Health Care Updates

Thousands Scramble To Prove They Are In US Legally To Continue Receiving Health Coverage.

In continuing coverage, the Wall Street Journal (8/14, Radnofsky, Subscription Publication) reports that ACA supporters are scrambling to make sure thousands of people provide documents to demonstrate that they are in the country legally and entitled to coverage under the law. The Journal notes that the Obama Administration announced Tuesday that it would end coverage for some 300,000 people who enrolled on if they do not provide information in the next few weeks showing they are US citizens or legal residents.

Two California Insurers Team Up To Create Health-Information Exchange.

The Wall Street Journal (8/5, Beck, Mathews, Subscription Publication) reports that two major California insurers, Blue Shield of California and WellPoint’s Anthem Blue Cross, are partnering to create one of the nation’s largest health-information exchanges. The Journal notes that about nine million plan members’ medical records will be available to participating physicians and hospitals.
The Los Angeles Times (8/5, Logan, Pfeifer) reports that “supporters say the effort by Anthem Blue Cross and Blue Shield of California could mean faster, cheaper and better healthcare,” although “the system faces significant technological challenges and privacy concerns.”

Covered California Health Plans Under Pressure To Add Physicians.

The Sacramento (CA) Business Journal (8/5, Robertson, Subscription Publication) reports that the Covered California plans are under pressure “to increase the size of provider networks,” with a particular focus on Anthem Blue Cross and Blue Shields of California, which was said to only have a “narrow network” of physicians. Although Anthem Blue Cross has added nearly 7,000 new physicians since January, the state legislature is putting forth a legislation to try and increase that number. One such bill is SB 964, which “would require the Department of Managed Health Care to review Medi-Cal managed care plans and plans sold through Covered California annually for compliance with state standards for timely access, network adequacy and other measures.” Modern Healthcare (8/5, Subscription Publication) also reports on this story.

In an op-ed for LifeHealthPro Craig Gottwalls, a healthcare attorney and benefit broker for BB&T Insurance Services, examines the longevity of the recently announced rate renewal of 4.2% in plans sold through Covered California. He writes that although it “is certainly at least partially a result of PPACA...this will not be the new normal in health insurance renewals.” Gottwalls says this is due to the fact that the “built-in bailouts” on the exchange plans, or the “three R’s programs” is set to expire in 2016. The “Three R’s” refers to “risk adjustment, reinsurance and risk corridors.”