant.” They must hold that newly created status for at least eight years.\u003c/p>\n\u003cp>From there, they can be declared a “Legal Permanent Resident” with a green card. But they must hold the green card for at least five years to qualify for public health benefits including the expanded version of Medicaid created by reform.\u003c/p>\n\u003cp>“If everybody else is covered,” Bauermeister said, “then the ones who aren’t are going to be our patients.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Learn more about \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/about\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>, \u003cem>an independent news organization reporting on health care issues.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "What's Up With the California Health Care Overhaul Bills?",
"title": "What's Up With the California Health Care Overhaul Bills?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_9250\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/05/affordable-care-act-in-california-getting-to-the-nitty-gritty-now/sacramento_capital_seliaymiwell_flickr/\" rel=\"attachment wp-att-9250\">\u003cimg class=\"size-medium wp-image-9250\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Sacramento_Capital_seliaymiwell_flickr-300x200.jpg\" alt=\"(seliaymiwell/flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(seliaymiwell/flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While President Obama's health care overhaul turns three on Saturday, many states are scrambling to get everything ready for the full rollout on January 1. California was the \u003ca href=\"http://www.californiareport.org/archive/R201008270850/b\" target=\"_blank\">first state to pass legislation\u003c/a> to set up a marketplace, and the Legislature has done a lot of work since. But there's still a lot left to do -- and fast.\u003c/p>\n\u003cp>To bring you up to date, three major sets of bills are before the Legislature in its Affordable Care Act special session. (Six bills total; Assembly and Senate have their own versions of three proposals).\u003c/p>\n\u003cp>Of those, two issues are key:\u003c/p>\n\u003cul>\n\u003cli>Reforming the individual market\u003c/li>\n\u003cli>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/07/how-to-expand-medi-cal-assembly-weighs-gov-browns-two-proposals/\" target=\"_blank\">Medi-Cal expansion\u003c/a> (the state's health insurance program for the poor.\u003c/li>\n\u003c/ul>\n\u003cp>As David Gorn of the CaliforniaHealthline reports, the California Legislature went on spring recess yesterday. These ACA bills are outstanding, much to the frustration of advocates. These special session bills take effect in 90 days, once they are passed. ACA proponents had hoped passage would have happened already.\u003c!--more-->\u003c/p>\n\u003cp>As far as the individual market reform goes, those bills were hung up over technical language which appears to have been resolved (tie-back to the federal law's individual mandate, for you wonks out there). Gorn reports that Sen. Ed Hernandez (D-West Covina) is confident the bill will be on Gov. Brown's desk soon after the Legislature is back in session.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That's the good news. More from \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2013/3/special-session-bills-still-pending-in-recess.aspx\" target=\"_blank\">CaliforniaHealthline\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The Medi-Cal expansion legislation, though, is a different story.\u003c/p>\n\u003cp>\"The one we're going to have trouble with is the Medicaid expansion bill,\" Hernandez said. \"We're miles apart on that one.\"\u003c/p>\n\u003cp>Assembly member Pan, who chairs the Assembly Committee on Health, said the hang-up on passage of the special session bills has to do, in part, with the debate over distribution of federal money. Counties are likely getting a large financial reprieve from optional Medi-Cal expansion and the state would like to get a piece of that.\u003c/p>\n\u003cp>\"The governor is looking for sources of funding for the Medi-Cal expansion,\" Pan said. \"The expansion itself, though, is more of a policy issue than a budget issue. Those are big issues, so let's not hold up the policy over other concerns.\"\u003c/p>\n\u003cp>Hernandez the Medi-Cal expansion portion of the special session could be bumped into regular session.\u003c/p>\n\u003cp>\"My sense is the administration wants to run this in the regular session,\" he said. \"That one's going to be bottled up for a long time, and I can't tell you how long.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The Legislature is back in session on Monday, April 1.\u003c/p>\n\n",
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"excerpt": "While President Obama's health care overhaul turns three on Saturday, many states are scrambling to get everything ready for the full rollout of the Affordable Care Act on January 1. California may have been the first state of pass legislation to set up a marketplace, and the legislature has done a lot of work since. But there's still a lot left to do -- and fast.