Most people are aware of the problem of bad faith denials by insurance companies, but there is another troubling practice that has not received enough attention: illegal rescissions. Illegal rescissions are cancellation of coverage sold in the individual insurance market by plans that want to avoid paying for expensive medical treatment. This problem is even more serious than bad faith denials because the consequences are far worse, plans have an even greater financial incentive to do it, and it is much more difficult to prevent.

For all of these reasons, government regulators have a critical role to play in protecting consumers from illegal rescissions, yet their response has largely been slow and ineffective. One regulator in California has finally taken steps to address this problem proactively. Last month, the Department of Insurance issued new regulations designed to combat illegal rescissions. These new rules are a good start, but unfortunately do not go far enough and leave too many consumers unprotected.

Continue reading "California's Anti-Rescission Rules are a Good Start" »

Kaiser Permanente has been prominently featured as a model of success that should guide our future health care reform efforts by a number of sources, including the Economist, the Los Angeles Times, and the NBC Nightly News. Yet each time these stories appear, people come to me confused because of the bad experiences they've had with Kaiser, heard about from others, or read about in the paper. Indeed, in the last five years, Kaiser has been the target of law suits, regulatory action by the California Department of Managed Health Care, and numerous media stories about the way it mishandled its kidney transplant program, endangering lives and causing deaths. A few years ago Kaiser hospital got into trouble for dumping homeless patients in Los Angeles. And currently, Kaiser is one of the plans being sued for discriminating against children with autism by denying them medically necessary care that it provides for other kinds of patients. Even a very cursory internet search yields a number of websites whose purpose seems to be to expose bad faith denials and poor quality of care by Kaiser by offering patient testimonials and compiling examples of lawsuits.

Many people can't believe that this Kaiser would be considered a model for reform, so why is there such a disconnect between the people who see this Kaiser and those who paint a picture of a "successful" Kaiser that should be emulated?

Continue reading "A Tale of Two Kaisers" »