Study questions need for two California agencies overseeing health plans
California should consider merging its two insurance regulatory agencies in the wake of the Affordable Care Act, according to a study that renews a contentious debate over how the state should oversee health plans.
California is the only state in the nation to have two agencies overseeing health insurance. The California Department of Insurance covers traditional indemnity insurance and some PPOs, while the California Department of Managed Healthcare has traditionally regulated HMOs but recently picked up some types of PPOs.
“The regulatory framework of who’s making decisions about the terms of engagement between plans and consumers is important, and it’s shifted a lot with the Affordable Care Act,” said Marian Mulkey, chief learning officer at the California HealthCare Foundation. “In the long run, we need to think about whether having to do it twice (with two agencies) instead of doing it once is serving California and California consumers.”
The not-for-profit health policy think tank commissioned the study to update a 2011 report that examined how California would implement the ACA with two regulatory agencies. That report also questioned the wisdom of having two agencies with different mandates.