Despite objections from regulators, health insurers Blue Shield of California and Aetna Inc. are proceeding with double-digit rate increases that state officials said were unreasonable.
Officials at the California Department of Managed Health Care said increases that average more than 11% for about 47,000 individual and small-business policyholders of Blue Shield and Aetna were unreasonable. But state officials don't have the authority to reject changes in premiums, and increasingly health insurers refuse state demands to lower rates.
"I am disappointed that after lengthy negotiations, Blue Shield and Aetna were unwilling to bring their proposed health plan increases down to a reasonable level," said Brent Barnhart, director of the Department of Managed Health Care.
Barnhart said negotiations were more productive with Anthem Blue Cross, the state's largest for-profit health insurer and a unit of industry giant WellPoint Inc. He said Anthem agreed to smaller rate increases for 202,000 individual and small-business policyholders that will save consumers about $13 million.

Republicans revisit Medicare reform to cut spending

A budget blueprint being drafted by Rep. Paul Ryan includes a proposal to create a voucher-like system, despite the GOP promise not to change the program.

By Lisa Mascaro and Michael A. Memoli, Washington Bureau
7:28 PM PST, March 2, 2013
WASHINGTON — Fired up as once-unimaginable spending cuts start to slice the federal budget, Republicans are launching a new phase in their austerity campaign — resurrecting the party's cost-cutting plan to turn Medicare into a voucher-like system for future seniors.
Despite public uncertainty Saturday about the $85 billion in so-called sequester cuts, Republicans now believe they have momentum to ask Americans to make tough choices on Medicare, as rising healthcare costs combine with an aging population to form a growing part of future deficits.
That effort will form the backdrop as the White House and congressional Republicans enter their next round in the budget wars — keeping the government funded through Sept. 30. Unless they make a deal by March 27, the government could run out of money and be forced to shutter offices and curtail services.
President Obama and Republican leaders have signaled that they are eager to avoid another bruising battle and federal shutdown as both sides position themselves for the next major pressure point, in late spring or early summer, when the government faces a potential debt default.
Rep. Paul D. Ryan of Wisconsin, the former Republican vice presidential nominee, is preparing a budget blueprint that aims to balance revenue and spending in 10 years. But his effort has run afoul of the GOP vow not to change Medicare — the federal healthcare program for seniors and the disabled — for those now 55 or older.
Medicare eligibility currently begins at age 65. Ryan's approach would transform the benefits program into one that would provide a fixed amount of money in a voucher that future seniors could apply to the cost of buying private health insurance or to buying coverage through traditional Medicare.
Throughout last year's presidential campaign, the GOP promised not to change Medicare for today's seniors — only the next generation. But Republicans familiar with the number-crunching in Ryan's budget committee say balancing the budget may not be possible unless the changes start for those who are now 56 and younger.
Critics say Ryan's plan would shift healthcare costs from the government and onto seniors. Democrats who sharply criticized Ryan's proposal during the 2012 campaign say voters rejected his arguments when they reelected Obama.
Even some Republicans who support Ryan's proposal are wary.,0,7366545,print.story

'Sequester' cuts to hit healthcare hard

Expected Medicare payment cuts have hospitals and doctors worried. Public health and medical research programs may suffer disproportionately more.