\r\n\r\nTo bring you up to date, three major sets of bills are before the legislature in its ACA special session. (Six bills total; Assembly and Senate have their own versions of three proposals).",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9250\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/05/affordable-care-act-in-california-getting-to-the-nitty-gritty-now/sacramento_capital_seliaymiwell_flickr/\" rel=\"attachment wp-att-9250\">\u003cimg class=\"size-medium wp-image-9250\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Sacramento_Capital_seliaymiwell_flickr-300x200.jpg\" alt=\"(seliaymiwell/flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(seliaymiwell/flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While President Obama's health care overhaul turns three on Saturday, many states are scrambling to get everything ready for the full rollout on January 1. California was the \u003ca href=\"http://www.californiareport.org/archive/R201008270850/b\" target=\"_blank\">first state to pass legislation\u003c/a> to set up a marketplace, and the Legislature has done a lot of work since. But there's still a lot left to do -- and fast.\u003c/p>\n\u003cp>To bring you up to date, three major sets of bills are before the Legislature in its Affordable Care Act special session. (Six bills total; Assembly and Senate have their own versions of three proposals).\u003c/p>\n\u003cp>Of those, two issues are key:\u003c/p>\n\u003cul>\n\u003cli>Reforming the individual market\u003c/li>\n\u003cli>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/07/how-to-expand-medi-cal-assembly-weighs-gov-browns-two-proposals/\" target=\"_blank\">Medi-Cal expansion\u003c/a> (the state's health insurance program for the poor.\u003c/li>\n\u003c/ul>\n\u003cp>As David Gorn of the CaliforniaHealthline reports, the California Legislature went on spring recess yesterday. These ACA bills are outstanding, much to the frustration of advocates. These special session bills take effect in 90 days, once they are passed. ACA proponents had hoped passage would have happened already.\u003c!--more-->\u003c/p>\n\u003cp>As far as the individual market reform goes, those bills were hung up over technical language which appears to have been resolved (tie-back to the federal law's individual mandate, for you wonks out there). Gorn reports that Sen. Ed Hernandez (D-West Covina) is confident the bill will be on Gov. Brown's desk soon after the Legislature is back in session.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That's the good news. More from \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2013/3/special-session-bills-still-pending-in-recess.aspx\" target=\"_blank\">CaliforniaHealthline\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The Medi-Cal expansion legislation, though, is a different story.\u003c/p>\n\u003cp>\"The one we're going to have trouble with is the Medicaid expansion bill,\" Hernandez said. \"We're miles apart on that one.\"\u003c/p>\n\u003cp>Assembly member Pan, who chairs the Assembly Committee on Health, said the hang-up on passage of the special session bills has to do, in part, with the debate over distribution of federal money. Counties are likely getting a large financial reprieve from optional Medi-Cal expansion and the state would like to get a piece of that.\u003c/p>\n\u003cp>\"The governor is looking for sources of funding for the Medi-Cal expansion,\" Pan said. \"The expansion itself, though, is more of a policy issue than a budget issue. Those are big issues, so let's not hold up the policy over other concerns.\"\u003c/p>\n\u003cp>Hernandez the Medi-Cal expansion portion of the special session could be bumped into regular session.\u003c/p>\n\u003cp>\"My sense is the administration wants to run this in the regular session,\" he said. \"That one's going to be bottled up for a long time, and I can't tell you how long.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The Legislature is back in session on Monday, April 1.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>By \u003ca href=\"http://www.kqed.org/radio/about/staff/mina-kim.jsp\" target=\"_blank\">Mina Kim\u003c/a>, KQED\u003c/p>\n\u003cfigure id=\"attachment_1175\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2011/12/09/one-womans-apology-to-president-obama/230136_president-obama-signs-health-reform-law-4/\" rel=\"attachment wp-att-1175\">\u003cimg class=\"size-medium wp-image-1175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3-300x200.jpg\" alt=\"President Obama signs health care reform law. (Photo: White House)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama signs the Affordable Care Act into law in March 2010. (Photo: White House)\u003c/figcaption>\u003c/figure>\n\u003cp>Saturday marks three years since the signing of the federal Affordable Care Act, and state health officials have been celebrating by touting the benefits of the health overhaul law.\u003c/p>\n\u003cp>On Thursday, the nonprofit group Health Access released a \u003cstrong>\u003ca href=\"http://www.health-access.org/files/expanding/HealthAccessACA3-YearReportMar21.pdf\" target=\"_blank\">report\u003c/a> \u003c/strong>that determined more than one million Californians have been able to get coverage through new options provided under the ACA. Those residents include adults with low incomes, people with pre-existing health conditions, and young people who can stay on their parent’s insurance plan until the age of 26.\u003c/p>\n\u003cp>“But much more is needed to be done,” said Health Access director Anthony Wright.\u003c!--more-->\u003c/p>\n\u003cp>Wright, Assemblyman Richard Pan and other health advocates urged Gov. Jerry Brown and lawmakers to pass a plan that would expand Medi-Cal -- the state’s health program for the poor -- and to pass bills that would ban price discrimination based on pre-existing conditions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>ACA proponents also held press conferences around the state. On the steps of San Francisco city hall Thursday, officials hailed the Affordable Care Act's benefits, even as it means less money down the line for the city’s universal care program, Healthy San Francisco. Patient fees and employer contributions to Healthy San Francisco will stop as residents move to Medi-Cal or buy coverage on the state’s marketplace Covered California.