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Poll: Californians Strongly Support Measure Regulating Health Insurance Rates

By Tracy Seipel, San Jose Mercury News

SAN JOSE, Calif. — Californians are showing overwhelming support for one of the most hotly contested propositions on the November ballot — a measure allowing the state’s insurance commissioner to reject proposed health insurance rate hikes.

A new Field Poll released Wednesday found that a stunning 69 percent of those surveyed favored Proposition 45 when the measure was explained to them, while only 16 percent said they would vote against it. Fifteen percent were undecided.

The measure is being championed by Consumer Watchdog, the same group that pushed through a landmark 1988 proposition that created an elected California insurance commissioner and required insurers to publicly justify auto and homeowner’s insurance rate changes and get the commissioner’s approval before they go into effect. Proposition 45 would extend that requirement to include health insurance.

Jamie Court, Consumer Watchdog’s president, was thrilled with the Field Poll numbers, saying he was confident that the new measure would pass.

“If there’s one thing certain in life beyond death and taxes, it’s health insurance rate hikes in California — unless voters enact Prop. 45,” Court said.

But Field Poll Director Mark DiCamillo cautioned that “this is a very early poll,” adding that many consumer-driven initiatives start out way ahead but “trend down” when opposition groups pour millions into statewide TV and radio ad campaigns.

Proposition 45 has already seen insurance companies contribute more than $37 million into the opposition campaign. Consumer Watchdog has raised only $2 million.

“It’s actually easier to get somebody to vote no because opponents can raise some doubt or reason why the status quo needs to be changed,” DiCamillo said.

He recalled that Proposition 103, the 1988 insurance measure, started out well ahead, but ended up passing with just 51 percent of the vote.

The new poll followed another Field Poll released Tuesday that showed that a solid majority of Californians now support the Affordable Care Act, commonly known as Obamacare — but they remain worried about escalating health insurance rate increases. Forty-six percent of voters said they have a tough time paying their health care premiums.

The Field Poll surveyed 1,535 registered voters from June 26 to July 19. The poll had an overall margin of error of plus or minus 2.6 percentage points.

The poll also showed:

-51 percent of California voters believe preventive health services provided by Medi-Cal, the state’s health care program for the poor, should be expanded to illegal immigrants. 45 percent were opposed, and 4 percent had no opinion.

-Another November measure, Proposition 46, which would require drug and alcohol testing of doctors and increase the cap on medical negligence lawsuits, was favored by 58 percent and opposed by 30 percent. Twelve percent were undecided.

-62 percent of voters say Medi-Cal, which was expanded under Obamacare to include childless adults, is important to themselves or their families. That represents an 11 percentage point increase from 2011.

In defending Proposition 45, Court pointed to a California HealthCare Foundation study that he said showed health insurance premiums have risen 185 percent since 2002 — five times the rate of inflation. This measure, he said, would give voters a fighting chance against proposed rate hikes.

But a coalition opposed to Proposition 45 — which includes health insurance companies, doctors groups and hospitals — insists the measure “takes valuable dollars away from our health care system by adding a new, unnecessary bureaucracy.”

DiCamillo described the survey question about whether illegal immigrants should benefit from Obamacare as “probably the most explosive” query.

Under the Affordable Care Act, illegal immigrants are ineligible to receive benefits.

In the poll, 68 percent of Democrats supported the proposal to extend preventative Medi-Cal benefits to undocumented residents, as did 53 percent of voters with no party preference. Only 23 percent of Republicans were in favor.

Photo: Amy The Nurse via Flickr

More Californians Support Affordable Care Act, Poll Finds

By Tracy Seipel, San Jose Mercury News

The nation’s new health care law is surging in popularity in the Golden State, according to the Field Poll, which finds more Californians today — of all political stripes — support the Affordable Care Act than at any time since it was signed into law four years ago.

And by a 2-to-1 margin, they praise the successful way it’s been rolled out in the state, compared to the federal government’s glitch-ridden system.

