California health insurance exchange opens October 1, 2013

Shop at the new health exchange, coveredca.com

In San Diego County, six insurance companies will offer plans in the exchange: Sharp Health Plan, Kaiser Permanente, Anthem Blue Cross, Blue Shield, Molina Healthcare and Health Net.

State health exchange opens Tuesday
By Paul Sisson
SDUT
Sept. 30, 2013

Outreach worker Ghaith Al Obaidi of the Borrego Community Health Foundation, chats about the new Covered California health insurance exchange with two unidentified men at the El Cajon Farmer's Market Thursday. The exchange has spent millions on outreach to spread the word about he new exchange at community events, health clinics and other locations across the state.

Despite the political battles being fought over the new federal health care law in Washington, Covered California, the state’s new insurance exchange, is set to open as scheduled on Tuesday.

Californians will be able to sign up for health insurance either on the new marketplace’s website or over the phone. Consumers also can apply for income-based tax credits designed to keep premium costs affordable for families.

Peter Lee, Covered California’s executive director, said Thursday that he is confident the new marketplace will be fully functional in two days, as promised.

“We’re good to go on Oct. 1,” Lee said.

Covered California is a key component of the Affordable Care Act, the sweeping federal health reform law approved in 2010. At the core of health reform, often called Obamacare, is the tenet that most Americans have health insurance by Jan. 1, 2014, or pay a small penalty. Enrollment in exchange plans must occur by Dec. 15 for coverage to start at the first of the year.

While the budget brinkmanship in Washington, D.C., continues, states and the federal government are moving forward with implementation of health exchanges required by the Affordable Care Act.

California is one of 17 states, and the District of Columbia, to create its own exchange while seven more are operating in partnership with the federal government. The federal government will also run exchanges in the remaining 27 states where leadership has generally opposed health reform.

A place to shop Covered California takes an Internet commerce approach to selling health insurance. Uninsured residents can go online, specify their locations, and see the plans offered in their area.

Much of what consumers will see is already visible on the website. Those who visit today can enter their family size, household income and ZIP code and receive a list of plans displayed side-by-side, with the premium they would pay and whether they would qualify for a tax credit from the federal government.

Lee said that, on Tuesday, a new button will appear on the website allowing visitors to enroll for policies effective Jan. 1. A consolidated physician directory will also be posted Tuesday, which will allow applicants to search for doctors across plans, Lee said.

“We think it’s a big deal to have a consolidated directory,” he said.

For people without computers, the exchange has created two call centers staffed by 442 operators who can guide applicants through the process.

In San Diego County, six insurance companies will offer plans in the exchange: Sharp Health Plan, Kaiser Permanente, Anthem Blue Cross, Blue Shield, Molina Healthcare and Health Net.

On the exchange, each carrier is required to clearly list the premiums and copays it charges, as well as the out-of-pocket maximums, for each policy sold.

Health reform also requires all exchange plans to cover the same 10 categories of “essential health benefits,” which range from emergency services to prescription drugs.

Because the health reform law is so strict about which benefits must be included, consumers will largely be deciding on premiums, coverage levels and doctor networks when making a decision about which plan to purchase.

Supreme Court upholds Obama’s health-care law

Supreme Court upholds Obama’s health-care law
By Robert Barnes
June 28, 2012
Washington Post

Chief Justice John G. Roberts Jr. on Thursday joined the liberal wing of the Supreme Court to save the heart of President Obama’s landmark health-care law, agreeing that the requirement for nearly all Americans to secure health insurance is permissible under Congress’s taxing authority.

Even as it upheld that central component of the Patient Protection and Affordable Care Act, however, the court modified another key provision of the law, ruling that the federal government cannot withdraw existing Medicaid funding from states that decide not to participate in a broad expansion of Medicaid eligibility.

The court’s historic compromise, which will affect the health-care choices of millions of Americans, amounts to a major victory for the White House less than five months before the November elections, although the Medicaid decision sets new limits on the power of the national government.

President Obama welcomed the ruling, which he called “a victory for people all over this country whose lives will be more secure.” He said the decision would allow the health-care law to offer millions of currently uninsured Americans “an array of quality, affordable health-insurance plans to choose from” starting in 2014.

“Today the Supreme Court also upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance,” Obama said in televised speech at the White House. He said he knew that this individual mandate “wouldn’t be politically popular” and that the debate over the law “has been divisive.” But he said the law was “good for the country” and “good for the American people.”

“The highest court in the land has now spoken,” Obama said. “We will continue to implement this law. And we’ll work together to improve on it where we can. But what we won’t do, what the country can’t afford to do, is refight the political battles of two years ago or go back to the way things were. With today’s announcement, it’s time for us to move forward.”

Illustrating the divided nature of the ruling, Justice Anthony M. Kennedy, representing the court’s most consistent conservatives, read a scathing dissent, while Justice Ruth Bader Ginsburg, representing the liberals, issued a separate opinion supporting Roberts but differing with him on key aspects of the case...

Obama healthcare reforms lead to $1.3 billion in insurance rebates

Obama healthcare reforms lead to $1.3 billion in insurance rebates
By Noam N. Levey
April 26, 2012

U.S. consumers and businesses will receive an estimated $1.3 billion in rebates from insurance companies this year, according to a new study quantifying a key early benefit of the healthcare law that President Obama signed in 2010.

That will translate into anywhere from a few dollars to more than $150 for some 15 million consumers nationwide, the new report by the nonprofit Kaiser Family Foundation found.

Obama’s healthcare law requires insurers to spend a minimum portion of customers’ premiums on medical care, a provision championed by consumer groups concerned that companies were hiking premiums to pay for executive salaries, shareholder dividends and other expenses unrelated to their customers’ care.

Starting last year, if insurers did not meet these targets – known as medical loss ratios – they had to pay rebates this year to people enrolled in their plans.

The Kaiser study, which analyzed rate documents filed with state regulators nationwide, found 486 health plans nationwide that will be required to pay rebates, with the largest number in the so-called individual market serving people who do not get health coverage through work.

Nearly a third of all consumers in this market, which is widely seen as the most trouble-plagued in the country, will be eligible for a rebate.

Approximately a quarter of consumers in the small group insurance market and less than a fifth of consumers in the large group market qualified for rebates.

The study also found wide variation in states, with insurers selling individual health plans in some states such as Alaska, Maryland and Pennsylvania required to provide average rebates of around $300. In Hawaii and Maine, by contrast, no insurers in the individual market will have to provide rebates.

Data was not available for California because HMOs in the state are not subject to the same reporting requirements...