Insurance Broadcasting reprinted a Consumer Watchdog article about the changing face of health care in California: “the state’s three largest health insurance companies would continue to dominate the health insurance market in the California health exchange with concerns that patients will continue to pay excessive premiums because of decreased competition….United Healthcare, Aetna and CIGNA said they would not participate in the exchange, and the law prevents them from reconsidering joining for the next two years.”
Health Care in California is changing!
“In some states with rate regulation in place, health insurance companies have proposed higher rates than necessary and lowered them when confronted both by regulators and competitors with lower prices. Consumer Watchdog expressed concern that absent competition and regulation consumers would pay too much for health insurance.”
Health Care Exchange in California
The following day, the Sacramento Bee posted an article focused on Covered California, stating that “Thirteen companies were selected to sell policies for the individual market through Covered California, a state-owned marketplace for comparing prices of coverage with identical benefits but different networks of doctors…Anthem Blue Cross, Blue Shield of California, and Kaiser Permanente, three of the state’s largest insurers, were among firms chosen by Covered California to sell policies this fall, subject to rate review by state regulators. Others chosen to compete in all or parts of California were Health Net, Western Health Advantage, Molina Healthcare, Alameda Alliance for Health, Contra Costa Health Services, and the Sharp, Valley, L.A. Care, Chinese Community, and Ventura County health care plans.”
Health Care Reform
“Under next year’s federal mandate, nearly all Americans will be required to have health insurance next year or pay a penalty of $95 or 1 percent of their income, whichever is more.” Further, health care “premiums will vary based on age, region, household size and type of coverage sought. Five tiers of policies will be sold in the individual market by Covered California: bronze, silver, gold, platinum and catastrophic coverage. The lowest premiums are for policies with the highest out-of-pocket costs for care – and vice versa. Monthly premiums will fall significantly next year for individuals of low or moderate income who qualify for subsidies. Rates are likely to rise for many higher-wage earners – though not by the average of 30 percent envisioned in March by the Milliman consulting firm,” said Peter V. Lee, director of Covered California.
“All policies sold on the exchange must cover preventive care, prescription drugs, contraception, medical screenings – such as mammograms – and other ‘essential benefits,’ including pediatric, mental health, maternity and rehabilitation services. Premiums cannot vary by gender, and insurers are not allowed to set a maximum dollar amount they will pay during a policyholder’s lifetime…California’s 19 geographic regions will average five health plans from which to choose. Even in most rural areas, consumers will have two or three options – though in a small number of counties only one plan will be available, officials said.”
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