2002 Legislative Update

The following pieces of legislation affecting health insurance went into effect this year: AB 25 Domestic Partner Coverage Requires health care service plans and insurers to offer employers domestic partner coverage as part of the group plan. AB 892 Hospice Care Requires health care service plans to provide certain coverage for hospice care for terminally ill members as a basic health care service. Hospice care at a minimum should be equivalent to that provided by Medicare. AB 938 Disclosure Form Requires health care service plan’s disclosure form to include any limitations on the patient’s choice of a non-physician health care practitioner, and include any general authorization requirements for referral by a primary care physician to a non-physician health care practitioner. Additionally, the bill requires plans and/or medical groups to provide a list of contracting providers to enrollees, upon request. SB 37 Clinical Trials for Cancer Requires health care service plans and certain disability insurers to provide coverage for certain routine patient care costs incurred during a qualifying FDA-, NIH-, DOD-, or VA- approved clinical trial relating to cancer. SB 446 AIDS Vaccines Requires health care service plans and insurers to provide coverage for FDA-approved AIDS vaccines when available and such becomes available. SB 1169 Emergency Contraception Permits pharmacists to initiate emergency contraception in accordance with standardized procedures or protocols developed by the pharmacist and an authorized prescriber. SB 1219 Coverage for Cervical Cancer Requires a health care service plan or a disability insured policy that includes coverage for the treatment or surgery of cervical cancer to cover an FDA approved annual cervical cancer screening test.

HEADLINE NEWS

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American's Coming Health Care Oligopoly:  Can you say "insuragopoly"? How about "hospigopoly"? Then you better learn, because they describe how the health care system is changing under President Obama's health care reform legislation.

Health Overhaul May Mean Longer ER Waits, Overcrowding:  Rand Corp. researcher Dr. Arthur L. Kellermann predicts this from the new law: "More people will have coverage and will be less afraid to go to the emergency department if they're sick or hurt and have nowhere else to go.... We just don't have other places in the system for these folks to go."

5 PAINFUL HEALTH-CARE LESSONS FROM MASSACHUSETTS:  The best guide to how President Obama's historic health-care legislation will reshape the nation's medical marketplace and fiscal future is the pioneering model in Massachusetts. The Bay State's reform program started in late 2006, and it shares virtually all the major features of the new federal plan.

Dartmouth Study on Health Care Costs:  In selling the health care overhaul to Congress, the Obama administration cited a once obscure research group at Dartmouth College to claim that it could not only cut billions in wasteful health care spending but make people healthier by doing so.

OBAMACARE'S FUZZY MATH -- HIGH RISK POOLS WILL COST 8 TIMES WHAT IS BUDGETED:  One feature of the health overhaul that the President is touting as an immediate benefit is the expansion of so-called "high risk pools" for people who want to buy insurance but can't because of their poor health. The problem is that there's no way that $5 billion, which is what's been budgeted, will cover the cost of covering 2 million people. The real cost will be more like $40 billion.

RESCISSIONS:  MUCH ADO ABOUT NOTHING:  How many times have you heard President Obama say, "Health insurers won’t be able to drop your coverage just because you get sick?" Or Kathleen Sebelius? Or the Democratic leadership in Congress? Or the mainstream news media? You would think that the private health insurance industry was being revolutionized.

OBAMACARE’S HIDDEN TIME BOMB:  One of the quirks of ObamaCare is that most of its key provisions don't go into effect until 2014. But in any 2,300-page law, there are bound to be provisions that have immediate and unintended consequences. One such provision is Section 2718, entitled "Bringing Down The Cost Of Health Care Coverage."

Getting to the Bottom of Health Care Cost:  A look at the high cost of health care, rising insurance premiums and what we're doing to help control them (Anthem Blue Cross).

HEALTH OVERHAUL WILL INCREASE NATION'S TAB:  President Barack Obama's health care overhaul law will increase the nation's health care tab instead of bringing costs down, government economic forecasters concluded Thursday in a sobering assessment of the sweeping legislation.

A.M. BEST ON LONG-TERM CARE COSTS, SALES, AND THE CLASS ACT:  Ratings agency A.M. Best recently released a market review of the long-term care industry and AHIP HI-WIRE took the opportunity to ask the report's two lead authors about long-term care costs, sales, and the CLASS Act.

DOCTOR SHORTAGE?  28 STATES MAY EXPAND NURSES' ROLE:   A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners.

Medicare Cuts May Burden Doctors:  A plan to slash more than $500 billion from future Medicare spending — one of the biggest sources of funding for President Obama's proposed overhaul of the nation's healthcare system — would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others, according to a government evaluation released Saturday.

Once-a-Week Workout Keeps Elderly Strong: One workout a week can mean the difference between frailty and freedom.

FDA OKs Device to Treat Back Pain: The government on Tuesday approved sales of a device that could radically change surgery for certain back pain sufferers.