Policy

Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed

RECENT POSTS

Hobby Lobby decision has limited impact on California

Most women in California won’t be affected by Monday’s U.S. Supreme Court landmark decision in Sebelius v. Hobby Lobby. The Christian owners of the craft store chain challenged the Affordable Care Act’s requirement that companies provide contraception coverage to their employees. The Court ruled that closely-held, for-profit companies can opt out if they object on religious grounds.

But it’s not so easy in California. That’s because the ruling doesn’t apply to state laws. And California has had the Women’s Contraceptive Equity Act on the books since 1999. It requires health insurance companies that cover prescription drugs to also cover birth control.

“For most workers in California, nothing will change,” says Maggie Crosby, attorney with the ACLU of Northern California. “Women should feel secure that if they have birth control coverage today, they will have it tomorrow.” Continue reading

Initial Mammogram Cost Comparisons in KQED’s PriceCheck Project

(Illustration: Andy Warner)

(Illustration: Andy Warner)

Last Monday, KQED, KPCC and ClearHealthCosts.com launched our community-created guide to health costs.

Share what you paid for a mammogram. Visit KQED’s PriceCheck.
As I outlined last week, health care costs lack transparency, and it’s virtually impossible for consumers to shop around. We’re asking you, members of our KQED community, to share what you’ve paid for common health care procedures. Your responses feed directly into a database so others can look up how much mammograms cost in their area.

So far, we’ve received a handful of submitted prices. Our partner, ClearHealthCosts, had previously collected a range of “self-pay” prices — that’s the price people are charged if they do not have insurance or have decided to go out of their insurance network and are paying out of their own pocket. Continue reading

Coordinated Care for Those Nearing Life’s End — But Does It Save Money?

Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)

Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)

Bob Martinez has been in the hospital so many times, the surgical staff treats him like a regular at a coffee shop.

“They all know me!” he says. “If I go in there today, they’d say, ‘How’re ya doing Mr. Martinez?’ ”

‘I’m so sick and tired of being in hospitals. I don’t want to go back no more. I said, God, no more.’

Martinez is 81, a long-retired life insurance salesman. In the last few years, he’s had more than a dozen surgeries on his right leg, including a foot amputation, a casualty of severe diabetes. His heart disease has warranted almost half a dozen heart procedures. After one of his recent operations, he said he’d had enough.

“I’m so sick and tired of being in hospitals,” he says shaking his head. “I don’t want to go back no more. I said, God, no more. No more.”

That’s when hospital staff told him about a program through Sutter Health that would send people to take care of him at home. It’s called the Advanced Illness Management program, or AIM. It’s designed for people like Martinez who have multiple chronic illnesses. Continue reading

KQED Launches ‘PriceCheck’ to Make Health Costs Transparent

(Photo: Getty Images)

(Photo: Getty Images)

Update June 30: Early PriceCheck data show Bay Area mammogram prices range from $125 to $801

Original Post:

Say you’re shopping for a new computer or a new car, and you want to get the best price. Within a matter of minutes on Google, you would have a pretty good idea of the price range for the product you want.

But in health care? Forget it.

Shining light on a system where the costs of the same procedure might range from $0 to $1,100. That’s just one example.

It’s well known to health policy types, but less so to consumers, that health care prices are utterly lacking in transparency and wildly variable.

If you’ve ever looked at a bill for a health care procedure — and been astounded by the numbers you see — or thought that you would like to find the best price on an elective procedure – and been astounded that there’s no easy way to compare prices — KQED is launching a new project for you.

Today we bring you “Price Check,” a community-created guide to health costs. Since no database yet exists where consumers can easily look up costs, we’re commencing the work of creating one. But we need your help.

This summer and into the fall, we’re turning to you, our community, to share — anonymously — what you have paid for some common procedures. We’re starting with mammograms. (More on “why mammograms?” in a moment.) Continue reading

Another Step Closer to Autism Therapy as Medi-Cal Benefit?

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

CMS officials last week approved a state plan amendment for the state of Washington that includes autism therapy as a Medicaid benefit.

