Blame, Blacklisting, Death, and Destruction

A packed Assembly Health Committee agenda kicked off today with AB1461, the bill that would reform the individual health insurance market in accordance with the Affordable Care Act. Chairman Monning, the bill’s author, outlined the protections covered by the bill, including community rating (rather than rating based health status) and guaranteed issue and renewal.

Carolyn Cunningham, a health care consumer and provided testimony of her own health care experience. An individual with 2 pre-existing conditions, Dr. Cunningham was priced out of the insurance market when her COBRA premiums became too high. She then was denied private insurance due to her pre-existing condition, and was forced to pay exorbitant out of pocket costs when uninsured. It was not until PCIP, the federally funded high-risk pool was created under the Affordable Care Act, that she finally found relief. She testified that as a person with pre-existing conditions, it was like she was “blamed and blacklisted for a condition she never wanted.” She also testified as a mental health practitioner, about the plight of her patients, who have resisted diagnosis for fear of being labeled with pre-existing conditions.

Representatives of the insurance industry testified in opposition, speaking of death (spirals) and destruction that is sure to ensue with if the bill were to pass without an individual mandate. However, Beth Capell, testifying on behalf of Health Access, pointed out that these protections have been in effect for almost 2 years for children in California, and there has been no death, destruction, or other calamity in that market. In fact, more children are now enrolled in these policies. Moreover, the bill would be implemented in the context of the Affordable Care Act, which has several provisions to prevent “adverse selection,” from the mandate to significant subsidies so people can better afford coverage. The bill passed on party lines.

The Committee also heard AB1921 (Hill), related to a transitional reinsurance program, as required by the Affordable Care Act. The program is designed to help with affordability of insurance for individuals who have high health care costs when they become eligible for coverage in 2014.

That measure passed the Committee, as did Speaker John A. Perez’s bill, AB2392, to requires the state to seek federal funding for interpretation services for Medi-Cal patients. Several groups, including the California Pan-Ethnic Health Network, Western Center on Law and Poverty, SEIU, Congress of California Seniors, and other groups testified about the importance of language access in health care.

The Committee also considered AB2350 (Monning) that requires health plans and insurers to report information regarding enrollees to regulatory agencies. The purpose of this bill is to collect data on individuals being disenrolled from or denied coverage, and who are enrolled in plans with different benefit designs. This would allow policymakers to track trends, including the prevalence of plans with very high out of pocket costs, for example.

Health Access California promotes quality, affordable health care for all Californians.