PATIENT PROTECTION BILLS HEAD TO FINAL FLOOR VOTES THIS WEEK;
ANTHEM BLUE CROSS AND OTHER INSURERS SEEK TO STOP LEGISLATION IMPLEMENTING AND IMPROVING HEALTH REFORM
* Key Bills Would Set Up New Exchange to Negotiate with Insurers for Best Price & Value
* One Bill Would Establish Minimum Benefit Standards, Allow Better Comparison Shopping
* Rate Review and Rate Regulation Hotly Debated
* Also At Stake: Affordable Access for Children with Pre-Existing Conditions
Key health consumer protection bills in the California legislature, including several that would implement and improve the federal health reform law passed earlier this year, are up for final floor votes this week.
“This week, California legislators will decide whether to institute new patient protections, to provide consumers with greater access and affordability for coverage, and to implement and improve the new federal health law,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “We need to put additional oversight over the insurance industry now–on rates, benefits, and how they do business–and not wait for 2014.”
Here are a few top bills of interest to health care consumers, which are being opposed by Anthem Blue Cross of California and other insurers, and are up for a vote this week as the end-of-month deadline for bill passage approaches.
Next the bills will be heard on the floor of the second house (Assembly bills will be heard on the Senate floor and Senate bills will be heard on the Assembly floor) for a final vote before heading to the Governor’s desk by the end of August.
* CREATING A NEW CONSUMER-FRIENDLY EXCHANGE WITH BARGAINING POWER: AB 1602 (Perez) and SB 900 (Alquist/Steinberg) are companion bills, up in the Senate today or tomorrow, that will establish a new health insurance Exchange as required by the federal health reform law. In 2014, the new Exchange will be the new one-stop shop for getting health coverage for individuals and small businesses, both providing easy-to-compare choices, access to federally-funded subsidies to make coverage affordable, and the bulk purchasing power (similar to large employers or CALPERS) of millions of Californians to bargain for the best price and value.
* TRANSITIONING TO A MORE TRANSPARENT AND COMPARATIVE MARKET: SB 890 (Alquist) would reform the individual insurance market, by setting basic benefit levels and categorizing health plans to allow consumers to compare plans based on the actuarial value, so that they can have some idea of how much of their medical costs they may need to pay out of pocket.
* REGULATING AND APPROVING HEALTH INSURANCE RATES: AB 2578 (Jones) would require approval by the Department of Managed Health Care or the Department of Insurance of an increase in the amount of premium, co-payment, coinsurance, deductible, or other charges under a health plan.
* MAKING RATES TRANSPARENT AND ACTURIALLY SOUND: SB 1163 (Leno) would require insurers to provide information about premium increases and insurer rate filings to be reviewed by the state and released to the public. The bill would also require insurers to notify consumers in writing of denials or rate increases, these notifications must include clear justifications and rate increase notifications must be sent at least 60 days prior to the change taking effect.
* LIMITING SURCHARGES FOR CHILDREN WITH PRE-EXISTING CONDITIONS: AB 2244 (Feuer) implements the federal prohibition on denying coverage to children with pre-existing conditions, and limits the amount that insurers can charge to cover those children.
Other Bills on the Assembly Floor
* SB 56 (Alquist) would authorize county-organized health plans and other health benefits programs to form joint ventures in order to create integrated networks of public health plans that pool risk and share networks. This will provide better public health insurance options for consumers.
* SB 208 (Steinberg) and AB342(Perez) renews California’s Medi-Cal financing waiver, drawing down up to $10 billion in federal funding. This would allow the state to begin phasing in expansions of public programs to build the bridge to full health reform implementation.
* SB 1088 (Price) would implement federal requirements that employers extend dependent coverage to dependents up to age 26.
* SB 810 (Leno) establishes the authority (but not financing) for a state administered Single Payer health care system.
Other Bills on the Senate Floor
* AB 1825 (De La Torre) requires all health insurance plans to cover maternity care.
* AB 2345 (De La Torre) requires insurers to eliminate cost-sharing for some preventive services such as pap smears, mammograms, other cancer screenings, and immunizations; continues to permit co-pays and deductibles for managing asthma, diabetes, heart disease, and other chronic conditions.
* AB 2470 (De La Torre) would eliminate rescissions by establishing standard information and health history questions used by health insurers on application forms, and requires insurers to complete medical underwriting and review for accuracy before issuing an individual a health plan contract or policy.
The next two weeks will be crucial in determining the extent of our ability to implement and improve upon health reform here in California. Many of these bills continue to face strong opposition from the insurance industry and other lobbyists.
For more information related to federal health reform, read the new report, “Health Reform Three-Month Status Report: Californians Begin To See the Benefit, Much More Work To Do.” which is available on the Health Access website.