Friday, May 24, 2013

Nation's Most Populous State Unwraps Its Health Care Exchange -- And At Least 13 Private Insurers Join The Effort

California has unveiled its private public state-run exchange. And it is a model of cooperation. Even the rhetoric in the health insurance companies' on-air ads reflects this: last fall, health insurers were referring to the effort's prospects "an uncertain time" -- as they pitched their products -- to individuals and businesses.

Yesterday, in the land of Big Sur, I heard several on-air FM radio ads that touted the "great opportunities" in "health care reform" for all of the state's insureds. Yes, a private, for profit insurer was calling "reform" by its name -- and lauding it, as "positive reform". That is how far we've come.

[BTW, Congressional Republicans planning on running at the mid-term against this wave, will do so at their considerable peril.]

Of course, there will be glitches, and of course it will need some fine tuning and mid-course correction(s) -- but we are seeing a new delivery model, in action, in California -- with millions more patients eligible for, and receiving at least basic health care, at an affordable price.

Yes, change is always hard -- but that is what most of the complaining will be about, from here on, in California -- people just get uncomfortable around change. But it is the way of all things -- they change. We will keep an eye on all of this for the readership, of course.

From a bit of The New York Times story, then -- do go read it all:

. . . .The new rates for individuals will be about the same — or lower — than the current rates for small businesses, according to officials from Covered California, the group operating the exchange.

“The changes in the market are really making individuals much more like employer groups,” Paul Markovich, the chief executive of Blue Shield, said. Like people who now receive health insurance through their employers, individuals buying policies on their own will be able to enroll next year even if they have a potentially expensive medical condition, and the policies’ benefits and premiums will be more standardized.

“We held insurers’ feet to the fire,” said Peter V. Lee, the executive director of Covered California, who said that the exchange had received interest from 33 insurers and actively negotiated with them over their proposed rates and the kind of network of doctors and hospitals they would offer. Covered California estimates that the plans offered will allow consumers access to about 80 percent of the state’s practicing physicians and hospitals.

While Washington, Vermont and several other states have also announced the details of their respective exchanges, California’s size and previous support for the health care law made it an important test of the law, said Paul B. Ginsburg, the president of the Center for Studying Health System Change, a nonpartisan research group in Washington. “A lot of people will be watching California to see how well it succeeds,” he added.

California chose to behave more like Massachusetts in aggressively negotiating with insurers on behalf of its residents. . . .

I think California (and Massachusetts) have that just right -- these states must negotiate fiercely with the private insurers -- on price. That is their duty, to their citizens. The charge is to provide as much health care as possible, at the best price, to the highest number, and widest swath, of state residents. It will be bumpy at first -- but it bears watching. It is the wave of the future. And it is the right thing to do.

Finally, even though anti-reform worry-warts were predicting close to 30 per cent premium increases for healthy young people in California, the increases are averaging around 13 per cent -- less than half the fear. And, it is highly likely that these healthy young people were being undercharged under the prior rubric. So now you know.


Anonymous said...

Kudos to the Golden State. It makes sense that they're system is one of the first up and running since they could also be known as the Tech State. I recently left a private insurer in a neighboring state and can assure you that the Fed exchange system doesn't seem so ready....

Condor said...

Thanks for your perspective, Anon.!

The federal exchanges were always supposed to be a backstop system, if the states couldn't get their collective acts together.

Truthfully, we didn't foresee or expect that (almost exclusively Republican) governors would reject aid for their neediest citizens, simply to spite Mr. Obama.

I suppose that was our fault -- for over-estimating the leadership abilities/ethics of these dozen or so governors.

Having said that, the NYT has a good story this morning, once again putting pressure on those same states -- to accept expansion, to cover their neediest citizens -- 95% from the federal fisc.

I'll likely comment on that latest NY Times story later this morning.

Again thank you for stopping by -- do stop back!