Health-insurance giant Blue Shield on Monday unveiled a health plan for migrant workers and their Mexico-based families.
State officials hope the program, which is the first of its kind to be deployed throughout California, becomes a model for other HMOs. Unlike previous plans, it does not require workers to choose either U.S.- or Mexico-based coverage but rather offers them both at once.
That means fewer workers, like those in the Bay Area, forgoing local health coverage so their families can visit doctors south of the border. It also means fewer Mexican families traveling north for care in costly U.S. facilities.
"It's an innovative product, and we're hoping that other HMOs will look to expand their offerings in this area," said Joy Higa, deputy director of plan and provider relations at the state Department of Managed Care.
"More people will have insurance, more people will have access to health care, and it takes some of the burden off of our public health care system in California."
In August 2000, Blue Shield began offering a Mexico-based health plan for U.S.-based workers -- another first. Thus far, it has enrolled about 2,000 members in that program. That's a tiny sliver of Blue Shield's total membership of 2.3 million, but Jim Arriola, the company's director of cross-border operations, says he hopes the new, more flexible program will attract even more people.
"It's going to provide better access to care for a segment of our society that is encountering a lot of challenges and difficulties in the health care system," said Arriola, who has been pitching the program to some companies since the start of the month.
Blue Shield is the state's fourth-largest health plan.
Also potentially benefiting from the program is the Mexican health care infrastructure, which could see an infusion of insurance money as more U.S.-based workers enroll themselves and their dependents in the new plan. "Mexican officials are very excited about this," Arriola said. Of course, the success of the plan will be limited by a number of factors.
Inside Mexico, Blue Shield coverage is offered only in Tijuana, a city of 1.2 million across the border from San Diego. The company plans to expand its network east to Mexicali before the end of the year. It will then adopt a wait-and-see posture.
Meanwhile, stateside, employers must agree to offer the plan -- it is not available outside the workplace -- and employees who must pick up the tab for dependent coverage will have to decide whether to pay. But dependent premiums will be 25 percent to 40 percent lower in comparison with U.S.-only plans, leaving "basically no downside to the employer" to offer the program, according to Arriola.
The new program, called the Access Baja Dependent Plan, became possible only after Gov. Gray Davis and his Department of Managed Health Care waived certain regulatory restrictions on health coverage, including a stipulation that all doctors had to be licensed to practice in California.
"It helps people who are adding to our economy," said Russell Wilson, Davis' deputy press secretary. "It gives them peace of mind."
Ryan Tate is a general assignment business reporter. Reach him at rtate@cctimes.com.
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