July 21, 2014:
California lawmakers have left Sacramento for the month of July. But when they return, they’ll consider a few health care measures supported by consumer advocates and opposed by insurance companies.
One bill would require insurance companies to track out-of-pocket expenses, and reimburse patients if they go over the limit. Another proposal would make specialty drug payments more affordable for chronic disease patients.
A third measure would require insurers to cover out-of-network care when a participating provider isn’t immediately available.
“These bills are trying to improve the experience once folks are in coverage, that they have access to the care that they need when they need it, that they are protected against too many out of pocket costs,” says Anthony Wright with Health Access.
Wright says the Affordable Care Act does limit out of pocket costs to about $6,300 a year, but that’s easier for some to pay than others. Health insurers ask: Why legislate to deal with problems that could sort themselves out?
Nicole Kasabian Evans is with the California Association of Health Plans. She says some of these ideas are unworkable or expensive.
“Let’s get the new law functioning well in California before we start talking about changing it so early in the process,” says Evans.
Lawmakers will consider the bills after they reconvene in the state capitol the first week of August.