Onto to Final Floor Votes…

Friday, August 13, 2010


* Multiple Bills Would Implement & Improve Federal Health Reform in California
* At Stake Are New Consumer Protections; New Federal Funds; New Rules for Insurers

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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 heading into final floor votes for the last two weeks of August.

Yesterday a number of health reform implementation bills moved off the suspense file and out of Appropriations Committees. 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 votes before heading to the Governor’s desk by the end of August. If the bills are passed, the Governor has the month of September to either sign or veto the measures.

At stake are bills that would draw down new federal funds, from a grant for rate review to a new Medicaid waiver that is hoped to bring down an additional $2 billion into our beleaguered health care system and safety-net. Other measures would institute new consumer protections and new rules and oversight over insurers.

Bills that Move to the Assembly Floor

* PUBLIC OPTIONS: 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.

* MEDI-CAL-WAIVER: SB 208 (Steinberg) 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.

* SINGLE-PAYER HEALTH SYSTEM: SB 810 (Leno) establishes the authority (but not financing) for a state administered Single Payer health care system.

* BENEFIT STARDARDIZATION: SB 890 (Alquist) to reform the individual insurance market, has been amended to set basic benefit levels and categorize 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.

* HEALTH INSURANCE EXCHANGE: SB 900 (Alquist) is one of 2 bills that will establish the health insurance Exchange as required by the federal health reform law. This bill will cover the governance of the Exchange and will be critical in facilitating access to insurance as well as federal subsidies when they become available in 2014.

* YOUNG ADULT COVERAGE: SB 1088 (Price) would implement federal requirements that employers extend dependent coverage to dependents up to age 26.

* RATE REVIEW: SB 1163 (Leno) would require insurers to provide information about coverage denials, premium increase, 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 180 days prior to the change taking effect.

Bills that Move to the Senate Floor

* HEALTH INSURANCE EXCHANGE: AB 1602 (Perez), the companion bill to SB 900, establishes the operations of the Health Insurance Exchange in California.

* MATERNITY COVERAGE: AB 1825 (De La Torre) requires all health insurance plans to cover maternity care.

* 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.

* PREVENTATIVE 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.

* RESCISSIONS: 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.

* RATE REGULATION AND APPROVAL: 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.

Some bills were held in Appropriations Committees, and thus are stalled for the year and legislative session. Among those that died are AB 2878 (Monning) would have established the Office of the California Health Ombudsman to educate consumers on their rights and responsibilities with respect to health care coverage, AB2287 (Monning) to help draw down federal funds for community transformation to encourage prevention, and SB1200(Leno) to facilitate timely access to care for children at school. Despite these setbacks, the vast majority of bills of interest to health care consumers passed Appropriations and are now pending floor votes.

The next two weeks will be crucial in determining the extent of our ability to implement and improve upon health reform here in California. While this legislation generally has the support of many consumer and community organizations, several 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.

For more information about these bills, contact the author of this report, Linda Leu, Policy Analyst, Health Access California, at lleu@health-access.org.

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