Exchange Launches, Bills Signed, Big Day

HEALTH ACCESS UPDATE: Wednesday, October 2, 2013


  • Government Shutdown Not Hindering Open Enrollment or Obamacare
  • Huge Interest and Demand on First Day Swamps Servers and Call Centers
  • The ACA and Covered California Offers Four Transformative Benefits:
    • No Denials for Pre-Existing Conditions
    • Financial Help If Needed to Afford Coverage
    • Standardized Benefits for Easy Comparison and Security in Coverage
    • The Bargaining Power of a Big Group To Get The Best Value
  • Governor Brown Signs Another Batch of Health Legislation
  • Bills Would Implement and Improve Health Reform, Continue California’s Leadership


Yesterday marked the begining of a six-month open enrollment in the new benefits and options of the Affordable Care Act, including with the launch of Covered California, our state’s marketplace for health care coverage.

Now millions of Californians are now able to shop, compare, and buy affordable, high quality health insurance through Covered California, a new insurance marketplace where individuals, families and small business can also get financial assistance to pay for health coverage. This brings us a major step close to the full implementation of the Affordable Care Act (ACA), also known as Obamacare.

Yesterday included the formal launch of new features of to enable consumers to determine their eligibility for premium assistance and no-cost or low-cost Medi-Cal and to shop for, compare and enroll in coverage that takes effect Jan. 1, 2014. It also included the statewide rollout of an advertising campaign and outreach efforts that will educate consumers about their options and how to enroll.

Californians can now call 1-800-300-1506, or visit, to get starting in reviewing their new options and benefits.

HUGE INTEREST: As of 3pm, there were 17,000 calls and 5 million website hits. The huge interest and demand is a testament to how much these new reforms and benefits were needed, especially in California. Californians are more likely to be uninsured, more likely to be unable to afford coverage, and more likely to be denied for pre-existing conditions than residents of all but a few other states. The federal health law and Covered California directly addresses these issues, providing new coverage that is more affordable and available than before.

This demand led to longer waits for the call centers at times during the day and issues with the website, including slow-loading pages and errors. Opening day crowds that swamped the systems but didn’t get to sign up today are encouraged to come back before December 15th, the deadline to sign up for coverage to start on January 1, 2015. The open enrollment period does extend to March 31st.

Advocates will be looking to see what problems originated from the spike of interest in opening day and other anticipated first-day issues, and if specific issues persist throughout the week that need to be addressed.

HISTORIC CONTEXT: This was a historic day when individual consumers buying health coverage are no longer all alone alone at the mercy of the big insurers, but now have new tools to compare and afford plans and get the best possible value.

Starting yesterday, consumers will no longer be denied or discriminated for pre-existing conditions. Starting yesterday, consumers will no longer be befuddled trying to compare complex and confusing benefit packages that may leave them in a lurch. Starting yesterday, consumers will no longer have to pay based on how sick they are, but rather on what they can afford, based on a percentage of income, on a sliding scale. These are transformational improvements in how consumers get coverage.

NO IMPACT FROM THE SHUTDOWN: The other historic moment was the unfortunate shutdown of the federal government as a tactic by House Republicans to attack the Affordable Care Act. At the press conference at the Rancho Cordova call center Tuesday morning, Covered California director Peter Lee said because all the federal dollars were already committed, the shutdown would have “zero impact,” except for the fact that a federal HHS official would not be able to attend one of the press conferences later that day.

While there’s no chance the Senate or the President would allow the Affordable Care Act to be defunded or delayed, the results would be catastrophic in California. Despite the rehashed debate and drama in Congress, the new health law is already in place and working here in California, with over one million Californians taking advantage of new coverage options made available because of the passage of the Affordable Care Act. Millions already have new consumer protections and new security that their coverage will be there for them when they need it. Millions of California already got financial assistance or benefit from the law–from reduced rate hikes to rebates on their premium, from seniors getting help affording prescription drugs to small businesses getting a tax credit to cover their workers.

Consumer advocates see the need to move from the political debate to the practical benefit, so millions more benefit next year from the new options, benefits, and consumer protections. The more Californians enroll, the fewer live sicker, die younger, and are one emergency away from financial ruin. For every person not enrolled by January 1, California leaves money in Washington, DC, rather than have those desperately-needed dollars come into our health system and economy.

KEY BILLS SIGNED: California has led the way in implementing and improving the Affordable Care Act, and we took another important step yesterday not just with the opening of Covered California but with the Governor’s signatures of key health bills that were pending on his desk.

These bills help boost enrollment in coverage, increase transparency in Covered California, prevent loss of key consumer protections in the small employer market, and provide other consumer protections. One key measure co-sponsored by Health Access, SB353(Lieu) will prevent deceptive market and encourage language access.

“While extreme radicals in Washington shut down our government, here in California we’re taking action to extend decent health care to millions of families,” said Governor Brown.

Governor Brown’s actions today reaffirm California’s status as a leader among states in implementing the federal Patient Protection and Affordable Care Act (ACA) and in part, serves as another example of California doing better than the federal government requires. For example, in SB 639, which is one of the bills that the Governor signed last week, California improves on federal law by limiting out of pocket costs in 2015 to no more than $6,350 for all essential health benefits, not allowing an additional limit of $1,000 for pediatric dental in 2015 and protecting small employers and their employees from higher out of pocket limits in 2014, a year earlier than federal guidance requires.

The following is a complete list of legislation signed by the Governor yesterday:

* AB 362 (Ting) – Tax Benefits for Domestic Partners: Allows Californians to exempt health benefit expenses for a domestic partner from personal income taxes.

* AB 422 (Nazarian) – 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 1180 (Pan) – Health Care Coverage/Consumer Protections: Updates California law implementing the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other individual coverage rights related to losing group coverage to conform with the federal ACA. The bill also requires health plans and health insurers to notify specified individuals about the availability of guaranteed issue coverage through Covered California.

* SB 28 (Hernandez) – California Health Benefit Exchange: Furthers implementation of the state’s expansion of Medi-Cal, authorized and required by the ACA, by giving the Department of Health Care Services greater flexibility in issuing all-county letters until regulations are adopted, and updating the budgeting methodology for Medi-Cal county administrative costs.

* SB 138 (Hernandez) – Confidentiality of Medical Information: Requires health care service plans and health insurers to take specified steps to protect the confidentiality of an insured individual’s medical information for purposes of sensitive services or if disclosure will endanger an individual, as specified.

* SB 161 (Hernandez) – Small Group Loss Coverage: Helps close a loophole that undermines consumer protections for workers for small employers, and protects the small employer market from insurers that undermine the risk pool. Establishes regulatory requirements for stop-loss insurance for small employers that “self-insure” their workers in 2016 and beyond, 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.

* SB 249 (Leno) – Health Records/Confidentiality: Authorizes the Department of Public Health and others to share health records involving the diagnosis, care, and treatment of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) related to a beneficiary’s enrollment in federal Ryan White Act (RWA) funded programs to coordinate care and enrollment as beneficiaries transition to new health coverage programs.

* SB 332 (Emmerson) – 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 353 (Lieu) – 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 800 (Lara) – Health Care Coverage/Healthy Families Transiton: Requires the Department of Health Care Services to provide Covered California with information about parents or caretakers of children enrolled in the Healthy Families program (HFP) or the targeted low-income Medi-Cal program in order to conduct outreach to potentially eligible individuals. Transfers specified employees of the Managed Risk Medical Insurance Board (MRMIB) to Covered California and DHCS, as specified.

ALERT: There are additional bills on the Governor’s desk pending consideration. A full list of consumer-oriented bills, both those inactive, pending, and passed, are on our website, at: