This past Sunday, October 13th, was the last day for Governor Jerry Brown to sign or veto bills passed by the Legislature. Of fourteen bills introduced in the regular session that health consumer groups including Health Access were supporting and/or sponsoring, eight bills were signed by the Governor in the weeks leading up to the Governor’s sign or veto deadline; the remaining six were vetoed.
A one-page bill list is available on the Health Access website. Descriptions are below.
SB 639 – LIMITING COST SHARING – Implements and improves on the provisions of the ACA which limit out of pocket costs to no more than $6,350 for an individual or $12,700 for a family in 2015. Consistent with federal law, establishes actuarial value tiers for individual and small group law and limits deductibles for small employer coverage. Allows large employer coverage to use the 2014 plan year as a transition period before requiring a single total out of pocket limit for all covered benefits starting in 2015. While federal guidance allows multiple out of pocket limits, SB639 provides better consumer protections against medical bankruptcy.
SB 353 – DECEPTIVE MARKETING – Requires a health plan or insurer that markets in a language other than English to provide a specified list of materials in that language so the consumer who is choosing coverage knows what they are buying—even if they speak a language other than English. These provisions would apply only to the individual and small employer markets.
SB 332 – CALIFORNIA HEALTH BENEFIT EXCHANGE RECORDS – Makes contracts and rates of payment under those contracts of the California Health Benefit Exchange (known as Covered California) open to public inspection under the California Public Records Act (PRA) except for health plan contracts and their rates, which are made public in three and four years respectively.
SB 161 – SMALL GROUP STOP LOSS COVERAGE – Protects the small employer market from insurers that undermine the risk pool by establishing regulatory requirements for stop-loss insurance for small employers including on or after January 1, 2016, setting an individual attachment point of $40,000 or greater and an aggregate attachment point of the greater of $5,000 times the total number of group members, 120% of expected claims, or $40,000.
AB 422 – MEDI-CAL/EXCHANGE AND SCHOOL LUNCH APPLICATIONS – Adds information about Covered California to the currently required information about Medi-Cal that is given to applicants for the school lunch program.
AB 362 – TAX BENEFITS FOR DOMESTIC PARTNERS – Allows Californians to exempt health benefit expenses for a domestic partner from personal income taxes.
AB 361 – HEALTH HOMES FOR “FREQUENT FLYERS” – Expands pilot projects that help acutely ill individuals who frequently seek care in emergency rooms through coordinated and intensive intervention.
AB 191 – MEDI-CAL/EXCHANGE AND CalFRESH APPLICATIONS – Gives families information about Medi-Cal and the Exchange when they apply for CalFRESH, so that they can get information about both health and human services programs.
SB 746 – LARGE GROUP RATE REVIEW – Would provide aggregate rate information for large employer health insurance and would also require integrated health plans to disclose information similar to what is disclosed by other health plans.
SB 205 – PRESCRIPTION DRUG LABELS – Requires prescription drug container labels to be printed in 12 point sans serif typeface
AB 1263 – MEDI-CAL MANAGED CARE INTERPRETERS – Requires the Department of Health Care Services (DHCS) to certify Medical Interpreters. DHCS, in consultation with an Advisory Committee of stakeholders would approve an examination and certification process to test and certify the competency of medical interpreters. Interpreters would be required to meet a seris of standards as a condition of certification. The measure also provides for collective bargaining by these interpreters.
AB 1208 – DATA COLLECTION – Would allow collection of demographic data on race, ethnicity, primary language, disability status, sexual orientation and gender identity in application for insurance affordability programs such as Medi-Cal and premium tax credits.
AB 411 – MEDI-CAL MANAGED CARE PERFORMANCE INDICATORS – Requires analysis of HEDIS data to monitor and reduce health disparities.
AB 50 – MEDI-CAL ELIGIBILITY AND ENROLLMENT – Expands full scope Medi-Cal to pregnant women up to 100% FPL.
The bills that were signed by the Governor give us reason to celebrate while those that were vetoed reflect the need for further advocacy. In recognition of the work that remains, the Governor’s veto messages suggest a path to resolving the outstanding issues that remain.
For example, on AB50, the Governor indicated that he would direct DHCS to put forward a broader solution for pregnant women in Medi-Cal in the state budget his administration will release in January. On data collection bills like AB411 and AB1208, the Governor stated that the Department of Health Care Services had existing authority if it saw fit. And in his veto message for SB 746 on large group rate review, the Governor states “my administration is moving forward to establish transparency programs that will cover all health plans and systems. I urge all parties to work together in this effort. If these voluntary efforts fail, I will seriously consider stronger actions.”
While disappointing to learn of these vetoes, the signing statements provide a path for continued advocacy in the next year, alongside new issues and efforts. For those efforts, we need to know how Californians are experiencing the Affordable Care Act, especially the process of shopping for insurance in Covered California. CLICK HERE TO SHARE YOUR STORY, good or bad.
To view the Governor’s veto messages, and other bills passed, please visit http://www.leginfo.ca.gov.