\u003c/p>\n\u003cp>But Tangerine Brigham who runs Healthy San Francisco says that’s okay, \"because we will have the opportunity to take upwards of 60,000 people who are in our access programs and move them into health insurance,” she said. “Health insurance that will provide comprehensive benefits; that will be affordable.”\u003c/p>\n\u003cp>Brigham said as more people move into health insurance under the federal law, costs for Healthy San Francisco will go down. She urged lawmakers and community leaders to do a better job communicating the benefits of the Affordable Care Act.\u003c/p>\n\u003cp>“The worst thing that could happen is that come January 2014, people are not aware that health insurance is available to them at low cost,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A recent Kaiser Family Foundation \u003ca href=\"http://www.kff.org/kaiserpolls/8425.cfm\" target=\"_blank\">\u003cstrong>poll\u003c/strong>\u003c/a> found that three years in, most Americans still don't understand the federal law and remain deeply divided over it.\u003c/p>\n\n",
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"excerpt": "Saturday marks three years since the signing of the federal Affordable Care Act, and state health officials have been celebrating by touting the benefits of the health overhaul law.\r\n\r\nOn Thursday, the nonprofit group Health Access released a report that determined more than one million Californians have been able to get coverage through new options provided under the ACA. Those residents include adults with low incomes, people with pre-existing health conditions, and young people who can stay on their parent’s insurance plan until the age of 26.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003ca href=\"http://www.kqed.org/radio/about/staff/mina-kim.jsp\" target=\"_blank\">Mina Kim\u003c/a>, KQED\u003c/p>\n\u003cfigure id=\"attachment_1175\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2011/12/09/one-womans-apology-to-president-obama/230136_president-obama-signs-health-reform-law-4/\" rel=\"attachment wp-att-1175\">\u003cimg class=\"size-medium wp-image-1175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/230136_President-Obama-signs-Health-Reform-Law3-300x200.jpg\" alt=\"President Obama signs health care reform law. (Photo: White House)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama signs the Affordable Care Act into law in March 2010. (Photo: White House)\u003c/figcaption>\u003c/figure>\n\u003cp>Saturday marks three years since the signing of the federal Affordable Care Act, and state health officials have been celebrating by touting the benefits of the health overhaul law.\u003c/p>\n\u003cp>On Thursday, the nonprofit group Health Access released a \u003cstrong>\u003ca href=\"http://www.health-access.org/files/expanding/HealthAccessACA3-YearReportMar21.pdf\" target=\"_blank\">report\u003c/a> \u003c/strong>that determined more than one million Californians have been able to get coverage through new options provided under the ACA. Those residents include adults with low incomes, people with pre-existing health conditions, and young people who can stay on their parent’s insurance plan until the age of 26.\u003c/p>\n\u003cp>“But much more is needed to be done,” said Health Access director Anthony Wright.\u003c!--more-->\u003c/p>\n\u003cp>Wright, Assemblyman Richard Pan and other health advocates urged Gov. Jerry Brown and lawmakers to pass a plan that would expand Medi-Cal -- the state’s health program for the poor -- and to pass bills that would ban price discrimination based on pre-existing conditions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>ACA proponents also held press conferences around the state. On the steps of San Francisco city hall Thursday, officials hailed the Affordable Care Act's benefits, even as it means less money down the line for the city’s universal care program, Healthy San Francisco. Patient fees and employer contributions to Healthy San Francisco will stop as residents move to Medi-Cal or buy coverage on the state’s marketplace Covered California.\u003c/p>\n\u003cp>But Tangerine Brigham who runs Healthy San Francisco says that’s okay, \"because we will have the opportunity to take upwards of 60,000 people who are in our access programs and move them into health insurance,” she said. “Health insurance that will provide comprehensive benefits; that will be affordable.”\u003c/p>\n\u003cp>Brigham said as more people move into health insurance under the federal law, costs for Healthy San Francisco will go down. She urged lawmakers and community leaders to do a better job communicating the benefits of the Affordable Care Act.\u003c/p>\n\u003cp>“The worst thing that could happen is that come January 2014, people are not aware that health insurance is available to them at low cost,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A recent Kaiser Family Foundation \u003ca href=\"http://www.kff.org/kaiserpolls/8425.cfm\" target=\"_blank\">\u003cstrong>poll\u003c/strong>\u003c/a> found that three years in, most Americans still don't understand the federal law and remain deeply divided over it.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"headTitle": "State of Health | KQED News",
