Consumer Advocates Press California for Stronger Standards and Enforcement of Health Care Industry at Senate Committee Hearing

[courtesy of California Progress Report]

Oversight by Schwarzenegger Administration of Timely Access, Language, So-Called Discount Health Plans, Retroactive Denials Of Coverage, and Mental Health to be Reviewed in 5 Hour Hearing

By Anthony Wright
Executive Director of Health Access California

Victoria Colliver at the San Francisco Chronicle has a preview of today's Senate Health Committee hearing--which is expected to be at least five hours of grilling on a range of meaty issues.

The Senate Health Committee, chaired by Senator Sheila Kuehl, will hold a hearing today on "Consumer Protection under the California Department of Managed Health Care: Adequacy of Implementation and Enforcement," reviewing the DMHC's oversight in five key areas: timely access, language access, so-called discount health plans, retroactive denials of coverage; and mental health.

In all these issues, they strike to the core of whether the coverage is meaningful, and whether the consumer is getting value for what they paid for. And on all these topics, there are pending decisions regarding regulations or implementation issues at the DMHC.

It won't be a surprise to readers of this site that health and consumer advocates will press for stronger standards and more aggressive oversight for the health insurance industry--and for good reason.

Consumers are increasingly concerned that their coverage won't be there for them when they need it--that they won't be able to get in to see a doctor or specialist, to get a translator if necessary, or even that their coverage will be retroactively rescinded.

In light of these HMO practices, the Department needs to be more--not less--aggressive in protecting patients and investigating the insurance industry.

Yet, the tendency by the Schwarzenegger Administration is to leave the decisions up to the insurers. Recent regulations would let insurers decide their own standards on timely access; to determine their own method of notifying patients about their rights to an interpreter. On new regulations of discount cards, the Department were shaped by the industry they were purporting to regulate-an industry that offers a product of dubious value to consumers.