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Archive for the ‘Laws’ Category

Healthy Families Coverage Losing Financial Support in California

Tuesday, September 8th, 2009

The State of California has been in financial crisis as of late and now is going to hit home for many families whose children are enrolled on the Healthy Families program. This is a low cost state run plan that offers affordable medical, dental, and vision coverage for California children. Unfortunately, due to a lack of financial support from the state, they are planning on disenrolling children from the program starting October 1, 2009.

Budget cuts that totaled over $128 million dollars caused a major financial strain, and further enrollments were halted this July. This resulted in a waiting list of over 55,000 children, and a prediction of the removal of nearly 670,000 children having to be removed from coverage.

It is important to keep updated on these proposals, to ensure that California’s children maintain comprehensive medical, dental, and vision care. With too many children already forgoing vital preventative care, we have to find a way to keep our future healthy. Please visit the California Major Risk Medical Board for updated information and ways to become involved.

Tags: health insurance, preventative care
Posted in Family, General, Individual, Resources, State | No Comments »

SB 810 (LENO) The California Universal Healthcare Act

Wednesday, July 1st, 2009

Senate Bill 810, the Universal Health Care Act, proposes methods to provide affordable and attainable healthcare to all Californians. In a time where there are more uninsured individuals than ever before, and more stringent medical underwriting requirements (leaving those with pre-existing conditions ineligible for coverage), this bill could bring some much needed relief to our strained economy.

Under SB 810, eligibility would be based on residency. All residents would be covered, regardless of health status, employment status, or income level. Would this mean an increase in taxes? Well, theory states that over $200 billion dollars were spent in California on healthcare last year. By utilizing this enormous cash flow already being spent on healthcare by Federal, State, and County funds, such a plan is possible. By changing the way the funds are directed, such as purchasing prescription medication and durable medical equipment in bulk, California can save billions in the first year alone.

Ensuring fair reimbursements to providers, allowing consumers to choose their own doctors, and relying on a shared source of financial support, may be the answer to one of the biggest issues facing our State and Nation as whole.

Tags: health insurance, pre-existing, Universal Health Care
Posted in General, Laws, Resources, State | No Comments »

The Argument Against Government Run Health Plans

Sunday, June 14th, 2009

While many people think the answer lies in a Government run health insurance plan, but there is also a negative side to the theory. While the idea of health coverage for all is a dream worth pursuing, we need to make sure the quality of coverage is not sacrificed in doing so.

Currently, there are state and government run plans in place, such as Medicaid and children’s health insurance. While these programs benefit many people who would normally not have any coverage at all, concerns lie in the fact that there are lower reimbursement rates to providers, thus resulting in less access to doctors.

Obama’s plan is to allow those who have a plan they already like to keep their current coverage. However, should Employers have the choice between current higher premiums, or a lower cost option of the Government run plan, the lesser of the two would be elected. Therefore, employees would now be subject to a plan with more limited access to providers, and could possibly lose their current doctors altogether.

In terms of the doctor’s themselves, they may refuse the low reimbursement rates altogether and decide not to accept any insurance. Lower compensation would also means cuts in care and staff at your doctor’s office. Would-be physicians may decide to pursue more lucrative careers, instead of dealing with the red-tape of a government dictated medicine.

Tags: health insurance, Universal Health Care
Posted in Federal, General, Laws, State | No Comments »

Insurance Policy Rescissions versus AB 1945

Wednesday, June 3rd, 2009

AB 1945 (amendment to Section 10384 of the Insurance Code) recently passed in the State of California in light of all the recent publicity from insurance policy rescission’s. This Bill “prohibits a health care service plan or health insurer from engaging in post claims underwriting, defined to mean the rescinding, canceling, or limiting of a plan contract or policy due to the plan’s or insurer’s failure to complete medical underwriting and resolve all reasonable questions relative to an application for health care coverage before issuing the plan contract or policy“.

Insurance companies are still able to retro-review policies for omission of pertinent health information. However, in order to follow through and rescind a policy, the insurance carriers must first seek approval from the Department of Managed Health Care or the Commissioner of the California Department of Insurance. This bill is intended to protect the individual in question from a biased review of their case.

There are, of course, pros and cons to this bill. Those in favor state that this bill will provide protection to patients by means of regulators who will independently scrutinize policy rescission’s, and ultimately develop a standardized application that health plans and health insurers must use. Those against state, amongst other things, that uniform applications do not guarantee success and that the rescission rate is only at about 1/10^th of all individual policies.

Tags: individual health, underwriting
Posted in Laws, State | No Comments »

Help for Uninsured Californians!

Wednesday, May 20th, 2009

Many Californians don’t have medical coverage, and are unable to qualify for health coverage due to pre-existing conditions. However, it is important to know that there are options you may qualify for:

Medi-Cal

Medi-Cal is California’s version of the federal Medicaid program. This program will pay for health services for California residents that qualify based on income and assets. Eligibility is determined by the Department of Health Services through its sub-agency Department of Public Social Services.

Access for Infants and Mothers (AIM)

The program is designed primarily for uninsured low income pregnant women and their infants who do not qualify for Medi-Cal. Since individual health plans will not approve you for coverage if you are currently pregnant, this provides an excellent opportunity for coverage.

Healthy Families Program

This program provides low-cost comprehensive health, dental and vision coverage for children and teens up to age 19 that do not have access to insurance and cannot qualify for Medi-Cal. If the mother qualifies for AIM, the baby is automatically eligible for enrollment in Healthy Families.

Major Risk Medical Insurance Program (MRMIP)

This program provides comprehensive health insurance for Californians who are unable to obtain coverage within the individual health market. You are able to enroll in the MRMIP program after you’ve been declined coverage by an insurance company or health plan due to a pre-existing condition.

Tags: individual health, pre-existing
Posted in Federal, General, Laws, State | No Comments »

California, the Stimulus Package, and You

Wednesday, May 13th, 2009

We have all heard by now that the American Recovery and Reinvestment Act of 2009, also known as the Stimulus Package should bring some much needed relief to the State of California. As the unemployment rate jumps to historic highs, and millions of Californians find themselves also without health insurance, it is vital that federal agencies step up to the plate. The goal is to obtain health coverage assistance, increase the quality of health care, and invest in health-related technologies.

So what does this mean for us? According to American Recovery and Reinvestment Act analysis, some of the major health care provisions are:

·· Medi-Cal support, including increases in federal matching payments, increased Disproportionate Share Hospital funding, a moratorium on federal Medicaid provider reimbursement changes, and extension of Transitional Medi-Cal and Indian health care programs

·· Assistance with health coverage, including subsidies for and extensions of COBRA coverage and expansion of the federal Health Care Tax Credit

·· Investments in primary care, including grant opportunities, enhanced reimbursement for community health centers, and additional support for primary health care workforce programs

·· Elevated status for comparative effectiveness research, including establishment of a federal advisory board and dedication of substantial funding.

·· Support for public health activities, health and science research and facility modernization, and health information technology, including telehealth and broadband programs.

We are always on top of current insurance news so we can ensure you are informed. Please call us with any questions or send an email with your comments. Thanks for your continued support!

Tags: COBRA, heath insurance
Posted in Family, Federal, General, Individual, Laws | 1 Comment »