"content": "\u003cp>OK, this is not as much fun as \"7 Ways to Lose Weight.\" But since a \u003ca href=\"http://www.kff.org/kaiserpolls/8425.cfm\" target=\"_blank\">national poll \u003c/a>this week showed that a majority of Americans don't understand how the health care overhaul (AKA: Obamacare) will impact them, it seemed like it was time to take \u003ca href=\"http://healthreform.kff.org/quizzes/health-reform-quiz.aspx\" target=\"_blank\">a quiz\u003c/a>. This one was put together by the Kaiser Family Foundation, and includes (short) helpful answers at the end.\u003c/p>\n\u003cp>It's just 10 questions. Click on the box below to get started. Good luck!\u003c/p>\n\u003cfigure id=\"attachment_11549\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://healthreform.kff.org/quizzes/health-reform-quiz.aspx\" rel=\"attachment wp-att-11549\">\u003cimg class=\" wp-image-11549\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-03-21-at-2.43.30-PM-620x230.png\" alt=\"\" width=\"620\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kaiser Family Foundation)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003cbr>\nA little more on the poll: the country remains divided about the Affordable Care Act: 40 percent of Americans view the law unfavorably and 37 percent are favorable. Views are split along party lines.\u003c/p>\n\u003cp>Nearly half of Americans says they have heard \"nothing at all\" about their state's decision to create a health insurance marketplace. To clarify for the Golden State, California is moving forward aggressively on establishing a marketplace (also called an exchange).\u003c/p>\n\u003cp>Gov. Jerry Brown and the California Legislature support the Medicaid expansion called for under the ACA and are working out the details in a special legislative session.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "OK, this is not as much fun as \"7 Ways to Lose Weight,\" but given that a new national poll this week showed that a majority of Americans don't understand how the health care overhaul (AKA: Obamacare) will impact them, it seemed like it was time to take a quiz.\r\n\r\nIt's just 10 questions. Go!",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>OK, this is not as much fun as \"7 Ways to Lose Weight.\" But since a \u003ca href=\"http://www.kff.org/kaiserpolls/8425.cfm\" target=\"_blank\">national poll \u003c/a>this week showed that a majority of Americans don't understand how the health care overhaul (AKA: Obamacare) will impact them, it seemed like it was time to take \u003ca href=\"http://healthreform.kff.org/quizzes/health-reform-quiz.aspx\" target=\"_blank\">a quiz\u003c/a>. This one was put together by the Kaiser Family Foundation, and includes (short) helpful answers at the end.\u003c/p>\n\u003cp>It's just 10 questions. Click on the box below to get started. Good luck!\u003c/p>\n\u003cfigure id=\"attachment_11549\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://healthreform.kff.org/quizzes/health-reform-quiz.aspx\" rel=\"attachment wp-att-11549\">\u003cimg class=\" wp-image-11549\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-03-21-at-2.43.30-PM-620x230.png\" alt=\"\" width=\"620\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kaiser Family Foundation)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003cbr>\nA little more on the poll: the country remains divided about the Affordable Care Act: 40 percent of Americans view the law unfavorably and 37 percent are favorable. Views are split along party lines.\u003c/p>\n\u003cp>Nearly half of Americans says they have heard \"nothing at all\" about their state's decision to create a health insurance marketplace. To clarify for the Golden State, California is moving forward aggressively on establishing a marketplace (also called an exchange).\u003c/p>\n\u003cp>Gov. Jerry Brown and the California Legislature support the Medicaid expansion called for under the ACA and are working out the details in a special legislative session.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "What Will California's Health Benefit Exchange Application Look Like?",
"title": "What Will California's Health Benefit Exchange Application Look Like?",
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"content": "\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/15/what-will-californias-health-benefit-exchange-application-look-like/draft/\" rel=\"attachment wp-att-11419\">\u003cimg class=\"alignleft size-medium wp-image-11419\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Draft-300x260.jpg\" alt=\"Draft\" width=\"300\" height=\"260\">\u003c/a>Immediately following the Supreme Court's decision on the Affordable Care Act, the head of California's Health Benefit Exchange \u003ca href=\"http://www.sfgate.com/health/article/Health-care-exchange-will-offer-policies-3675063.php\">laid out his vision\u003c/a> for revolutionizing the health insurance market.\u003c/p>\n\u003cp>\"We know buying insurance is really complicated. We want to make it as easy as buying a book on Amazon,\" said Peter Lee, executive director of the \u003ca href=\"http://www.healthexchange.ca.gov/Pages/Default.aspx\" target=\"_blank\">California Health Benefit Exchange\u003c/a>.\u003c/p>\n\u003cp>But as the state has worked to create the actual application for health insurance, the idea of a one-click purchase is far from the reality.\u003c/p>\n\u003cp>“This is a brand new law and it’s complicated,” says Sam Karp, vice president of programs at the California HealthCare Foundation (CHCF). “It’s reasonable to expect the implementation will take not just a year. It will take a few years.”\u003c!