Implementing and improving health reform…

Wednesday, April 20, 2010

* CA Assembly Health Moves Several Bills to Line State Up With Federal Health Reforms
* Groundwork is Laid for a State-Run Exchange, Expanded Medi-Cal, High-Risk Pool
* AB 2244 Passes, Protects Kids from Discriminatory Pricing Based on Health Status

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In a “deadline” week, the California Assembly Health Committee on Tuesday passed a package of health care consumer protection measures, which lay down some basics for making federal health reform real in California.

CHILDREN FIRST, PLEASE: One prominent bill was AB 2244, by Assemblyman Mike Feuer (D). The bill, sponsored by Health Access on behalf of its coalition members, “phases in several key provisions for children,” Feuer told the committee.

The rollout of the Patient Protection and Affordable Care Act signed by President Obama on March 23 begins with children. Insurers will no longer be able to deny coverage to children with pre-existing conditions, and they will also have to rescind pre-existing condition exclusions for children already covered by their family policies.

AB 2244 goes beyond federal law in not just preventing denials, but limiting discriminatory charges for “pre-existing conditions” for children as well. The bill phases in “modified community rating” so that insurers are limited to charging plus or minus 20% for a child’s health status. The price difference would be phased to plus or minus 10%, and then to no different charges allowed by 2014.

The bill had the support of the Congress of California Seniors, Consumers Union, the 100% Campaign, the California School Employees Association and others. Speaking out in opposition were the California Association of Health Plans and the California Association of Life and Heallth Insurance Companies, saying they believed AB 2244 was “premature.”

The opposition by insurers was not a surprise. Just days after Obama signed the landmark law, insurance companies tried to interpret the new rights for children very narrowly. Not so, said the feds. This woule take the next step. In the Assembly Health Committee, the vote was pretty clear: “11 Ayes” and 6 “Nos”. The measure now goes to the Assembly Appropriations Committee.

MAKING MEDI-CAL AVAILABLE TO MORE CALIFORNIANS: AB 1595, authored by Dave Jones (D) lined California’s income eligibility requirements right up with the new federal law. Under federal reform by January 2014, Medi-Cal, which is administered by the Department of Health Care Services, will offer Medi-Cal coverage to all adults who earn up to 133% of the federal poverty levels — even adults without children. The income ceiling would be $14,404 for individuals and $29,326 for a family of four.

Funding for the expansion of Medi-Cal will come from Washington, which will provide 100% of the cost of newly eligible starting in 2014 for the first three years. Then the percentage starts to taper off a bit so that, by 2020, the federal government is sending 90% of the cost of newly-eligible Medi-Cal patients. Health Access is in support of the measure, which passed out of committee with 10 votes. Also in support are the 100% Campaign, the Western Center of Law and Poverty, and the American Federation of State, County and Municipal Employees.

THE CALIFORNIA PATIENT PROTECTION AND AFFORDABLE CARE ACT: Assembly Health Committee members adopted Speaker John A. Perez’s central bill, AB 1602, which is more or less the leader of the package. AB1602 “makes several sweeping changes,” said Perez (D). Among them are creating the California Health Benefit Exchange, where individuals and small businesses can purchase health care coverage. The measure also prohibits group of individual health care plans from establishing lifetime or unreasonable annual limits of the dollar value of benefits. Carriers will also be required to provide preventative services, outlaws denying people coverage for pre-existing conditions and extends dependent coverage to young adults up to age 26. “Let’s be clear,” Perez told the committee. “Federal health reform is now the law of the land and California will implement it fully.” He described the bill as “by necessity a work in progress as we still need an enormous amount of guidance” on implementation from the U.S. Department of Health and Human Services. The bill won 12 votes in its favor.

MATERNITY COVERAGE, ONCE AGAIN: California insurers have been dropping maternity coverage steadily for years now. Just four or five years ago, 82% of policies [CLARIFIATION: offered in the individual market] included maternity coverage and now only 19% do. Arguing in favor of AB 1825, Assemblywoman Bonnie Lowenthal (D) said, “We can’t wait another four years to see what happens.” She presented AB 1825 for her colleague, Assemblyman Hector De La Torre, who authored the bill. Health Access, the California Medical Association and many other groups supported the bill, which requires every individual or small group health insurance policy to cover maternity services. Insurers had been dropping the coverage from plans in an effort to make them more affordable and sell more policies. Several organizations, however, have criticized this practice as part of an overall trend of gender discrimination by insurance companies. AB 1825 passed with 12 “aye” votes and 6 “nos.”

The Senate Health Committee is due tomorrow with more key bills on health reform. More bills to implement and improve health reform are available for review here.

Health Access California promotes quality, affordable health care for all Californians.

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