By Noam N. Levey, Los Angeles Times
6:00 PM PST, February 27, 2013

WASHINGTON — As the Obama administration begins to implement $85 billion in cuts to federal spending this year, no part of the budget other than defense will take a bigger hit than healthcare.
And the so-called sequester appears likely to have a disproportionate effect on areas of the health system already hobbled by years of retrenchment or underfunding, including public health and medical research.
Although the Medicare program will account for the largest chunk of dollars cut from healthcare simply because of its great size, the scheduled 2% reduction in its payments to doctors and hospitals is significantly smaller than what many public health and research programs face.
Laboratories at major universities and medical centers are already laying off scientists, even before the latest round of cuts is scheduled to take effect. And local public health officials, hit by years of cutbacks, are scaling back immunization campaigns and other efforts to track and control infectious diseases.
"They are doing cuts on top of cuts on top of cuts," said Eric Hoffman, director of the Center for Genetic Medicine Research at Children's National Medical Center in Washington. Hoffman's labs have had to delay several major projects, including new research into muscular dystrophy in children.
Also threatened are new initiatives sparked by public health crises such as mass shootings — which have generated calls for strengthening the nation's mental health system — and outbreaks of food-borne illness.
Compounding the challenges is a lack of direction from Washington. Obama administration health officials have provided little guidance about how they plan to implement many of the cutbacks and when precisely they will hit.
A Health and Human Services Department spokesman said only that the agency would be sending general notifications Friday to those who rely on federal money. More specific instructions will follow. The agency is expected to cut about $15.5 billion from its overall spending, with about two-thirds of that coming from Medicare, which covers the elderly and disabled.
Major medical groups, including the American Medical Assn., the American Hospital Assn. and the American Nurses Assn., have warned that the Medicare cuts will lead to lost jobs. The reimbursement cuts may be particularly difficult for providers with fewer privately insured patients.,0,443972,print.story

Covered California's plan to partner with Wal-Mart is criticized

The state wants retail workers to help consumers enroll in healthcare expansion. Critics say Wal-Mart does not provide adequate health coverage and shouldn't be advising consumers on the matter.

By Chad Terhune, Los Angeles Times
2:59 AM PST, March 7, 2013

California officials face mounting criticism from union leaders over plans to let retail giant Wal-Mart Stores Inc. enroll shoppers in President Obama's healthcare expansion.
The state wants employees at Wal-Mart and other retailers to help consumers learn about their options and assist them in buying federally subsidized private insurance. These plans are part of state efforts to implement the federal healthcare law and reach out to 5 million Californians eligible for new coverage starting in January.
Labor unions as well as some consumer advocates protest the idea of government officials partnering with Wal-Mart and paying for its help. They contend that the nation's largest retailer has no place advising others on health coverage when so many of its workers don't qualify for company benefits and end up in taxpayer-funded programs such as Medi-Cal.
"We are appalled and offended that the exchange would contemplate partnering with Wal-Mart and other retailers notorious for failing to provide health benefits to many of their workers and providing substandard benefits to the workers who do qualify," said James Araby, executive director of the United Food & Commercial Workers Union's Western States Council. "That is highly contradictory to the mission of the program."
Quiz: Test your healthcare knowledge
Wal-Mart defended its employee benefits and said they exceed what the retail industry generally offers. A spokesman for Wal-Mart said it supports the state's efforts, but it would be premature to discuss any partnerships.,0,5409783,print.story

LePage: Will issue bonds after hospital payback plan gets OK

By Eric Russell
Staff Writer
AUBURN — Gov. Paul LePage said Friday that he would issue voter-approved bonds the minute lawmakers pass his proposal to pay back hospitals with future liquor revenue.
"If I could trust them, I'd do it on a promise," LePage said at an event at Roopers Beverage in Auburn.

For several weeks, the governor has stressed the importance of passing a bill to repay the hospitals. His bill would put the state's liquor contract out to bid with the understanding that a portion of future proceeds would go to the state. The state would then borrow the money to pay the hospitals and pay off the bond with those future revenues.

LePage has vowed to veto every bill that comes before his desk until that happens, and didn't back away from that pledge on Friday.

"I don't like to go back on my word," he said. 

Sen. John Cleveland, an Auburn Democrat, attended the event and said after LePage's remarks that both parties want to pay back the hospitals. But Cleveland said there is real concern that the governor's bill is unconstitutional.

"I spoke to the attorney general three days ago and asked 'Can we issue bonds to pay debt?' She said 'No,' " Cleveland said.

Lawmakers are scheduled to take up the governor's bill on Monday.