Still more now say they’re satisfied with the way the health care system is working in the state, compared to a year ago.

But for all their applause, many Californians aren’t happy with the cost of their health care and say they are having a tough time paying their premiums.

Those are among the highlights of the survey released Tuesday that tracked California voters’ overall opinion of the federal health care law.

The poll of 1,535 likely voters from June 26 to July 19 showed that 56 percent of registered voters say they support the law, while 35 percent are opposed.

That 21-point margin in support is up six points from last year, and Mark DiCamillo, director of the Field Poll, believes the results have national implications.

“If it’s going to be an effective law, you would probably see it in California — and we are seeing it,” DiCamillo said.

The poll found 60 percent of voters believe California’s smoother roll-out and implementation, through the Covered California health exchange, is a big part of its success, while 30 percent disagreed.

“By a 2-to-1 margin, the voters gave us five gold stars,” said Dr. Judy Belk, president and CEO of The California Wellness Foundation, which funded the poll. “We nailed it big-time.”

But what intrigues DiCamillo is the story behind the upward swing of support for the health care law statewide now that voters have had a chance to see the impact of the law. Last year’s survey results were based on voters’ predictions.

“The biggest increase in support or the largest reduction in opposition are coming from those groups that were previously opposed or evenly divided in prior years,” DiCamillo said. Like other Americans, Californians’ views of the law, known as Obamacare, are still highly partisan. While 79 percent of the state’s Democrats support the law, up by 2 percentage points from last year, only 22 percent of Republicans back it. However, GOP support is up 5 percentage points from last year. Fifty-six percent of voters with no party preference, also up 2 percentage points, favor the law.

While it’s no surprise that in California the health care law’s strongest backers are residents in the nine-county San Francisco Bay Area (67 percent) and Los Angeles County (62 percent), both well-known liberal bastions, some favorable views appear to be surfacing in more conservative areas of the state.

The poll shows support in the Inland Empire is now 48 percent, up 9 percentage points, while the Central Valley support is now 50 percent, up by 8 percentage points.

Another key change: The state’s ethnic voter population continues to be overwhelmingly supportive of the law, but now a plurality of the state’s white non-Latino voters are too (50 percent to 44 percent).

But the poll also found frustration among voters over the continued escalation of insurance rate increases. Statewide, 47 percent of those surveyed said their health care costs have gone up over the past year.

Meanwhile, 46 percent of voters say they have a tough time paying their health care premiums, including 17 percent who say it’s very difficult.

“You can see the problem area for voters, at least in terms of the affordable part of the Affordable Care Act,” said DiCamillo, who noted that premiums increased most for voters earning between $40,000 to $100,000 or more.

Still, the proportion reporting that their health care costs are very difficult to afford declined four points from 21 percent who said this last year.

A November ballot measure, called Proposition 45, would require health insurance companies to get state approval before raising rates, as they must do in 35 other states.

The poll was done in seven languages and dialects and has a margin of error of plus or minus 2.6 percentage points.

A second part of the poll that examines other aspects of the health care law, and subsequent proposals surrounding the law in California, will be released Wednesday.

AFP Photo/Karen Bleier

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‘Health Care Sharing Ministries’ Increase Membership In Wake Of Law

By Tracy Seipel, San Jose Mercury News

SAN JOSE, Calif. — Go to church, be faithful to your spouse and shun tobacco, booze, and drugs.

Promising to adhere to that “biblical lifestyle,” more than 300,000 Americans are taking advantage of a little-known provision in the nation’s health care law that allows them to avoid the new penalties for not having health insurance.

Long before Christian groups and Obamacare opponents cheered Junes’s Supreme Court ruling that allows many private businesses to stop offering certain types of birth control they find immoral, the 4-year-old law gave its blessing to Americans to opt out of the insurance mandate if they object on religious grounds.

So many instead are enrolling in “health care sharing ministries” that spread medical care costs among people of similar beliefs. Participants make monthly contributions to help cover each other’s major health care costs, but forgo coverage for most routine care.

