Health Insurance Blog

Erin Allday from the San Francisco Chronicle recently reported on a proposal from the S.F. Attorney General that would eliminate bias in health insurance rates. Health insurance companies claim that they should be allowed to charge women under 55 more for health insurance than men, since they are more likely to suffer from some chronic illnesses and visit doctors for preventative care more often.

While 12 states ban or restrict the practice of gender rating, California does not. Women who buy individual health plans in California pay up to 39% higher premiums than men, according to Erin. The city of San Francisco is getting involved because women end up going to city clinics or emergency rooms because they can’t afford health insurance, costing the government money. 

A spokesman from America’s Health Insurance Plans, an industry group, states that gender rating is not discriminatory since women use more services. In addition, older men pay more for health insurance than older women. However, the Equal Employment Opportunity Commission prevents women from being charged more for their premiums based solely on their gender.

The National Women’s Law Center report found that women nationwide pay up to 48% more for health insurance than men, excluding maternity coverage. Maternity coverage is the most obvious factor that could drive up the cost of women’s health insurance.

It has been proven that preventative health care (check-ups and screenings) ends up costing insurance companies and society less in the long run. Should younger women be punished for taking responsibility for their well-being?

(Photo credit: Adria Richards under CC 2.0)

The LA Times reports that Blue Shield of California has agreed to reinstate the health insurance policies of roughly 700 California residents whose health plans were canceled after they got sick.  Blue Shield also agreed to the way they handle their individual health insurance plans. In exchange for the agreement, the state of California dropped its lawsuit against Blue Shield and will not pursue $12.6million in fines.

In September the state reached a similar settlement with Health Net, who agreed to reinstate nearly 1,000 policy holders whose health coverage was canceled when they got sick.  In addition, Anthem Blue Cross, Kaiser Permanente and other California health insurance companies reached similar agreements with the state last year.

The health insurance companies have maintained no wrong doing and maintain that the state allows them to review old medical records after the policy holder becomes ill, and determine if the policy holder left vital information off of their enrollment application.

California’s state sponsored health insurance program for working poor and uninsured children received a last minute contribution from First 5 California.  The $16.8 Million contribution will allow Healthy Families California to continue accepting new members through June of ‘09.  Without this last minute lifeline, an estimated 162,000 California children would have went without health insurance for at least the next six months.

The Managed Risk Medical Insurance Board, which runs the Healthy Families program, had scheduled a meeting for today December 17th  to limit new enrollments into the health care program, which currently provides California health insurance for 900,000 children who would otherwise be uninsured.

First 5 California is an organization that is tasked with improving the healthcare of young children in California.

In an attempt to close the $11 Billion budget cap this year, the state of California is considering putting a freeze on Healthy Families, California’s state sponsored health insurance plan for children.

Nearly a million California children are enrolled in Healthy Families that would not have health insurance coverage otherwise.

The Healthy Families Program is $17 Million over budget, as enrollment is growing by 27,000 new children each month, largely due to the tough economic climate and growing unemployment.

Freezing enrollment in the program is clearly not a desired action to address the budget shortfall, and although President Elect Obama is making children’s healthcare a priority, a decision will need to be made regarding this programs solvency before he takes office in January.

Some California health insurance companies, inlcuding Kaiser Permanente, Health Net, and Blue Shield of California, have warned brokers across the state that if they combine health insurance plans offered by their companies with other forms of insurance or “wraparound” plans to cover the gaps in coverage, they may be refused earned commissions or even lose their appointment with the health insurer.

One example of one of these wraparound plans is Ben-e-lect, a flexible benefits program that sells wraparound plans to businesses and has partnered with more than 30 chambers of commerce.

Health insurers do not like the practice of bundling because they claim it encourages their members to not be judicious about their health care spending and actually overuse their health coverage.

California Insurance Commissioner Steve Poizner is investigating the issue to determine whether firing health insurance brokers in this scenario would constitute a brach of legality and contractual obligation.