An opportunity to lead…

Assemblyman Bill Monning opened his Assembly Health Committee similarly to his Senate counterpart last week, by addressing a mix of legislation mandating specific health benefits. But unlike his Senate colleague, Chairman Monning stating that the Assembly Health Committee would be holding votes on these benefit mandate bills.

This was in contrast to Senator Ed Hernandez, Chair of the Senate Health Committee, who had announced last week that the Senate committee would not act on benefit mandate bills prior to the announcement of federal minimum essential benefit standards, and hold the bills without prejudice until next year.

Monning had a different take, and asserted the purpose of the Health Committee is to hear bills based on their health policy merits, without regard to matters such as state financing, which falls under the purview of the Appropriations Committee. He further stated that these hearings provide an opportunity to inform national conversations, as in the case of the development of Minimum Essential Benefits.

Along those lines, when presenting AB1334 (although not a mandate bill), Assemblymember Mike Feuer, encouraged California to do better than the federal health law to protect consumers, saying “integration [into federal law] when we can is important, and leadership when we can is important.” Feuer referenced last year’s AB2244, which went beyond the federal standards for protecting children with pre-existing conditions, bringing insurers back into market for children’s coverage and providing additional access and affordability. AB2244 has received national acclaim for its important role in protecting the health of children and the children’s insurance market in the state.

AB1334 which attempts to simplify for California families, the daunting task of purchasing health insurance passed this afternoon in Health Committee. The bill would help consumers navigate the individual insurance market, where products vary so greatly with respect to price, benefits, co-payments, coinsurance, and a variety of other factors, that consumers are often unable to accurately determine which plans might meet their needs in the most cost effective manner. Feuer explained that the bill would help consumers by doing two things: first, it would inform consumers whether the plans they are considering meet federally defined Minimum Essential Benefits (and thus, if they were buying substandard coverage prior to 2014), and secondly, require that plans sold on the individual market can only vary slightly from the tiered benefit categories defined by actuarial value in the Exchange. AB1334 passed out of Health Committee and moves on to Appropriations.

AB1296 was presented by author Assemblymember Susan Bonilla as the “no wrong door, one open door” bill for health insurance. The bill would streamline and modernize eligibility and enrollment systems to make it easier for Californians to apply for insurance by assuring that no matter what coverage they apply for, they are accepted and directed to the appropriate program. It will no longer be up to the consumers to figure out what programs they might be eligible for and where they can apply. This effort will be fully funded by the federal government through the Affordable Care Act. The bill passed on party lines and moves on to Appropriations.

AB1083 by Assemblymember Monning also implements part of the Affordable Care Act by conforming California’s current rules for the small employer or “small group” market. Virgina Donohue, owner of a small business called Pet Camp, testified eloquently about the challenges small businesses face in providing health care to their workers in the current market, a system where insurers are allowed to charge vastly higher rates for workers based on age. “As a society,” she said, “we don’t want small employers shedding older workers because their health costs are higher, if I were motivated solely by finances, that is exactly what I would do…the system that exists now is simply unacceptable.” AB1083, which would limit how much a company with older workers could be charged, and also limit rate hikes for small buisness that happen to have workers who become sick, also passed on party lines.

Also moving out of health committee today was AB310 (Ma) which would limit the amount that insurers could charge consumers in “coinsurance” for 4^th tier prescription drugs that are often used for individuals with chronic or genetic illnesses and prevent disability. These individuals must often pay to 30% in coinsurance for prescriptions, which can be so cost prohibitive that many chose to forgo treatment for illnesses such as Multiple Sclerosis. Insurers argued that they opposed the bill because it would discourage consumers from using less costly generic drugs, but in reality, consumers testified on behalf of the bill precisely because their prescriptions were too costly, and many of the applicable drugs do not have generic versions.

This is the last meeting the committee will have to consider health related bills originating in the Assembly. The next time the committee meets, in June, will be to consider bills from the Senate.