Earlier today, Governor Arnold Schwarzenegger vetoed both AB1825(De La Torre) to require maternity care as a basic benefit, and SB890(Alquist), a patient protection measure that would have helped consumers avoid “junk” coverage by setting some key standards for health coverage, and better categorizing the health insurance market for better comparison shopping. The bill would have conformed state law to the new federal health law in key areas, ensuring Californians benefits from these new consumer protections.
* MATERNITY COVERAGE: AB 1825, by Assemblyman De La Torre, would have phased in a requirement for all health insurance plans to cover maternity care. Plans would have been required to have maternity coverage, but until 2014 they can impose a one-year waiting period. This measure would have helped provide equity for women trying to buy coverage, save the state money by preventing women from having to rely on public programs for maternity benefits, and crucially help provide the public health benefit of getting babies the prenatal and early care coverage needed to live healthy and productive lives.
* AVOIDING “JUNK” INSURANCE: SB 890 by Senator Alquist would have reformed the individual insurance market, by setting basic benefit levels and classifying health plans in tiers (Platinum, Gold, Silver, Bronze) to allow consumers better ability to make apples-to-apples comparisons based on actuarial value, so that consumers can have some idea of how much of their medical costs they may need to pay out-of-pocket with different health plans.
The bill would have helped the California implement and transition to federal health reform in other ways as well:
* by instituting the new federal requirements on medical loss ratios, to ensure that premiums dollars go to patient care rather than administration and profits; and
* by eliminating annual and lifetime caps on coverage that cause individuals with serious illnesses to incur significant medical debt.
While the Governor signed important bills to implement federal health reform today, we are disappointed he vetoed key patient protections as well. He vetoed a bill to phase in maternity coverage as a basic benefit, to provide equity to women and savings for the state,
We are also saddened that he vetoed SB890, which would have helped prevent consumers find out too late that they have junk insurance that doesn’t cover their health costs. It was needed to implemented health reform by eliminating annual and lifetime caps on coverage, and by ensuring premium dollars go to patient care rather than insurer’s administration and profit. Categorizing plans based on actuarial value will allow consumers to make apples-to-apples comparisons and to have some idea of how much they will be responsible for paying out-of-pocket.
Right now, consumers are flummoxed by the over 100 choices in the individual insurance market, and rightly concerned that some of those choices won’t cover them when they need it. California lost an important opportunity to transition to a standardized and transparent marketplace for health insurance.