CA legislators put Kaiser under microscope

CA legislators put Kaiser under microscope

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SACRAMENTO — When the Legislature returns from its July recess, it will take up several health-care bills. A top one will be SB 746, by state Sen. Mark Leno, D-San Francisco. It would require new data reporting requirements for large group market health plans. It aims for greater transparency of health care costs to help contain the rising cost of health insurance.

At the Assembly Committee on Health hearing on July 2, Kaiser Permanente opposed the bill. The committee passed it anyway that day, 12-6.

“Only with this information can we all better contain the cost,” Leno said at the hearing, which I attended.  “This bill would require all health plans to publicly disclose aggregate information about the rates for large purchasers.”

It would require insurers selling coverage to employers with 50 or more employees to provide detailed information to the Department of Managed Health Care about how and why rates would be raised. Additionally, that information would be available to the public so consumers actively could question and track rate hikes.

Opposition from Kaiser 

The bill received strong opposition from Kaiser. The company claimed that, even though some amendments made improvements, the bill still unfairly targets Kaiser.

“We have no objections to transparency or sharing info with customers, but the sponsors of the bill are trying to change our business model and care delivery system,” said Teresa Stark, a legislative advocate for Kaiser.

Stark said Kaiser’s integrated health system is different from other health insurance, so they cannot provide the same type of information.

“The bill is meant to send a message to Kaiser: Kaiser, you are doing everything wrong,” she said.

Leno disagreed and said the amendments by the Assembly Committee on Health made sure the bill doesn’t target any specific health plan.

Charles Bacchi, executive vice president of the California Association of Health Plans, also spoke in opposition. He called the bill unnecessary and expensive, as it is not a requirement of the Affordable Care Act, usually called Obamacare.

“Health care plans are in the middle of implementing the most important changes to our health care system since Medicare,” Bacchi said. “There’s much to be done. We’re focused on getting that done and we think we should be spending our time focusing on the ACA.”

Stark added that the DMHC has never questioned Kaiser regarding its rates and transparency.

“We do need to make some changes in how we help our customers and purchasers understand their health care costs but we don’t need a bill to tell us that,” Stark said.

Background and motivation for SB 746

Assemblymember Dan Logue, R-Chico, asked Leno why there was a need for this bill.

Leno said that the San Francisco health service system found that, between 2010-2012 Kaiser was getting $87 million more from San Francisco members than it costs to serve them. Additionally, San Francisco County found rates increased by 11 percent, yet people’s use of hospitals, doctors and prescription services decreased by 16 percent.

Sponsors of SB 746 are Unite Here and the United Food and Commercial Workers Union, Western States Council. Also supporting the bill were representatives from Health Access California, a statewide health care consumer advocacy coalition.

“We need good information to negotiate on health care costs and also to provide better care,” said Beth Capell, legislative advocate for Health Access.

HAC sponsored Leno’s previous bill on health care rate transparency, SB 1163, which he authored in 2010 in response to the ACA.

SB 1163 requires health plans and health insurers to file with the California Department of Insurance and the DMHC rate information for individuals and small group plans and polices 60 days prior to implementing rate changes.

Leno said SB 1163 as an example of how information transparency helped lower costs.

“We know that transparency works,” Leno said. “We’re told that within the first two years, as a result of that bill, over $300 million has been saved.”

Leno said SB 746 addresses large group purchasers of health insurance, which SB 1163 did not.

The Assembly Committee on Health analysis of SB 746 said the DMHC indicates that Kaiser sets rates differently than other insurers.

SB 746 next will be heard after the summer recess ends in August in the Assembly Committee on Appropriations.

16 comments

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  1. queeg
    queeg 24 July, 2013, 05:50

    The business model for socialized medicine gets bit back by big government…..Hmo’s are truly the death stars of personal and confidential care……

    Reply this comment
  2. Bill - San Jose
    Bill - San Jose 24 July, 2013, 06:21

    HMOs in general, were forced onto the market by the left. HMOs like Kaiser were the natural course of things post communists intervention back before I was even in California.

    Kaiser offers tremendous coverages and the rates are what they are and they do not pose any sort of influence on other health care plans or providers.

    The state needs to butt out of private business operations and especially how often I buy a product through that service.

    Reply this comment
  3. Ted Steele, The Decider
    Ted Steele, The Decider 24 July, 2013, 13:54

    HMOS made by the left? LOL– Ok little buddy—-question-

    Name the Dems on the Kaiser BOD?

    Answer— Zero

    Reply this comment
  4. doug
    doug 24 July, 2013, 10:03

    nothing is confidential with healthcare.
    our company is now enrolling in a HRA program. Health Risk Assessment to determine overall health fitness. my guess its a way to figure the best rate for med. ins. for next year. still nobody knows how much our premiums will increase.

    the first steps to socialized medicine……..

    Reply this comment
  5. queeg
    queeg 24 July, 2013, 10:37

    HMO’s are terrible…..9-5 third world doctors…..if your sick…..defer defer till you shrivel a bit more and crawl into a ball and die….if
    healthy you sing the platitudes of full coverage at bargain prices….just like a village idiot before being beheaded for being useless to the monarchy!

    This is commie medicine….how naive can you be…..

    Reply this comment
  6. Bill - San Jose
    Bill - San Jose 24 July, 2013, 10:51

    Remember self important wise one …. Kaiser Steel created their own health system for the mill in SoCal that built ships, etc.

    So again, when you discuss left or right in regards to who runs the show, that has zero bearing on the market and the Dems in govt. setting the table for HMOs to have to exist.

    Now, being someone who runs a business and provides Kaiser coverage to the employees, I am betting I have more knowledge of this than you.

    Capt. Zero tries but you can’t deflect facts. Butting into medical coverages has been one of the main planks of the Democommunists party platform for almost a century.

    Reply this comment
  7. Ted
    Ted 24 July, 2013, 12:45

    Billl,
    Wow, u think I’m important? Thanks amigo I don’t feel that way but its nice.

    Reply this comment
  8. Ted
    Ted 24 July, 2013, 12:49

    Oh and Bill, since you’ve said this is a communist Dem conspiracy, why don’t u go ahead and name the Demo’s on kaisers board little budd?

    Lol waiting

    Reply this comment
  9. queeg
    queeg 24 July, 2013, 13:41

    Kaiser steel was a massive polluter…yukee steel mills….the HMO was modeled after early 1900’s company stores, company owned housing, kblkgatory band aide dispensaries that exploited Euro immigrants…once step above Hell and indentured servitude…..unions and Kaiser….great mix….commies and capitalists gave you the company store of health care….HMO’S.

    Undefensible…PPO’s give employees choice to see specialists instead of 9-5 quacks educated in
    Grenada,Cuba and Middle East. No one in right mind can defend HMO’s.

    Reply this comment
  10. The Ted Steele Conceptual Abstraction Unit
    The Ted Steele Conceptual Abstraction Unit 24 July, 2013, 15:00

    I agree Queeg—–but Doomer Bill thinks HMO’s are a Demo/Commie plot—- Turns out they are a bipartisan invention.

    Bill should never leave his cubicle.

    Reply this comment
  11. queeg
    queeg 24 July, 2013, 19:36

    Teddy…Go light on Bill…he is reasonably lucid and not a Caver…you can discourse with him…how can you converse with corn dog dippers and snow cone maker queens?

    Reply this comment
  12. Ted Steele, The Decider
    Ted Steele, The Decider 25 July, 2013, 06:44

    OK– but it seems like Bill sees commies everywhere……

    Reply this comment
  13. queeg
    queeg 25 July, 2013, 09:30

    Teddy….if your correct he is dangerous….keep close tabs on him….people with commie fettishes can ip further into insanity real quick!

    Reply this comment
  14. queeg
    queeg 25 July, 2013, 09:31

    Slip

    Reply this comment
  15. stolson
    stolson 25 July, 2013, 17:14

    Well, a senior MBA working in infamous Wall St. told me that HMO’s were the brain child of the MBA’s (Master in Business Management) as a way to make profits and contain costs. Once that took hold, healthcare for the masses meant fighting to get the best care and not put on pharmaceuticals(versus also needing surgery and pricey testing). He told me only sign up for them if you absolutely have to. Just passing this on….

    Reply this comment

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