According to a report released by Avalere Health on April 7, 2015, Covered California only re-enrolled 65% of its consumers, as compared to federally run exchanges which re-enrolled an average of 78% of consumers. Further, California posted only a 1% increase in overall enrollment, the third-lowest in the country. The authors of the study speculate that state-run health insurances exchanges, such as Cover California, may be displaying lower re-enrollment rates due to a larger proportion of their consumers over reporting income in 2014 and thus being shifted to Medicaid in 2015.
A new report released by the Movement Advancement Project (MAP) and the Center for American Progress (CAP) in March 2015 illustrates the challenges LGBT women face reaching economic, social, and health security. Among the major findings of the report are that LGBT women are less likely to find a job and more likely to lose or face harassment on the job due to their orientation. Furthermore, LGBT women are less likely to have access to educational opportunities, as they face higher levels of discrimination and harsher discipline at secondary schools. In terms of health security, LGBT women are less likely to be insured and more likely to face denials for treatment from health care providers. The report calls for strengthening nondiscrimination laws across employment, education, health care, and housing.
The California HealthCare Foundation released a report on March 2015, summarizing the goals, progress, and challenges of expanding the managed care model to the approximately 400,000 Medi-Cal recipients who reside in California’s rural and remote counties. The report is based on interviews with state officials, providers, and health care consumers. The report finds that oversight and regulatory requirements for the health plans that received the Medi-Cal contracts in rural areas did not specifically address the unique concerns of the rural areas; most requirements are precisely the same as those for more populated areas. Further, the plans often lagged behind in creating provider networks, most notably for specialty care. Additionally, while state officials recognize that medical transportation is a greater challenge in rural areas, there were no requirements in the state contracts with the plans to focus on transportation issues, and beneficiaries often have no knowledge of their rights to transportation.
Two New Looks at Racial Equity in Health Care
The December 2014 volume of the New England Journal of Medicine featured two new studies that focused on health outcomes across race. In the first study, funded by the Centers of Medicare and Medicaid Services and the Veterans Affairs Health Services Research and Development Program, the authors compared outcomes for patients in hospitals across the country that were treated for heart attacks, heart failure, and pneumonia. Over the period of 2005-2010, the authors found that disparities in care between black, Hispanic, and white patients decreased. The authors attributed this decrease to minority patients receiving better care in hospitals that served diverse populations and to proportionally greater quality improvements in hospitals that serve minority patients.
However, another study, funded by the National Institute on Aging, found persistent racial disparities in the health outcomes for Medicare Advantage enrollees. In this study, the authors compared high blood pressure, high cholesterol, and diabetes rates among elderly enrollees in Part C plans. The authors found that, from the period between 2006 and 2011, black and Hispanic Part C enrollees were less likely to have these three conditions improved than white enrollees.