California leads the nation on health care reform

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California passed legislation creating a health-insurance marketplace, a move set to be echoed across the country as states take steps to implement federal law.

Millions of Americans around the U.S. are expected to eventually purchase their coverage through such exchanges, which will offer health plans to individuals and some small businesses.

The California legislature on Wednesday passed the second of two related bills to set up the exchange, putting the state at the forefront of efforts nationwide and creating a blueprint that will likely influence other states. Under the national health-care overhaul law passed in March, states are supposed to set up exchanges, or their residents will be offered a federal version.

California Gov. Arnold Schwarzenegger, who has said he supported implementing the federal law, is expected to sign the bills.

Many aspects of the exchange are mandated under the federal law, so many features of California's model will be included in those adopted by other states. The exchange is expected to offer insurance through a website that will provide standardized and detailed information about plans, so consumers can compare them. It will have a toll-free number, and will set up a program of live helpers, or navigators, to help explain plans to consumers.

The exchanges aren't required to be fully up and running until January 2014, when key provisions of the new federal health law kick in, although some exchange operations may start earlier. Following federal requirements, the California exchange will sell insurance in five categories, ranging from rich "platinum"-level benefits to a plan for young people offering catastrophic coverage.

It will also link eligible Californians to federal subsidies that would help pay for their coverage, or to government programs such as Medicaid.

...

California's legislation would make it the first state to enact a full exchange since the national law passed.

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California's exchange may be the largest one established by a single state. Researchers at the University of California, Berkeley projected that as many as 8.3 million people might be eligible for plans through the exchange, including individuals and 3.8 million through small employers.

The federal law says businesses with up to 100 employees can purchase coverage through the exchanges, and states can raise that cutoff in 2017. The availability through the exchange of subsidies for some people who are sole proprietors, and tax credits for certain small businesses, should be lures for those that qualify, said Scott Hauge, president of Small Business California, an advocacy group, and an insurance agent.

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The California exchange would be governed by a new board, which will be given robust authority, including the power to selectively contract with insurers to offer plans within the exchange.

http://online.wsj.com/article/SB10001424052748704540904575452020633405364.html?mod=WSJ_hpp_MIDDLETopStories

Edited August 26, 2010 by Legacy member

[Ban Hammer 13,407]

like they ain't broke enough already.

[Atencio 43]

People can get medical care in California anyway. Over 70% of the patients that come to the hospital I work at have no health care.

[Mr. Big Dog 10,747]

like they ain't broke enough already.

I imagine that the below isn't cheap for the state. But God forbid people actually have to pay for their coverage and care when they can just hang on the state's teat.

People can get medical care in California anyway. Over 70% of the patients that come to the hospital I work at have no health care.

[evli1966 88]

like they ain't broke enough already.

They aint broke just built $573 million school. after building 2 others at about $300 million.

They aint broke. They just lay off 1000's of teachers so the kiddies can sit in the nice schools with no one to teach them.

I imagine that the below isn't cheap for the state. But God forbid people actually have to pay for their coverage and care when they can just hang on the state's teat.

I agree imagine having to pay. such a new concept to people.

no worries it now gives the medical centers reasons to lay off 1000's of medical workers to pay for the freebie coverage.

[Mr. Big Dog 10,747]

I agree imagine having to pay. such a new concept to people.

no worries it now gives the medical centers reasons to lay off 1000's of medical workers to pay for the freebie coverage.

Freebie coverage? The coverage on those exchanges is purchased.

[ValerieA 350]

Freebie coverage? The coverage on those exchanges is purchased.

Thank-you, I was getting confused by the comments above.

the California exchange will sell insurance in five categories, ranging from rich "platinum"-level benefits to a plan for young people offering catastrophic coverage.

Maybe some of those 70% without health care insurance will be able to afford it under the new system.

[evli1966 88]

Freebie coverage? The coverage on those exchanges is purchased.

ok

again it gives them reason to lay of 1000's of medical workers or furlough them or make them part time to pay for the coverage.

Do not be silly enough to believe the payment the people will be paying here truly covers the costs.

example for you.

You build a bunch of houses for $100000 (build cost) each to sell.

Government passes a bill stating everyone has a right to a house and you can not sell those houses for more than $50k.

The masses line up and pay you $50k for your houses.

Now answer these questions.

Did you make, lose or break even?

will you build more houses?

If you do not build more houses what happens to all the people you had working to build those houses?

[ValerieA 350]

So, evli, you are saying that having them pay for some coverage costs more than them coming in to the hospital and getting it for free?

[Mr. Big Dog 10,747]

ok

again it gives them reason to lay of 1000's of medical workers or furlough them or make them part time to pay for the coverage.

Do not be silly enough to believe the payment the people will be paying here truly covers the costs.

The coverage is provided by private insurance companies. The exchanges do not set prices but are designed to actually create competition in a marketplace that has been largely monopolized over the last few decades. The exchanges will enable consumers to make informed purchase decisions. Yes, there will be watchdogs monitoring premium increases but those aren't exactly new - we have them in most states already. Problem is that they are largely ineffective. If you believe in the power of the markets, then you should be an advocate for these exchanges. They are marketplaces where private companies compete for business.

