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Broker Guide
Blue Shield Spotlight

Legislative Corner

By Tom Epstein

As of this writing, the future of health care reform in California remains a mystery. Governor Schwarzenegger and the Democratic leaders of the legislature continue their negotiations, and hope for a workable compromise remains.

Whatever happens in the end, the 2007 healthcare debate should be considered historic for the degree of unanimity that emerged on the core concepts of universal coverage and shared responsibility.

  • The California Health Underwriters Association joined other business groups in offering thoughtful, serious plans for coverage expansion.
  • Hospitals stepped up and agreed to pay a fee that will attract federal funds and reduce the cost-shift caused by extremely low payments to doctors and hospitals that serve Medi-Cal patients. This will reduce costs for businesses and individuals who purchase private health coverage.
  • Nearly all the state's major health plans have agreed to support a system that requires insurers to cover everyone regardless of their medical history in a system that is truly universal. That's a giant leap for the industry that financed Harry and Louise in 1993.

One of the issues on which Blue Shield has focused during our consultations with policy makers has been making sure that the role brokers will play in implementing reform is recognized and rewarded.

With nearly 7 million currently uninsured Californians suddenly entering the insurance market, the transition to an individual mandate system could threaten to be extremely chaotic. Some people feel that the state government would be able to provide those people with the guidance they need to make good decisions, but it's hard to see where that confidence comes from. The state's health care bureaucracy does not have the kind of Main Street presence in communities and expertise in helping people choose from competing options that would be needed to make the transition work smoothly.

Fortunately, California has an important resource to help people navigate this thicket. The network of nearly 2,500 brokers and consultants across the state who already spend their lives helping people through the health coverage maze is perfectly suited to the job. This private sector network, provided that appropriate incentives are in place, will provide an invaluable public service if an individual mandate is passed, simply by conducting its business.

As the debate enters its final stages, the differences that remain are less significant than the agreements that have been reached. With free or subsidized coverage for more than 80% of the lowest income uninsured Californians, universal coverage for kids and $3 billion in federal matching funds at stake, California can't afford to fail.

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Supporting the Latino Market -- Health Care Shouldn't Get Lost in Translation

Selling plans to and supporting your Spanish-speaking clients just got easier. Blue Shield of California has expanded its Spanish-speaking physician HMO network by more than 2,000 providers in Los Angeles, San Bernardino and Orange Counties.

This expansion addresses a critical need voiced by our Latino members and employer groups in these counties -- easy, proximate access to Spanish-speaking physicians they can communicate with effortlessly.

Spanish-speaking members will also benefit from:

  • An interactive, dedicated website in Spanish that allows users to search their zip code for nearby physicians:
  • A dedicated, Spanish-speaking toll-free customer service number with representatives that can help members find Spanish-speaking providers in their area, in their language, effortlessly.
  • We've also created new marketing materials for you to use, including an open enrollment brochure in Spanish and English, and an online interactive tool which recognizes the unique needs and stories of Spanish-speaking members.

Blue Shield already has one of the largest provider networks in California and will continue to expand its network to serve you and your clients. For more information about the expanded, Spanish-speaking network or to order open enrollment brochures and materials, please contact your sales representative.

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