Assembly Health Committee Gives Green Light to Key Consumer Health Bills

Earlier today the Assembly Health Committee voted on several priority bills impacting health care consumers and the remaining uninsured, including SB 4 (Lara)

For those who keep score, here’s how key consumer protection bills came out in today’s vote:

  • SB 4 (Lara) Health Care Coverage, Immigration Status: 10-6
  • SB 137 (Hernandez) Accurate Provider Directories 16-2
  • SB 43 (Hernandez) Essential Health Benefits 16-1

SB 4 (Lara): Allowing Broader Access to Covered California 

As amended, SB 4 (Lara) seeks to allow all Californians, regardless of immigration status, to purchase coverage through Covered California, using their own money. While the Affordable Care Act limits participation in health insurance exchanges to citizens and legal permanent residents, SB 4 directs the administration to seek a Section 1332 waiver–special permission from the federal government–to open Covered CA up to undocumented Californians. “The fact that the ACA leaves out those who can actually afford premiums is why we are running this bill,” said SB 4 author Senator Lara in today’s hearing.

SB 4 no longer includes the expansion of Medi-Cal for low-income immigrant adults—this is now addressed by a separate bill, SB 10, also authored by Senator Lara.  SB 10 has been “parked” as a “two year bill” and can be taken up again in next year’s budget and legislative session. Thanks to the final budget agreement to dedicate an initial $40 million for the expansion of coverage to an estimated 170,000 undocumented children, the scope—and cost–of SB 4 is smaller as a result and potentially more doable in 2016.

With a majority of undocumented immigrants in mixed status families, SB 4 would also allow Covered California staff to help the entire family–even those not eligible for subsidies. With Ron Coleman of California Immigrant Policy Center, Beth Capell of Health Access, and the many supporters of the bill who came forward today, SB 4 recognizes that immigrants take care of California in so many ways, and so “it is time for California to take care of immigrants.”

Despite the modest reach of SB 4 after the splitting of the bill, several groups rising in opposition to SB 4 and largely for reasons unrelated to its content, from “Save Our State” and other anti-immigrant groups, to the “Long Beach Heterosexual Resistance.” They argued, falsely, that SB4 was “back door amnesty, or that it would place stress on an overburdened health system–not acknowledging these Californians are already in our health system, but in the least efficient and most expensive ways.

Republican Assemblymember Rocky Chavez distanced himself from some of the opposition rhetoric, and the recent comments of presidential candidate Donald Trump, but still stated his opposition to the bill, saying he wanted more time to see how the ACA would play out.

While the cost of the bill is little (it allows undocumented Californians to buy in Covered California without subsidies), Democratic Assemblymember Jim Wood offered a helpful counterpoint to the cost issues raised by those speaking against SB 4. “Consider the costs burdening the health care system from having so many without coverage,” said Wood.

SB 137 (Hernandez) Accurate Provider Directories

Passing on a vote of 16-2, an amended SB137 (Senator Ed Hernández) creates better standards for provider directories and requires regular updates so people know what doctors and hospitals are in their network when they shop for or change coverage or when they seek care. The bill is needed, says bill co-sponsor Betsy Imholz of Consumers Union, because 25-50% of provider directories are inaccurate by some estimates, including a recent DMHC survey.

Beth Capell for Health Access, a bill co-sponsor, said “it is time for directories to come into the digital age.” According to Kimberly Chen of California Pan-Ethnic Health Network, also a bill co-sponsor, today’s inaccurate directories present yet another barrier to care for people of color.  It’s frustrating for consumers to have to make so many calls to find a provider that will accept their coverage…“Now imagine making those calls in a foreign language,” said Chen.

The sticking point for opposition, mostly health plans and provider groups that remain opposed or concerned about the current format of SB 137, is the timeframe for updating the directories.  The current bill defers to the Administration’s preference for a quarterly timeframe for updating the directories. This bill is still a work in progress, and we anticipate further amendments. Consumer advocates will continue to press on for this bill and principle.

SB 43 Essential Health Benefits passed 16-1

SB 43 (Hernandez) would renew and update California essential health benefits standards under the Affordable Care Act. The bill would extend the sunset on Essential Health Benefits (EHB) standard for California and updates the EHB standard in light of recent federal guidance on habilitative services (services and devices that help a person keep, learn, or improve skills and functioning for daily living). The new Federal standard for habilitative services is more generous than California’s current definition. The bill passed.

Also passing today was a SB35(Hernandez), to help implement the Medicaid waiver–but the bill doesn’t have very many details yet, given that negotiations with the federal government are ungoing.

Tomorrow is Senate Health Committee, with several other key bills up for consumption.