It’s the second state in a month to receive that go-ahead from the federal government, and it means autism coverage should be a Medi-Cal benefit in California, as well, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, a not-for-profit autism advocacy group.

The budget passed this week by the California Legislature omitted autism therapy as a Medi-Cal benefit.

Autism advocates hope one day soon CMS will make it clear that applied behavior analysis treatment — known as ABA therapy — should be a required benefit for all states receiving Medicaid, including California. Continue reading

Covered California Questions Health Insurance Initiative

Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)

Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)

UPDATE: June 20

KQED’s April Dembosky attended the Covered California board meeting Thursday afternoon where the board expressed concern that a voter initiative on the upcoming November ballot could compromise its authority. The initiative would give the state’s insurance commissioner the authority to reject excessive rate increases in health insurance premiums.  But Covered California already negotiates rates with insurance plans. How would the initiative, if passed, affect Covered California?

Covered California board member Susan Kennedy called on agency staff to conduct an intensive analysis of the initiative’s potential impact Covered California’s ability to operate — and to get it done soon.
Continue reading

California Caregivers Sue Their Employer for Wage Violations

Plaintiff Ginger Rogers with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)

Plaintiff Ginger Rogers (right) with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)

Professional caregivers filed a class action lawsuit in California Wednesday on behalf of hundreds of workers throughout the state. They say their employer, Kindred Healthcare and its affiliates, shorted them on wages, overtime, and breaks.

Ginger Rogers, a caregiver with 25 years experience, says Kindred Healthcare hired her in 2012 to look after a patient at a skilled nursing facility in Castro Valley, outside San Francisco. She says she asked her supervisor if she could leave her patient’s bedside to take a lunch break. The supervisor told her no, adding that coffee breaks weren’t allowed either, according to the complaint filed in Alameda Superior Court today.

“That’s illegal,” says Hina Shah, co-director of the Women’s Employment Rights Clinic at Golden Gate University, who is representing Rogers and the other plaintiffs. “The law mandates two 10-minute breaks and a 30-minute meal break for every five hours of work. But more importantly, the type of work that these caregivers are doing is physically and mentally demanding, and to require someone to work 12-hour shifts without any kind of break is very detrimental to their health and is onerous.” Continue reading

California Assembly Rejects Sugary Drink Warning Label

(KJM-427/Flickr)

(KJM-427/Flickr)

By Fenit Nirappil, Associated Press

A bill that would have made California the first state in the nation to require warning labels on sodas and other sugary drinks was effectively killed Tuesday.

Sen. Bill Monning’s SB1000 failed on a 7-8 vote as his fellow Democratic lawmakers doubted whether a label would change consumer behavior. It needed 10 votes to pass.

Certain sodas, energy drinks and fruit drinks would have included a label reading, “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.” Continue reading

Low-Income Latinas Turn to Group Visits for Prenatal Care

Araceli eats fruit during a break following an exercise on healthy eating during a Centering Pregnancy group in San Francisco. (Deborah Svoboda/The World)

During a Centering Pregnancy group prenatal appointment in San Francisco, Araceli (left) eats fruit following an exercise on healthy eating. (Deborah Svoboda/The World)

Once a month, Irma Vásquez goes for prenatal check-ups at a clinic in San Francisco’s Mission District. But her appointment looks nothing like a doctor’s appointment. Instead of getting one-on-one care, she meets with 12 other Latina immigrants for a group visit.

Studies show group prenatal care leads to better birth outcomes.
The women meet at a community clinic and first take their own blood pressure, weigh themselves, and write down the results. Then they take turns seeing a midwife in a makeshift exam area in the corner of the room. The midwife checks each baby’s heart rate and talks privately with each woman.

Afterward they all sit in a circle and talk — in Spanish — about everything from eating healthy to dealing with domestic problems at home. Finally, there’s group meditation. Vásquez says this is her favorite part.

“It clears your mind of all the things that are going on around you, going on outside,” she says in Spanish. “It makes you more relaxed.” Continue reading