Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
Many insurance agents who sell health plans and have vehemently opposed the Affordable Care Act have gone through the classic stages of grief over its passage: denial, anger, depression, bargaining and finally, acceptance. While some in the industry still hold out hope that the fortieth plus attempt to repeal the ACA will be a charm, most have accepted the new law and are looking ways to adapt and profit from its provisions.
Covered California released their small business health option plans (SHOP) for small employers and they might prove competitive for some companies with less than 50 employees. There will absolutely be small businesses that will not participate because they don’t want to support any government bureaucracy, even if it is to their benefit.
From past experience, Lujan’s focus has been in the small business group market and that was the area he was initially brought in to manage. In recent months it has become evident that SHOP may not play as well as some people had anticipated. On top of the nervousness from small businesses and their lack of enthusiasm over the ACA, Anthem Blue Cross announced they won’t participate in SHOP.
The new strategy of the GOP and Tea Party unveiled this summer to derail Obamacare is to encourage young adults not to purchase health insurance. It is beyond my comprehension that they would rely on the government, either through the promise of the individual mandate or persuasive marketing, to deliver a certain percentage of young adults for enrollment.
Covered California has been assuring health insurance agents that they will be an important part of the effort to enroll millions of residents in affordable health insurance. Unfortunately, many of the health plans they have selected for the California market place are giving insurance agents the cold shoulder.
Anthem Blue Cross of California has withdrawn their application to offer small group health insurance plans through Covered California. Unlike the individual and family market health plans purchased through Covered California that will be invoiced directly by the respective carrier, the SHOP plans are to be purchased and administered by Covered California.
Covered California has already awarded $43 million for public outreach and education. Seven of the recipients that received grant money are organizations that are already involved with the health care industry. Yet we need more money spent just to talk to doctors, nurses and physical therapists?
Children’s dental insurance options have now been added to the line of plans being offered through California’s health insurance exchange Covered California. Part of the ten Essential Health Benefits that must be offered through the new health insurance exchanges or Marketplaces is pediatric dental. The state exchanges can meet this requirement in various ways and Covered California has opted to offer stand alone plans.
Part of Covered California’s mission is to improve health care quality and lower costs. In an attempt to meet these goals they announced a partnership with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely initiative. The Choosing Wisely initiative seeks to encourage better dialog between patients and physicians to reduce duplicative tests based on evidence when charting the most effective course of treatment.
Covered California hosted another webinar to provide a progress update of the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) website. In short, this is the website Californians will use to enroll in one of the qualified health plans offered in their area through Covered California.
