health insurance

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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.
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Insurance Commissioner Defends Health Insurance Initiative

Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)

Dave Jones leads the California Department of Insurance. (Courtesy: Department of Insurance)

In this lull between the end of the first open enrollment for Covered California and the release of rates for next year — expected to be made public in July — San Francisco’s Commonwealth Club invited the state’s Commissioner of Insurance Dave Jones to talk about the state of the health care overhaul in California.

The commissioner closed his remarks by pitching for the rate review ballot initiative coming up in November. As moderator of the discussion following, I fielded several questions from the audience about the upcoming initiative. To recap the basics: If passed, the initiative would give the insurance commissioner the authority to reject excessive health insurance rate increases.

The insurance commissioner already has that authority over auto, homeowner, property and casualty insurance — via voter-passed Proposition 103 back in 1988. Many voters are surprised, Jones said, to find out he cannot also reject health insurance premium increases.  He called this lack of explicit authority a “major missing piece of the Affordable Care Act.” Continue reading

Why Are Nearly All Covered California Enrollees in Just Four Plans?

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College in November. (David McNew/Getty Images)

By Dan Diamond, California Healthline

Anthem Blue Cross had 1,591 people use Covered California to get subsidies and sign up for its health plans in October.

Valley Health Plan had five.

That data point’s taken from a Covered California release that offers some of the first insight into the makeup of early enrollees through the exchange and which plans they’re picking. And while it’s hardly fair to directly compare the two issuers — Anthem has a presence in all 19 of Covered California’s regions, whereas Valley is only offering plans in Santa Clara County — the contrast is eye-catching.

It’s also telling. The biggest players, so far, are getting enormous market share from Covered California’s customers. The smaller plans are seeing a trickle.

So Far, Exchange Strengthens Market Position of Large Plans Continue reading

Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes

Insurers say some of their policies do not meet the standards required by the Affordable Care Act and must be dropped. (Getty Images)

Insurers say some of their policies do not meet the standards required by the Affordable Care Act and must be dropped. (Getty Images)

By Anna Gorman and Julie Appleby, Kaiser Health News

The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010.  At least a few are cancelling plans sold to people with pre-existing medical conditions.

By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost — especially after the inclusion of federal subsidies for those who qualify. The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers’ annual expenses at levels lower than many plans sold before the new rules.

“I don’t feel like I need to change, but I have to.”

But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama’s promise that people could keep their plans if they liked them.

“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.

An estimated 14 million people — 2 million of them in California — purchase their own coverage because they don’t get it through their jobs. Calls to insurers in several states showed that many have sent notices. Continue reading

For Legal Immigrants, Obamacare Has Options for Aging Parents

A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)

A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)

Mohan Iyer has been in a bind. He’s lived in the U.S. since he came here for college from India in 1980. He ultimately got a job, a green card and became a citizen in 1994. Most of his siblings live here now, too.

After his father passed away two years ago, Iyer and his siblings have wanted their mother to move here. But there’s one big problem: she is effectively barred from any kind of reliable health insurance.

“Health care has been a big issue,” said Iyer, who is 50 and lives in Menlo Park.

New immigrants of any age can purchase health insurance on Covered California
That’s because new immigrants over age 65 are not eligible for Medicare. For legal immigrants like Iyer, who are people of working age, the impossibility of obtaining health insurance for their parents has been a barrier in their hopes of moving aging parents or grandparents to the U.S.

Americans over 65 tend not to worry much about health insurance, because of Medicare, the government insurance program for the elderly and the disabled. But while Medicare is available to virtually all citizens, starting at age 65, immigrants legally present in the U.S. for less than five years are not eligible.

And because of the very existence of Medicare, private insurance companies generally do not offer health insurance plans for those over 65. “There are health insurance options,” Iyer said, “but these are usually catastrophic traveler’s insurance. They usually have a very high deductible and they’re expensive.”

They also tend to exclude pre-existing conditions, he said. Continue reading

Obamacare Downside: Reports of Premiums Going Up

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Luke Donavan reviews information from Kaiser, detailing how his health insurance coverage will change on Jan. 1. His family’s premiums are going up. (Lisa Aliferis/KQED)

The notice from Kaiser came in the mail about ten days ago.

