State Report: California

April 1, 2008

Commonwealth Fund Overall Rank (2007): 39

The proposal failed in the state senate following a pessimistic report about its long-term financial prospects. Workers feared they would be forced to buy policies they could not afford.

STATE SLASHES MEDICAID PAY

PACIFICARE FACES FINE

California Insurance Commissioner Steve Poizner says his department will begin audits of the eight largest health insurers in the state to address similar alleged claims-processing violations.

Blue Cross of California in February said it would stop sending letters to physicians asking them to report pre-existing medical conditions that could be used to rescind patients' coverage. The California Medical Assn. urged regulators to order the insurer to stop.

MEASURES CRITICIZED

The DMHC has been slow to implement a 2002 state law requiring insurers to provide HMO patients with timely access to appointments with physicians, according to the Los Angeles Times. The DMHC released its guidance three years after its deadline says the Times but "scrapped the rules in favor of ones that let health plans come up with their own methods of complying with the law," because HMOs and physician groups objected.

HOSPITALS COLLECT FROM UNINSURED

Researchers from RAND and the University of Southern California found that from 2001 to 2002, hospitals collected on average 18% more of their charges from uninsured patients than from Medicare, according to Health Affairs. From 2004 to 2005, they collected on average 20% more of the charges from uninsured patients. Medicare increased payments to hospitals by 13% between 2001 and 2005.

MHE Sources: CMS, Urban Institute, Kaiser Commission on Medicaid and the Uninsured, U.S. Census Bureau, The Commonwealth Fund.