The New York Times was reporting on a one-year delay for very specific circumstances announced back in February, and in doing so significantly overstated the scope of the change.
* The delay is for group plans, but not the individual market, including those in Covered California (where the benefits and cost sharing had already been negotiated).
* The delay is only for when an employer (typically self-insured large employers) contract with multiple plan providers (such as having a separate plan for prescription drugs), and thus there is no one plan that can figure out what a patient has paid in out-of-pocket costs over the year. Presumably there is a way for this information to be shared among plans, but that’s the reason for the delay to figure this out.
And that’s why SB639(Hernandez) is so important. This is the last important piece of legislation to ensure that all the consumer protections and benefits from the federal Affordable Care Act is in state law, so state regulators can enforce it. With this bill, California can once again not just implement the federal law, but improve upon it, so our patients get these benefits as soon as possible. This bill ensures that no California consumer in individual or small group coverage has to wait to get these important consumer protections. Beyond ensuring Covered California offers these key protections, this bill also extends some cost-sharing protections to the insurance market as a whole, so more patients benefit.
The bill now goes to Assembly Appropriations Committee.