As of this writing, two important health consumer protection bills helping to blunt federal attacks on the individual market face final votes on the final day of the 2017 California Legislative session. The bills seek to protect California consumers from the actions of the Trump Administration seeking to undermine the success of the Affordable Care Act and the individual insurance market, injecting uncertainty into the marketplace, disrupting people’s health care and is making it more difficult for people to sign up for coverage.
With these bills, legislators can help hold harmless California consumers from the whims of the Trump Administration’s attacks on not just the ACA but the whole individual insurance market. We can take steps to ensure Californians can sign up for coverage, and continue to get the care from their doctors during a course of treatment. Health Access California, the statewide health care consumer advocacy coalition is a strong supporter of these two bills, SB 133 (Hernandez) & AB 156 (Wood).
CONTINUITY OF CARE: The Trump Administration has not made clear that they will carry out certain parts of the ACA, discouraging enrollment and potentially leading to a smaller and sicker pool of enrollees. Largely because of this, two insurers in California, Anthem Blue Cross and Cigna, are pulling out of the individual market in many of their coverage areas for 2018. This means that the over 300,000 health consumers covered by those plans will need to find a new insurance provider next year, and possibly have to change doctors. SB 133 by Senator Hernandez will protect patients from losing their doctor during treatment if the patient is forced to switch health plans because their insurer is leaving the market.
For almost 20 years, Californians with serious conditions or chronic health needs who have employer coverage have been protected by our state’s continuity of care laws. These consumer protections allow patients up to 12 months to complete their course of treatment. Currently, these protections only apply to consumers who get coverage through employers and not to those who purchase their own coverage in the individual market. SB 133 would close the loophole to allow those in the individual market to have continuity of care with their health provider in the middle of a treatment like pregnancy or chemotherapy–even when their health insurer abandons them and they have to choose a new health plan.
OPEN ENROLLMENT PERIOD: Earlier this year, the federal Centers for Medicare and Medicaid Services (CMS) moved to adopt a shorter annual open enrollment period that starts on November 1 and ends December 15, which is 45 days instead of California’s current 90-day period. This would also mean that consumers would need to make important health decisions during the holiday season. AB 156 by Assemblymember Wood will change California law to comply with the new federal rule, while also adding additional time before and after in order to maintain the 3-month open enrollment period and give consumers more time to shop after the holidays.
Under AB 156, California’s open enrollment would run from October 15 through January 15, starting in the 2019 plan year. The open enrollment period will remain unchanged for the 2018 open enrollment period, starting November 1, 2017 and going to January 30, 2018. It’s nuts that the Trump Administration wants to shorten the time to allow people to sign up for coverage, and end it right during the holiday season when families are financially stretched. More time means more California consumers can sign up–especially into January when people have a better sense of their finances for the new year.
Health Access Fact sheet: SB 133 (Hernandez) Continuity of Care
Health Access Fact sheet: AB 156 (Wood) Open Enrollment Periods
All 2017 legislation must be voted on by midnight tonight in order to be sent to the Governor for final signature.
Providing these continuity of care protections and keeping a 12-week open enrollment period are simple but important steps to ensure access to care. If we keep the framework and financing of the ACA intact, California has the will and the wherewithal to ensure we hold harmless our consumers from the troubling attacks of the Trump Administration. We’ll be watching.VIEW THE FILE Uncategorized