health insurance


Do High-Deductible Health Plans Cut Costs Now, But Backfire in Long Run?

(Getty Images)

(Getty Images)

By Jay Hancock, Kaiser Health News

Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs.

People with high deductible plans are foot soldiers in the war against high health costs.  

Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more. Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they’re making medically wise choices.

Consumers with high deductibles sometimes skip procedures, think harder about getting treatment and shop for lower prices when they do seek care.

What nobody knows is whether such plans, also sold to individuals and families through the health law’s online exchanges, will backfire. If people choose not to have important preventive care and end up needing an expensive hospital stay years later as a result, everybody is worse off. Continue reading

State Lawmakers Investigating High Health Costs

stethoscope and dollar

(Getty Images)

By Rebecca Plevin, KPCC

Last spring, KPCC, KQED and teamed up and started a conversation about health costs in California.

We knew a growing number of people wanted to shop around for affordable mammogramsMRI’s and other procedures. But it was nearly impossible to discover the costs. As part of our project, called #PriceCheck, we invited you to share what you paid for certain procedures. In the process, we began building a database of health costs.

On Wednesday, the California State Senate Committee on Health picked up that conversation.

During a hearing at the state Capitol, doctors, researchers and consumers told lawmakers that despite the federal health care law, health costs are still a barrier to care. Continue reading

Covered California Patients Not Only Ones with Network Woes

(Getty Images)

(Getty Images)

Charlie Spiegel said he was “thrilled” when he learned that the Department of Managed Health Care was taking action against two major insurers that sell policies on the Covered California marketplace. The companies, DMHC says, had violated state law by listing doctors on their online directories who were not part of their network.

Spiegel, of San Francisco, is not a Covered California policy-holder, but he’s having significant problems of his own with the individual policy he bought from Anthem Blue Cross earlier this year.

Here’s the background: Spiegel, 56, says he enjoys good health, but had been postponing various preventive tests due to cost. Before the Affordable Care Act went into effect, he had a high deductible plan. Continue reading

KQED’s #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers

(Illustration: Andy Warner)

(Illustration: Andy Warner)

Since June, KQED has been crowdsourcing health care prices.

For starters, insurers paid from $128 to $694 for a screening mammogram.  

Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.

So we asked you, the members of our community, to share what you paid.

Together with our collaborators KPCC in Los Angeles and, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices. Continue reading

Prop. 45 Fight Worthy of Television Drama

Kevin Spacey stars as Frank Underwood in the Netflix series "House of Cards." (Kevin Winter/Getty Images)

Kevin Spacey stars as Frank Underwood in the Netflix series “House of Cards.” (Kevin Winter/Getty Images)

The power play behind Proposition 45 could be fodder for an episode of House of Cards:

Dave Jones might not like this comparison, but he’s the Frank Underwood in this fight.

“Power is a lot like real estate. It’s all about location, location, location. The closer you are to the source, the higher your property value,” so goes protagonist Frank Underwood, who plays the menacing House majority whip scheming to get closer to the president.

You’d never think there’d be such positioning over who gets to regulate health insurance.

But this is California. And no less than three state agencies want to have a say in this one. Continue reading

Poll: Majority of California Voters Support Health Coverage for Undocumented Immigrants

(Getty Images)

(Getty Images)

A majority of the state’s voters support extending current health insurance programs to all low-income Californians, including undocumented immigrants, according to a new statewide poll released Monday.

The poll was commissioned by The California Endowment, a foundation that has been actively working to expand health insurance access to all people, regardless of immigration status. The Affordable Care Act expressly bars undocumented immigrants from receiving any of its benefits, including subsidies to purchase health insurance.

In the poll, 54 percent of those surveyed said they support covering the undocumented. Support was strongest among younger voters as well as Latino respondents and African Americans.

Continue reading

Stanford Terminates Anthem’s Contract; Anthem Uses KQED Data to Cite Stanford’s Cost

The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)

The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)

Effective Monday at 12:01a.m., Stanford Health Care terminated its contract with Anthem Blue Cross. Anthem says that roughly 10,000 of its policyholders have used Stanford services in the last year.

In a statement, Anthem said it had requested that “Stanford agree to a two-week extension of the terminated contract at existing rates.” Both parties say negotiations are ongoing.

Stanford had notified the insurer on Feb. 28, Anthem says, that it intended to terminate the contract.

The sticking point appears to be the duration of the contract. Both sides say that they reached agreement on rates for a two-year contract, but Stanford seeks a three-year contract. Because no agreement has been reached on the third year, and because Stanford did not extend its current contract, no contract is in force. Continue reading

Stanford Health Care Terminates Anthem Blue Cross Contract

As many as 10,000 patients may be affected by Stanford Health Care's termination of its contract with Anthem Blue Cross. (Robert Skolmen/Wikimedia Commons)

As many as 10,000 patients may be affected by Stanford Health Care’s termination of its contract with Anthem Blue Cross. (Robert Skolmen/Wikimedia Commons)

Stanford Hospital and Clinics — now known as Stanford Health Care — is ending its contract with Anthem Blue Cross effective Sunday night at midnight. The move could affect 10,000 patients.

According to both Stanford and Anthem spokespersons the two sides had reached agreement on a two-year contract. But Stanford seeks a third year; Anthem does not. The two parties could not come to terms as of Friday, so there is no new contract.

Stanford said the current contract ends Sunday, and since they do not have a deal for a new contract, they opted to terminate.

But, Anthem sees the termination of the contract as unnecessary. “Nothing compels (Stanford) to terminate on Sunday night,” said Anthem spokesman Darrel Ng. Continue reading

Report: California State Employees Get Relatively Generous Health Insurance

(Getty Images)

(Getty Images)

SACRAMENTO, Calif. (AP) — Health insurance plans offered to state employees in California and elsewhere are relatively generous, with government picking up a large share of deductibles and co-pays, according to a report released Tuesday.

The report by The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation was a first-of-its kind survey of state government health insurance plans nationwide. It found that state plans paid on average 92 percent of a typical enrollee’s health care costs, which is equivalent to the best offerings — “platinum” plans — that the public can purchase on one of the new health insurance exchanges.

In California, Pew found that figure was 95 percent and that 68 percent of plan members had no annual deductible.

Putting the report into a broader context that can make the data easily understood is difficult. Continue reading

On California Exchange, Only Kaiser’s Rates Will Go Down in 2015

Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)

Kaiser Permanente’s lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)

As all the other health insurers on California’s Obamacare exchange raise their rates for next year, Kaiser Permanente plans to lower them.

The Los Angeles Times reports that a new analysis by Citigroup shows Kaiser’s premiums dropping by 1.4 percent in 2015.

At the same time, the average premium across all plans on the Covered California exchange will rise 4.2 percent.

Citigroup health care analyst Carl McDonald told the Times he thinks Kaiser’s move is meant to draw customers: Continue reading