--more-->\u003c/p>\n\u003cp>Karp says CHCF has been working on modernizing enrollment in health and social service programs for the last 15 years. Recently they partnered with others to create a model, called UX2014, that can be used as a standard for online health insurance enrollment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The contract for California’s application was awarded to \u003ca href=\"http://newsroom.accenture.com/news/accenture-chosen-to-implement-california-health-insurance-exchange.htm\" target=\"_blank\">Accenture\u003c/a> last summer. While a draft of the federal application was just released, stakeholders have yet to see a version of California’s application, which, like the federal model is being based on the \u003ca href=\"http://www.ux2014.org/\" target=\"_blank\">UX2014\u003c/a> work.\u003c/p>\n\u003cp>The new federal draft application is 15 pages long for a 3-person family. A single applicant is only required to fill out 6 pages. Meanwhile a YouTube video shows what to expect from the online federal version:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.youtube.com/embed/BB1QOUoYFQQ\" frameborder=\"0\" width=\"420\" height=\"315\">\u003c/iframe>\u003c/p>\n\u003cp>Karp says after early promises that this would be like buying an airline ticket online, it’s important to set the right expectations.\u003c/p>\n\u003cp>“The law says we should have a consumer friendly process ... it should be better than what people are experiencing today and we should go to lots of lengths to make it easier for people,” Karp says.\u003c/p>\n\u003cp>The law requires the application be available online, in person, by mail or by telephone.\u003c/p>\n\u003cp>Karp says he has a few concerns about California's process so far.\u003c/p>\n\u003cp>\"I’m concerned the premiums will be high and people will have sticker shock,\" says Karp. And he says unlike the federal system which will be a streamlined workflow, California will be integrating its application with some county websites and program.\u003c/p>\n\u003cp>\"Service may not be as smooth as it could be because of this hand off to counties,\" says Karp.\u003c/p>\n\u003cp>Elizabeth Landsberg, director of legislative advocacy for the Western Center on Law and Poverty, says she has been involved in some of the recent talks about the application flow. She says there are some aspects of the proposed California application she applauds.\u003c/p>\n\u003cp>\"If you’ve gone through this whole process of applying for health benefits,\" she says, \"you can have the information transferred to get other public benefits too – including CalWorks and Cal Fresh [food stamps].\"\u003c/p>\n\u003cp>But she says she'll be keeping an eye on certain aspects of its development.\u003c/p>\n\u003cp>“The income is going to be especially tricky for people. People have different ideas about this. Certain income counts and certain other things don’t,” says Landsberg. “I think very few of us know what our adjusted gross income is. So there is going to have to be a lot of help and guidance to define these terms and give accurate information.”\u003c/p>\n\u003cp>Landsberg says she also thinks the proposed application organization requires a social security number too soon.\u003c/p>\n\u003cp>“We have a lot of families with mixed immigration status,” Landsberg says. “We may have a parent without a social security number applying for child who does have a social security number… You can’t require a non-applicant to give a social security and it might dissuade someone from moving forward.”\u003c/p>\n\u003cp>Landsberg says a draft of the California application is expected in April, to allow group testing in the spring and summer.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The application is due to go live online in October.\u003c/p>\n\n",
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"excerpt": "Immediately following the Supreme Court's decision on the Affordable Care Act, the head of California's Health Benefit Exchange laid out his vision for revolutionizing the health insurance market.\r\n\r\n\"We know buying insurance is really complicated. We want to make it as easy as buying a book on Amazon,\" said Peter Lee, executive director of the California Health Benefit Exchange.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/15/what-will-californias-health-benefit-exchange-application-look-like/draft/\" rel=\"attachment wp-att-11419\">\u003cimg class=\"alignleft size-medium wp-image-11419\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Draft-300x260.jpg\" alt=\"Draft\" width=\"300\" height=\"260\">\u003c/a>Immediately following the Supreme Court's decision on the Affordable Care Act, the head of California's Health Benefit Exchange \u003ca href=\"http://www.sfgate.com/health/article/Health-care-exchange-will-offer-policies-3675063.php\">laid out his vision\u003c/a> for revolutionizing the health insurance market.\u003c/p>\n\u003cp>\"We know buying insurance is really complicated. We want to make it as easy as buying a book on Amazon,\" said Peter Lee, executive director of the \u003ca href=\"http://www.healthexchange.ca.gov/Pages/Default.aspx\" target=\"_blank\">California Health Benefit Exchange\u003c/a>.\u003c/p>\n\u003cp>But as the state has worked to create the actual application for health insurance, the idea of a one-click purchase is far from the reality.\u003c/p>\n\u003cp>“This is a brand new law and it’s complicated,” says Sam Karp, vice president of programs at the California HealthCare Foundation (CHCF). “It’s reasonable to expect the implementation will take not just a year. It will take a few years.”\u003c!--more-->\u003c/p>\n\u003cp>Karp says CHCF has been working on modernizing enrollment in health and social service programs for the last 15 years. Recently they partnered with others to create a model, called UX2014, that can be used as a standard for online health insurance enrollment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The contract for California’s application was awarded to \u003ca href=\"http://newsroom.accenture.com/news/accenture-chosen-to-implement-california-health-insurance-exchange.htm\" target=\"_blank\">Accenture\u003c/a> last summer. While a draft of the federal application was just released, stakeholders have yet to see a version of California’s application, which, like the federal model is being based on the \u003ca href=\"http://www.ux2014.org/\" target=\"_blank\">UX2014\u003c/a> work.