This week, the California Legislature is scheduled to vote on key consumer protections and other bills to implement the Affordable Care Act in California, including bills to ban denials for pre-existing conditions, set an essential benefits package for health plans, and better ensure that Californians know about and enroll in their new coverage options in 2014 and beyond.
This implementation legislation, critical to put in place so California will to be ready to adopt the insurance reforms scheduled to go into effect in 2014, needs to pass final floor votes this week, before the end of the legislative session on Friday, August 31st. If passed, the Governor has the month of September to sign or veto these and other bills.
The legislation includes SB961(Hernandez) and AB1461(Monning), would ban denials or discrimination based on pre-existing conditions, and limit how much more insurers can charge older Californians in comparison to younger policyholders. Another bill, AB1083(Monning) adapts similar reforms to the small employer market. Two other measures, SB951(Hernandez) and AB1453(Monning) would define an “essential benefits package” for health plans, so consumers have more confidence in their coverage.
The bills to reform the indiividual market are especially important in California, since Californians are less likely to get coverage on-the-job, and thus are more likely to have to buy coverage as individuals, and thus more likely to be denied for pre-existing conditions. While this changes under the federal law in 2014, these bills put these new protections in state law, providing clear guidance and oversight for insurers, and allowing state regulators to enforce them.
Other bills will better inform Californians about their coverage options. AB792(Bonilla), sponsored by Health Access California, would require that consumers are informed of their coverage options when losing coverage–such as during a job or other life change. SB970(DeLeon) would better integrate enrollment with human services, so people in need get the help to which they are entitled.
A broader list of health reform bill pending is on the Health Access website.
All bills need to pass by Friday’s August 31st end of session deadline in order to make it to the Governor’s desk. If passed, the Governor will then have the month of September to sign or veto the bills.
Health Reform Bills Pending Final Floor Votes
Here’s a selected list of health reform-related bills implementing the Affordable Care Act heading to final floor votes this week. Supporters should send floor alerts ASAP. The bills are:
AB1453 (Monning) ESSENTIAL HEALTH BENEFITS: Protects consumers from underinsurance and junk insurance by requiring health plans regulated in the Health and Safety Code to cover a set of minimum essential health benefits equivalent to the Kaiser Small Group HMO.
SB951 (Hernandez) ESSENTIAL HEALTH BENEFITS: Protects consumers from underinsurance and junk insurance by requiring health plans regulated in the Insurance Code to cover a set of minimum essential health benefits equivalent to the Kaiser Small Group HMO.
AB1461 (Monning) REFORMING THE INDIVIDUAL MARKET: Prevents insurers from denying or discriminating for pre-existing conditions, and otherwise conforms the Health and Safety Code to the ACA and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits different premiums based on age to 3:1.
SB961 (Hernandez) REFORMING THE INDIVIDUAL MARKET: Prevents insurers from denying or discriminating for pre-existing conditions, and otherwise conforms the Insurance Code to the ACA and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits different premiums based on age to 3:1.
AB1083 (Monning) REFORMING THE SMALL GROUP MARKET: Conform to federal law and phase-in new insurance market rules for small businesses, particularly so that small employers don’t get additional premium spikes based on the health of their workforce.
AB792 (Bonilla) COVERAGE OPTIONS DURING LIFE CHANGES: Ensures that Californians can easily sign up for coverage during key life changes. Requires California consumers are provided information about the coverage options and subsidies at the new Exchange upon filing for divorce, separation, adoption, or when losing group coverage through job change or other life circumstances.
SB970 (DeLeon) ENROLLMENT INTEGRATION WITH HUMAN SERVICES: Helps individuals applying for public programs apply through an integrated no wrong door approach, whether applicants are interested in social services or health programs.
SB1431 (DeLeon) SELF-INSURANCE IN THE SMALL GROUP MARKET: Ensures consumer protections for workers and a affordable small group market for small businesses by limiting a loophole for small employers to “self-insure” in order to evade requirements of the small group market.
Bills Passed and Heading Toward the Governor’s Desk
AB441 (Monning) ACTIVE TRANSPORTATION, HEALTHY COMMUNITIES: Requires that transportation planning include health criteria in order to foster healthier communities.
AB1580 (Bonilla) STREAMLINING ELIGIBILITY AND ENROLLMENT: A follow-up to AB1296 (Bonilla) which was signed into law last year to streamline eligibility and enrollment processes.
ADDED UPDATE: HEALTH EXCHANGE MAKES KEY DECISIONS
Our Health Access blog features a full report on last week’s board meeting of the California Health Benefits Exchange. Decisions made include how (and to who) consumer will pay premiums in the Exchange, the method of paying agents and brokers, the set-up of the SHOP small employer Exchange, the standards for the Exchange to negotiate with health insurers to offer Qualified Health Plans, and the set-up of a consumer assistance Service Center.
Many more consequential decisions are forthcoming in future meetings, including a decision about a new name for the Exchange, for which they are seeking more feedback and ideas. As always, Health Access post summaries on our blog, and livetweets the meetings, using the hashtag #CaHBEx.