Luke Donavan’s health insurance premiums were going up. A lot.

Donavan, 41 of San Francisco, is self-employed and buys his own health insurance. Currently he pays $841 per month for insurance for himself, his wife and three young children. But, Kaiser is canceling that policy and offering him a new one that fully complies with the Affordable Care Act. Effective Jan. 1, his family’s premium is going up to $1,000, with a higher deductible.

Donavan says he voted for Obama in both elections and calls himself a “big proponent” of the health law. He has a pretty calm demeanor and says he was “surprised” by this news from Kaiser.

“I just keep coming back to the name ‘Affordable Care Act,'” he said. “I thought I’d pay the same or less for better coverage.”

Subsidies are available for people to buy insurance, but they are dependent on income. Donavan says he earns too much to qualify.

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Days Away From Signing-up, Many Californians Still Don’t Understand Obamacare

Women knit as they attend a Senior Information & Resource Fair in South Gate, California September 10, 2013 . The event included a discussion of how the Affordable Care Act, also called 'Obamacare' will impact senior citizens and what insurance plans will be available to them. (Robyn Beck/AFP/Getty Images)

Women knit as they attend a Senior Information & Resource Fair in South Gate, California September 10, 2013 . The event included a discussion of how the Affordable Care Act, also called ‘Obamacare’ will impact senior citizens and what insurance plans will be available to them. (Robyn Beck/AFP/Getty Images)

In five days, a key piece of the Affordable Care Act goes live in California — the state-run insurance marketplace Covered California. Yet, most Californians eligible to participate, are confused.

A Kaiser Family Foundation survey released Thursday, finds three in four state residents eligible for government-subsidized private plans are either unaware they quality, or wrongly believe they don’t qualify.

This survey was taken just about a month ago.

KQED’s Mina Kim spoke to Mollyann Brodie, the Director of Public Opinion and Survey Research and Senior Vice President for Executive Operations at Kaiser Family Foundation, about the survey. Continue reading

3 Out of 4 Uninsured Californians Eligible, But Unaware of Obamacare Benefits

(Getty Images)

(Getty Images)

By Sarah Varney, Kaiser Health News

As uninsured Californians head into a new era of health coverage, they’re worried about costs and unaware of the help they’ll get from the government, a new survey finds.

The survey, by the Kaiser Family Foundation, found that three out of four Californians who earn modest incomes and could buy government-subsidized private coverage wrongly believe they’re not eligible for federal assistance or simply don’t know if they qualify.

In addition, many undocumented immigrants, who constitute about a fifth of the state’s uninsured population, erroneously believe they will be eligible for coverage. The law specifically bars them from getting coverage from the state’s new health insurance marketplace, which opens next Tuesday, for coverage beginning Jan.1, 2014.

“This has been, for so long, a political debate,” said Anthony Wright, executive director of Health Access, a Sacramento-based consumer advocacy group. “We’re just starting to move it into a practical reality. Now that the benefits are close at hand, there is a concerted effort to educate people about what their benefits are.” Continue reading

Some Say Obamacare’s ‘Affordable’ Coverage Isn’t So Affordable

(Getty Images)

(Getty Images)

When it comes to the Affordable Care Act, a lot of emphasis has been placed on enrolling the so-called “young invincibles,” young people who tend to be healthy. The new Covered California insurance marketplace opens next Tuesday, and outreach workers across the state are spreading the news about new options and the coveted subsides, available from the federal government in the form of tax subsidies to make insurance more affordable.

But “more affordable” is relative. Kaiser Health News today tells the story of Michelle La Voie, a single mom making $38,000 a year and supporting two teenagers. She wants health insurance, but even with the subsidy she would likely get, she’s still not sure she can afford it. From KHN:

La Voie … would still have to pay $191 a month, or about 6 percent of her income toward the premium. She could also face as much as $2,000 in potential out-of-pocket costs for hospital care and prescription drugs, if she needs those things.

“What’s the point of having [a policy] if I can’t afford to use it?” asks the 47-year-old librarian in upstate Franklinville, New York, referring to the co-pays and deductibles that she might incur if she sought treatment.

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