Your example, by the way, has nothing to do with the matter discussed in this thread.

[evli1966 88]

So, evli, you are saying that having them pay for some coverage costs more than them coming in to the hospital and getting it for free?

Absolutely not it just shows that the so called competition you think is there will not promote what you think it does.

This will backfire in a way that will cause possibly you, me and others who currently pay for our health care ins, deductibles and out of pocket expenses to not be able to afford the health care we now have or recieve such watered down care that maintenance and elective care will no longer be available to us.

The coverage is provided by private insurance companies. The exchanges do not set prices but are designed to actually create competition in a marketplace that has been largely monopolized over the last few decades. The exchanges will enable consumers to make informed purchase decisions. Yes, there will be watchdogs monitoring premium increases but those aren't exactly new - we have them in most states already. Problem is that they are largely ineffective. If you believe in the power of the markets, then you should be an advocate for these exchanges. They are marketplaces where private companies compete for business.

Your example, by the way, has nothing to do with the matter discussed in this thread.

I understand what it says but with the entrance of the public care this will not have the effect you think it will see above.

The example fits well in how it will be paid for; you just ignore it for your own reasons.

If a medicine is to expensive it will not be offered.

If you want preventive care you will be waiting to see your practtioner.

If your practitioner has a full load of patients you could be delegated to a new doctor with out your consent. (this is and will be the practice to even the case loads of doctors in regions)

If it costs you $100k to build a house to sell and the laws states that the government will provide the same size house for $50k you will not sell a house.

If you do not sell the houses you will not build more and layoff people.

Do you think your 100K house is of the same quality as the $50k houses from the governemnt? No but people will not care about the quality until20 years from the purchase when it is falling down.

People will go for the cheapo public plan why....becasue they will not care for 20 years until they realize they are falling apart with an illness that will not be covered

I think the expamples will fit well.

[Mr. Big Dog 10,747]

This will backfire in a way that will cause possibly you, me and others who currently pay for our health care ins, deductibles and out of pocket expenses to not be able to afford the health care we now have or recieve such watered down care that maintenance and elective care will no longer be available to us.

1) You, me and others who currently buy insurance already pay for those who do not. Uncompensated care is factored into the overall cost and those who actually pay for their cost or have insurance coverage that does that pony up for those that rather take the free ride.

2) Coverage has gotten ridiculously expensive while covering ever less and requiring ever higher dedcutibles as it is. The more it costs, the more people will be unable to afford it and the larger the uncomensated care portion of the bill gets amking coverage even more expensive leading to more uncompensated care, etc. This is the donward spiral we're on.

To blame additional competition via the exchanges and a push to have people assume personal responsibility for their health care - i.e. make them pay for it - for the broken system we already have is nonsense.

I understand what it says but with the entrance of the public care this will not have the effect you think it will see above.

The example fits well in how it will be paid for; you just ignore it for your own reasons.

If a medicine is to expensive it will not be offered.

If you want preventive care you will be waiting to see your practtioner.

If your practitioner has a full load of patients you could be delegated to a new doctor with out your consent. (this is and will be the practice to even the case loads of doctors in regions)

What "public care" are you referring to? You are aware that there's no public insurance plan offered through the exchanges, right?

As for the coverage of certain medicines and procedures as well as the availability - or lack thereof - of physicians, that's all nothing new. That's the situation we have today. Insurance companies do not cover everything and anything. You can't necessarily get appointments to any physician of your choice. Not even close.

[ValerieA 350]

Absolutely not it just shows that the so called competition you think is there will not promote what you think it does.

This will backfire in a way that will cause possibly you, me and others who currently pay for our health care ins, deductibles and out of pocket expenses to not be able to afford the health care we now have or recieve such watered down care that maintenance and elective care will no longer be available to us.

I don't understand how more people paying for health care means the services will degrade. There will still be the same number of people using health care. So, if revenues increase, and expenses stay the same...hmmm. Seems like a good thing to me.

[Obama 2012 1,714]

I'm still amused by the fact people think the exchanges actually help people.

The only thing the exchanges do is create another system that essentially will either have to limit coverage OR not pay doctors appropriately like medicare.

The 'cost' of health care will not change until our obsession with new technology immediately changes and we're willing to address malpractice.

[Mr. Big Dog 10,747]

I'm still amused by the fact people think the exchanges actually help people.

The only thing the exchanges do is create another system that essentially will either have to limit coverage OR not pay doctors appropriately like medicare.

I'm still amused how little people understand about the exchanges. They don't set reimbursement rates nor limit coverage. They are nothing more but a marketplace where consumers can effectevily compare different private insurance plans and select the plan that best meets their needs and budget.

The 'cost' of health care will not change until our obsession with new technology immediately changes and we're willing to address malpractice.

This, I mostly agree with.