\u003c/p>\n\u003cp>The new federal draft application is 15 pages long for a 3-person family. A single applicant is only required to fill out 6 pages. Meanwhile a YouTube video shows what to expect from the online federal version:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.youtube.com/embed/BB1QOUoYFQQ\" frameborder=\"0\" width=\"420\" height=\"315\">\u003c/iframe>\u003c/p>\n\u003cp>Karp says after early promises that this would be like buying an airline ticket online, it’s important to set the right expectations.\u003c/p>\n\u003cp>“The law says we should have a consumer friendly process ... it should be better than what people are experiencing today and we should go to lots of lengths to make it easier for people,” Karp says.\u003c/p>\n\u003cp>The law requires the application be available online, in person, by mail or by telephone.\u003c/p>\n\u003cp>Karp says he has a few concerns about California's process so far.\u003c/p>\n\u003cp>\"I’m concerned the premiums will be high and people will have sticker shock,\" says Karp. And he says unlike the federal system which will be a streamlined workflow, California will be integrating its application with some county websites and program.\u003c/p>\n\u003cp>\"Service may not be as smooth as it could be because of this hand off to counties,\" says Karp.\u003c/p>\n\u003cp>Elizabeth Landsberg, director of legislative advocacy for the Western Center on Law and Poverty, says she has been involved in some of the recent talks about the application flow. She says there are some aspects of the proposed California application she applauds.\u003c/p>\n\u003cp>\"If you’ve gone through this whole process of applying for health benefits,\" she says, \"you can have the information transferred to get other public benefits too – including CalWorks and Cal Fresh [food stamps].\"\u003c/p>\n\u003cp>But she says she'll be keeping an eye on certain aspects of its development.\u003c/p>\n\u003cp>“The income is going to be especially tricky for people. People have different ideas about this. Certain income counts and certain other things don’t,” says Landsberg. “I think very few of us know what our adjusted gross income is. So there is going to have to be a lot of help and guidance to define these terms and give accurate information.”\u003c/p>\n\u003cp>Landsberg says she also thinks the proposed application organization requires a social security number too soon.\u003c/p>\n\u003cp>“We have a lot of families with mixed immigration status,” Landsberg says. “We may have a parent without a social security number applying for child who does have a social security number… You can’t require a non-applicant to give a social security and it might dissuade someone from moving forward.”\u003c/p>\n\u003cp>Landsberg says a draft of the California application is expected in April, to allow group testing in the spring and summer.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The application is due to go live online in October.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Consumers Don't View Curbing Costs As Their Job in Treatment Choice",
"title": "Consumers Don't View Curbing Costs As Their Job in Treatment Choice",
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"content": "\u003cp>by Michelle Andrews, \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/031213-Michelle-Andrews-on-consumers-not-wanting-cheaper-treatments.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11330\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/13/consumers-dont-view-curbing-costs-as-their-job-study-finds/alex-e-proimosflickr/\" rel=\"attachment wp-att-11330\">\u003cimg class=\"size-medium wp-image-11330 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Alex-E.-Proimosflickr-300x200.jpg\" alt=\"Consumers don't want to factor costs into their health care decisions (Alex E. Proimos/flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Consumers don't want to factor costs into their health care decisions (Alex E. Proimos/flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In recent years, consumers have increasingly been encouraged by employers and insurers to help control rising health care costs. That may be by avoiding unnecessary tests, buying generic drugs and reducing visits to the emergency room, among other things. The hope is that a patient better educated and more engaged in health decisions will choose options that will promote better health and decrease costs.\u003c/p>\n\u003cp>Such \"patient engagement\" efforts assume that patients welcome the opportunity--or at least are willing--to get more involved in their own care. But as a study published last month in the journal \u003ca href=\"http://content.healthaffairs.org/content/32/2/338.abstract\" target=\"_blank\">Health Affairs\u003c/a> found, a majority of patients didn’t want to factor costs into their medical decisions, nor did they want their doctors to do so.\u003c/p>\n\u003cp>\u003cstrong>\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">\"One of the beliefs people expressed was that you get what you pay for, that more expensive care is by definition better.