A bill that sets up the governance of a new health insurance exchange, SB900(Alquist/Steinberg), passed the Assembly earlier today, 49-25. This, along with the companion bill AB1602(Perez), which creates the exchange, is a central element of health reform, as it will how California families and small businesses will be able to get coverage easily and affordably.
Starting in 2014, individuals will be able to get coverage regardless of pre-existing conditions. The exchange will offer one-stop shopping, providing easy-to-compare options. It also will be the vehicle for consumers to get which to get subsidies to afford coverage. In the exchange, basic coverage won’t cost more than a certain percentage of premium, based on a sliding scale. And for those under 400% of the poverty level (around $88,000 for a family of four, which is just above median income), the exchange will provide a (federally-funded) subsidy between that percentage of income (a sliding scale from 2%-9.5%) and the cost of coverage.
This bill package of SB900 and AB1602 just doesn’t set up an Exchange, but gives it the power to negotiate for the best possible price and value for consumers. The insurers–led by Anthem Blue Cross–oppose allowing the Exchange to have such bargaining power, but it’s essential for a better reform.
SB900 now goes back to the Senate, to be voted on with AB1602(Perez), the companion bill to SB900. So more work to do…
This is a crucial piece of the work for implementing and improving health reform. More commentary about this work nationally is in the new edition of Health Wonk Review, hosted by Joe Paduda at Managed Care Matters.