California Continues Its Leadership in Implementing Health Reform…

Earlier today, Governor Brown signed legislation to improve California’s health system and provide key consumer protections. One measure, SB51(Alquist), would allow state regulators to enforce new federal standards that ensure that at least 80%-85% of health insurance premiums go to medical care. Another bill, AB1296(Bonilla), revamps eligibility and enrollment systems in public health programs, to better allow millions of Californians to get the coverage they need in 2014 and beyond.

These bills are aligned with other measures signed this week by Governor Brown that would get California ready for reform in 2014, including key consumer protections for Californians, from a requirement that maternity services are covered in all health plans, to a reorganization and expansion of consumer assistance for California patients.

Governor Brown has rightly seized the opportunity to both improve our health system for California consumers. California’s health system needs all the help it can get, and we should take advantage of the opportunities under the Affordable Care Act to adopt new consumer protections and revamp the structures that assist California families get care.

Under these new laws, Californians can now be assured that at least 80% of our health coverage premium dollars are going to patient care, rather than insurance company administration and profit. Governor Brown’s signature on SB51 give state regulators the ability to enforce the federal standard, improving the previous California law. From ensuring maternity coverage to other consumer protections, it’s crucial that consumers get the benefit of the Affordable Care Act and that the states provides for a smooth transition to a better health marketplace.

To get ready for the reforms scheduled for 2014, and to improve the experience for families in our health system today, we are pleased Governor Brown signed legislation to revamp the process of signing up for coverage, and in getting consumer assistance. With these signed bills, California continues to lead the nation in implementing health reform, but has much more to do to fulfill its promise by 2014. If he chooses, with these bills as a foundation, Governor Brown can lead in building a health system for California’s future.

These bills also build upon legislation implementing and improving the Affordable Care Act that was enacted last year, that set up the first-in-the-nation-after-health-reform Exchange, that instituted rate review of insurance rate hikes, that allowed children with pre-existing conditions to get affordable coverage, that allowed young adults to stay on their parents coverage, and that eliminated cost-sharing for preventative care.


* SB 51 (Alquist) MEDICAL LOSS RATIO: Ensures that premium dollars go to patient care rather than administration or profit. Requires (per the Affordable Care Act) that insurers who do not spend the specified percentage of premium dollars on patient care provide refunds to patients.

* SB 222 (Evans/Alquist)/ AB 210 (R. Hernandez) MATERNITY COVERAGE: Requires that maternity services be covered in individual and small group health coverage products, respectively.

* AB 922 (Monning) CONSUMER ASSISTANCE: Improves consumer assistance, which will be needed with the implementation of federal health reform, by augmenting the Office of Patient Advocate as a central place for Californians to call with questions or complaints about health care and coverage.

* AB 1296 (Bonilla) ELIGIBILITY AND ENROLLMENT: Outlines a “no wrong door” policy as part of revamping of eligibility and enrollment processes into Medi-Cal, Healthy Families, and the Exchange, to be ready for federal health reform in 2014

* AB 151 (Monning) GUARANTEED ISSUE FOR MEDI-GAP: Allows seniors to switch from Medicare Advantage plans back to traditional Medicare by providing “guaranteed issue” access to Medi-Gap plans without regard to pre-existing conditions.

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

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