\"\u003cstrong>\u003c/strong>\u003c/aside>\n\u003cp>The study investigated the attitudes of focus group participants in Washington, D.C. and Santa Monica, California. They were asked about weighing their own out-of-pocket costs and the costs borne by their insurer in medical decisions. The participants, researchers said, did not generally understand how insurance works and felt little personal responsibility for helping to solve the problem of rising health care costs. They were unlikely to accept a less expensive treatment option, even if it was nearly as effective as a more expensive choice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Study co-author Susan Dorr Goold is a professor of internal medicine and health management and policy at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan. Dorr Goold says her team was surprised at how frequently people talked about not wanting cost considerations to factor into decision-making at all.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\"It surprised us as we were analyzing the data that there weren't some people speaking out and saying, 'Wait, we're all going to pay more if we don't consider the costs,'\" says Dorr Goold. \"We heard it, but not very often and not very much. If patients think we shouldn't consider costs at all, doctors are put in a difficult position.\"\u003c/p>\n\u003cp>In the study, the researchers asked patients to consider how cost might influence their thinking if, for example, someone had a headache for three months and discussed getting an MRI versus a CT scan with his doctor. In this scenario, the doctor explained that a CT scan would identify nearly all the problems that were serious enough to need treatment for a fraction of the cost of an MRI. In general, people were unwilling to consider the cheaper test.\u003c/p>\n\u003cp>Dorr Goold says the team wonders if the response would have been different if they'd asked about a different health problem, say a toenail fungus.\u003c/p>\n\u003cp>\"There’s a whole spectrum of medical problems, from life threatening to living with ugly toes,\" she says.\u003c/p>\n\u003cp>She says other research has shown while patients certainly consider their out of pocket costs, they're not very good at deciding what's worth spending extra money on. In fact, one of the beliefs people expressed was that you get what you pay for, that more expensive care is by definition better.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\"The idea that you get what you pay for is a very American, market-oriented point of view,\" says Dorr Goold. \"I often talk to patients about generic versus brand-name medications, for example, and how for the most part there’s no difference in value. If you're trying to get your blood pressure down or treat a rash, using a generic medication is fine. But you'd be surprised at how many people resist something just because it's cheaper, even if it is just as good.\"\u003c/p>\n\u003cp>Participants talked about being unwilling to make any tradeoffs between health and money, no matter how expensive the treatment. And people expressed concern that they don't want physicians to factor in patient resources when they make treatment decisions. Care should be the same, they said, whether someone is penniless or just flew in on a private jet.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>Dorr Goold says patient resources do not influence care and treatment recommendation. BUT, that doesn't mean patients will be able to afford it.\u003c/p>\n\u003cp>\"Lots of places have looked at what care we should pay for, and frankly the insurance companies are making those decisions now,\" says Dorr Goold. \"They're deciding what’s covered and what’s not, what's medically necessary and what’s not. That's a judgment. No matter what kind of system you have, somebody has to decide what's going to be paid for.\"\u003c/p>\n\u003cp>One of the interesting findings was that some participants seemed motivated to choose expensive care \"out of spite,\" because they were angry at their insurance company.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Dorr Goold says there was an almost vengeful attitude toward insurance companies, something like \"I'm going to get them back for all the money I've paid in all these years.\"\u003c/p>\n\u003cp>\"The motivation that 'I'm sick and I don’t want to think about the money,' that's understandable,\" says Dorr Goold. \"But 'I want to hurt the insurance company?' Why? Those health care payments come from money all of us have paid to insurers. It's an interesting finding that requires more looking into.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced by Kaiser Health News with support from \u003ca href=\"http://www.thescanfoundation.org/\">The SCAN Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>by Michelle Andrews, \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/031213-Michelle-Andrews-on-consumers-not-wanting-cheaper-treatments.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11330\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/13/consumers-dont-view-curbing-costs-as-their-job-study-finds/alex-e-proimosflickr/\" rel=\"attachment wp-att-11330\">\u003cimg class=\"size-medium wp-image-11330 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Alex-E.-Proimosflickr-300x200.jpg\" alt=\"Consumers don't want to factor costs into their health care decisions (Alex E. Proimos/flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Consumers don't want to factor costs into their health care decisions (Alex E. Proimos/flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In recent years, consumers have increasingly been encouraged by employers and insurers to help control rising health care costs. That may be by avoiding unnecessary tests, buying generic drugs and reducing visits to the emergency room, among other things. The hope is that a patient better educated and more engaged in health decisions will choose options that will promote better health and decrease costs.