Even as many Christian conservatives fight to repeal Obamacare, the obscure provision has quietly been a boon for the ministries.

After the law kicked into high gear last fall, “our phones were ringing off the hook through most of March,” said James Lansberry, executive vice president of Samaritan Ministries International, one of the three largest U.S. health care sharing ministries.

According to the ministries, enrollees jumped by at least 100,000 over the last year to more than 300,000 through mid-April, the deadline to enroll in an Obamacare plan. About 23,700 enrollees live in California.

Samaritan surveyed a group of its members and found they feel so strongly about the ministries that almost all were willing to give up subsidies under Obamacare that would have dramatically reduced their medical costs.

“Obamacare has raised everyone’s awareness of the need for health insurance, or something else that will help,” said Dr. Andrea Miller, medical director and vice president of sharing at Medi-Share Christian Care Ministry. “A lot of people are looking at what we can offer them.”

Advocates say the attraction to the ministries is threefold: They honor religious beliefs – claims are denied for things such as abortion and alcohol- or drug-related injuries or illnesses. And participants say they have the personal satisfaction of helping out their fellow Christians with major health care costs, confident the same will be done for them in their time of need. Also, the plans are cheaper — but offer less coverage — than many health plans.

“Everyone understands the way traditional insurance works,” said Jeffrey Rotsko, a 61-year-old general contractor from San Jose who signed up for a ministry plan in 2007. “For some people, this is a new concept.”

Critics, however, say that because the ministries are not considered health insurance companies by about half the states in the country, they are not subject to state regulations that apply to health insurers. That’s generally the case in California, where Department of Insurance officials say based on the ministry plans they’ve reviewed so far, they do not offer consumers protection that is available to those who purchase health insurance.

“My general message when asked about health care sharing ministries is very much ‘buyer beware,’ ” said Sabrina Corlette, a project director at Georgetown University’s Health Policy Institute. “If the company does not pay your claim or denies coverage for service, or God forbid, they go belly-up, there is no protection for the consumer.”

Since the ministries are nonprofits, however, complaints can be lodged with states’ attorneys general.

Lansberry and other ministry executives say the plans are solvent and provide members an opportunity to resolve any concerns. The federal government also requires the ministries to be audited annually by an independent accounting firm and, with few exceptions, have good track records, he said.

Still, experts point out, the plans include practices outlawed by the Affordable Care Act.

Unlike Obamacare, which forbids annual or lifetime caps on medical claims, some ministries impose them. Moreover, the free preventive care guaranteed by Obamacare is not included in the ministry plans. And, most importantly, the ministries generally refuse to enroll people with pre-existing conditions — a practice that Obamacare ended.

Janet Coffman, an associate professor of health policy at UC San Francisco, said that sends a mixed message.

“There is a bit of a disconnect between limiting your enrollment to a mostly healthy population,” said Coffman, herself a Protestant. “As Christians, we are taught to embrace everyone — especially those who are the least fortunate in one way or another.”

Adopting a philosophy that began in biblical times and that has been marketed in the United States by religious nonprofit health care sharing groups since the 1980s, most of the plans require their participants to commit to a “statement of faith” surrounding their belief in the Holy Trinity. Members are asked to make a monthly contribution, similar to a premium, based on their desired level of coverage. They can choose their own doctors and submit their claims for medical costs to the ministries.

In return, participants agree to follow a “biblical lifestyle,” including attending church regularly, abstaining from sex outside of marriage and tobacco, in addition to not abusing drugs or alcohol.

By agreeing to do this, ministries say, members avoid habits that can lead to higher health care costs.

Mike Garner, a 57-year-old San Jose resident who signed up for a plan with his wife in 2008 to help reduce costs, said he doesn’t consider it a sacrifice.

“If I have a glass of wine every two months, I’m living it up,” said Garner, a Presbyterian pastor who is now a missionary.

Photo: Bay Area News Group/MCT/Aric Crabb

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