Governor Jerry Brown has signed two important health consumer protection bills, SB 133 (Hernandez) and AB 156 (Wood), aimed at protecting the 2 million Californians who purchase health care on the individual market from the Trump Administration’s attempts to undermine the Affordable Care Act, inject uncertainty into the marketplace, disrupt people’s health care and make it more difficult for people to sign up for coverage.
Due to federal uncertainty, Anthem & Cigna left much of California’s individual market,forcing 300,000 to find a new provider. At the same time, the Trump administration cut the federal open enrollment in half to just 45 days, ending in the middle of the holiday season.
The bills signed into law today ensure patients don’t have a break in their care, even when forced to switch health plans, and that California consumers have a full 12 week open enrollment period to sign up for coverage.
These bills are a crucial part of California’s efforts to maintain stability in spite of the the Trump Administration’s attacks on not just the ACA but the broader individual insurance market. With these bills now signed into law, Californians will have more time to sign up for coverage, and keep their doctors if they are in the middle of treatment. This will provide a practical benefit for California health care consumers to get the coverage and care they need, despite the health system sabotage we are seeing by the federal government.
Providing these continuity of care protections and keeping a 12-week open enrollment period are simple but important steps to ensure access to care. By keeping the framework and financing of the ACA intact, California has the will and the wherewithal to ensure we protect consumers from the Trump Administration’s troubling attacks.
CONTINUITY OF CARE: The Trump Administration has not made clear that they will carry out certain parts of the ACA and discouraging enrollment, which could potentially lead to a smaller and sicker pool of enrollees. Largely because of this, Anthem Blue Cross announced earlier this year that it is pulling out of 16 of 19 Covered California regions, impacting 60% of their individual market enrollees–around 300,000 consumers. Cigna is also leaving the individual market, impacting another 5,000 Californians. Over 300,000 health consumers covered by those plans must switch health plans for 2018, and possibly have to change doctors. SB 133 by Senator Hernandez protects 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, even if their doctors is no longer with their plan. Prior to SB133, these protections only applied to consumers who get coverage through employers and not to those who purchase their own coverage in the individual market. SB 133 closes this loophole in our continuity of care consumer protections.
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 busy holiday season, when families are the most financially strapped. AB 156 by Assemblymember Wood changes 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 will run from October 15 through January 15, starting in the 2019 plan year. (Covered California’s open enrollment period will remain unchanged for the 2018 open enrollment period, starting November 1, 2017 and going to January 30, 2018.)
Covered California already is going ahead with its own marketing and enrollment plans despite the Trump Administration defunding these efforts nationally. With this new law, California is making sure our consumers have the maximum time available to sign up for coverage.
Health Access Fact sheet: SB 133 (Hernandez) Continuity of Care
Health Access Fact sheet: AB 156 (Wood) Open Enrollment Periods