\u003c/p>\n\u003cp>Such \"patient engagement\" efforts assume that patients welcome the opportunity--or at least are willing--to get more involved in their own care. But as a study published last month in the journal \u003ca href=\"http://content.healthaffairs.org/content/32/2/338.abstract\" target=\"_blank\">Health Affairs\u003c/a> found, a majority of patients didn’t want to factor costs into their medical decisions, nor did they want their doctors to do so.\u003c/p>\n\u003cp>\u003cstrong>\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">\"One of the beliefs people expressed was that you get what you pay for, that more expensive care is by definition better.\"\u003cstrong>\u003c/strong>\u003c/aside>\n\u003cp>The study investigated the attitudes of focus group participants in Washington, D.C. and Santa Monica, California. They were asked about weighing their own out-of-pocket costs and the costs borne by their insurer in medical decisions. The participants, researchers said, did not generally understand how insurance works and felt little personal responsibility for helping to solve the problem of rising health care costs. They were unlikely to accept a less expensive treatment option, even if it was nearly as effective as a more expensive choice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Study co-author Susan Dorr Goold is a professor of internal medicine and health management and policy at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan. Dorr Goold says her team was surprised at how frequently people talked about not wanting cost considerations to factor into decision-making at all.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\"It surprised us as we were analyzing the data that there weren't some people speaking out and saying, 'Wait, we're all going to pay more if we don't consider the costs,'\" says Dorr Goold. \"We heard it, but not very often and not very much. If patients think we shouldn't consider costs at all, doctors are put in a difficult position.\"\u003c/p>\n\u003cp>In the study, the researchers asked patients to consider how cost might influence their thinking if, for example, someone had a headache for three months and discussed getting an MRI versus a CT scan with his doctor. In this scenario, the doctor explained that a CT scan would identify nearly all the problems that were serious enough to need treatment for a fraction of the cost of an MRI. In general, people were unwilling to consider the cheaper test.\u003c/p>\n\u003cp>Dorr Goold says the team wonders if the response would have been different if they'd asked about a different health problem, say a toenail fungus.\u003c/p>\n\u003cp>\"There’s a whole spectrum of medical problems, from life threatening to living with ugly toes,\" she says.\u003c/p>\n\u003cp>She says other research has shown while patients certainly consider their out of pocket costs, they're not very good at deciding what's worth spending extra money on. In fact, one of the beliefs people expressed was that you get what you pay for, that more expensive care is by definition better.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\"The idea that you get what you pay for is a very American, market-oriented point of view,\" says Dorr Goold. \"I often talk to patients about generic versus brand-name medications, for example, and how for the most part there’s no difference in value. If you're trying to get your blood pressure down or treat a rash, using a generic medication is fine. But you'd be surprised at how many people resist something just because it's cheaper, even if it is just as good.\"\u003c/p>\n\u003cp>Participants talked about being unwilling to make any tradeoffs between health and money, no matter how expensive the treatment. And people expressed concern that they don't want physicians to factor in patient resources when they make treatment decisions. Care should be the same, they said, whether someone is penniless or just flew in on a private jet.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>Dorr Goold says patient resources do not influence care and treatment recommendation. BUT, that doesn't mean patients will be able to afford it.\u003c/p>\n\u003cp>\"Lots of places have looked at what care we should pay for, and frankly the insurance companies are making those decisions now,\" says Dorr Goold. \"They're deciding what’s covered and what’s not, what's medically necessary and what’s not. That's a judgment. No matter what kind of system you have, somebody has to decide what's going to be paid for.\"\u003c/p>\n\u003cp>One of the interesting findings was that some participants seemed motivated to choose expensive care \"out of spite,\" because they were angry at their insurance company.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Dorr Goold says there was an almost vengeful attitude toward insurance companies, something like \"I'm going to get them back for all the money I've paid in all these years.\"\u003c/p>\n\u003cp>\"The motivation that 'I'm sick and I don’t want to think about the money,' that's understandable,\" says Dorr Goold. \"But 'I want to hurt the insurance company?' Why? Those health care payments come from money all of us have paid to insurers. It's an interesting finding that requires more looking into.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced by Kaiser Health News with support from \u003ca href=\"http://www.thescanfoundation.org/\">The SCAN Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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