"Don't Litigate, Innovate." How To Implement A Fully Funded Alternative To The New Health Care Overhaul -- And It's Already In The Law

This post of mine first appeared at Kaiser Health News last week.What if a Republican governor and a Republican legislature had the ability to implement their version of health insurance reform and the federal government would have to pay for it? It's a great idea. And I'm thrilled to say that a bi-partisan bill has already been introduced in the Senate by Ron Wyden, D-Ore., and Scott Brown,

Will it Be the Bond Market That Finally Forces Serious Health Care Financing Change?

When will the Congress and the White House finally make the hard decisions in order come to grips with the federal deficit problem?When will we finally deal with real health care reform and get the entitlements, and with them the private health care cost issue, under control?My focus on trying to answer those questions has always centered on what's going on in the health insurance market: When

The 300 Page MLR Rules—About as Valuable as Taking Your Shoes Off at the Airport

This whole medical loss ratio (MLR) provision in the new health care law is a fool’s errand. When it comes to controlling health care costs it is about as productive as taking your shoes off at the airport is valuable at improving air travel security.Without a doubt, the new health care law does far too little toward making health care costs affordable. And, marginal health insurance carriers

Health Care—Tell Us the Truth Before You Tell Us Why You Are Right

This is post of mine that appeared last week at Kaiser Health News.Just after the election, I saw an exchange between CNN’s Anderson Cooper and the head of the Tea Party House Republican caucus, Michele Bachmann. Cooper tried to pin Bachmann down on just exactly what “specific spending cuts” she would make to get federal spending under control. When he suggested that Medicare was going to need

Shame on AARP For Their Response to the Deficit Commission Co-Chairs' Report

The Co-Chairs of the President’s Deficit Reduction Commission are out with their preliminary recommendations.They’ve done a great job—they’ve offended about everyone!But we have a nearly impossible but unsustainable challenge in front of us if we are ever going to crawl out of this deep hole.It is not so much what is on their list as what this list tells us about just how fundamental the changes

PCIP Premium Decrease (HHS)

According to recent press, the federal government has indicated that it plans to decrease the premiums for the federal PCIP (temporary risk pools) by 20% in order to encourage greater enrollments.

Apparently enrollment in the new PCIP has been lackluster at best.

I do not yet know if the decrease will be applied to the CA PCIP as it is being run by the state (MRMIB) and not a direct federal risk pool.

Unless the government can find more $$$ to pump into the pools, this is going to likely create a reduced number of enrollment slots meaning less people will be able to be covered at the lower premium.

California's PCIP is scheduled to hold an average of 23,100 people at any given time with a possible increase in two years if scheduled federal funding is available. Obviously a 20% premium decrease under existing funding ($761MM) would likely lower the number of subscribers by that same percentage.

Health Care and the 2010 Mid-Term Elections--the Only Thing Now Certain is the Uncertainty

@font-face { font-family: "Cambria"; }p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; }div.Section1 { page: Section1; } The election has given us a Republican House and a still Democratic controlled Senate. But, instead of Democrats having the 60 Senators they had when health care was passed in December, they will have a

Health Net CA Blackout Coming Up

Health Net of California has announced a blackout for individual & family coverage plans (IFP) in a couple of weeks. The blackout will be lifted when the new PPACA-compliant plans are approved and available for January 1, 2011.

The blackout will occur on November 18th (online quoting), and the last day to submit applications for December 1, 2010 start dates will be November 22nd. Any applications received after 11/22 will not be processed.

Any application submitted on or before 11/22 that is not approved and enrolled by 12/10/10 will be cancelled and returned to the applicant.

Health Net CA will advise agents as to the progress of the PPACA-compliant plans and at what point applications and online quoting will be made available after the blackout.

This blackout does not effect HIPAA plans, only underwritten coverage plans.

Congratulations Rick Bronstein!

Rick Bronstein, a fellow agent and friend, ran for the office of CA Insurance Commissioner in the 2010 election.

Rick placed third in the race and garnered almost 300,000 votes. Not to shabby for a 3rd party candidate with no corporate backing nor war chest.

Congratulations, Rick. You certainly made them take notice. Now, get back to work LOL!

Anthem Blue Cross CA Update

Just wanted to update on my suspending sales with Anthem Blue Cross CA.

I have spoken with Anthem concerning my issues with their processes and am supposed to be receiving some correspondence from "on high" regarding my issues and concerns. As of today I have not yet received anything from Anthem in this regard. I understand the correspondence has to be cleared by the legal department due to technical nature (I am sure it's HIPAA-related).

I am willing to work with Anthem Blue Cross to resolve these concerns and to assist people in buying both guaranteed-issue HIPAA coverage and underwritten coverage (one the plans are actually available -- they are still blacked out pending DOI approvals).

In the meantime, I am continuing with Anthem Blue Cross small group products as they are a good carrier for the types of groups with which I specialize (spousal/family).

I just wanted to update and let you all know where things stand.