HEALTH ACCESS UPDATE
Friday, June 12th, 2009
HEALTH CONSUMER PROTECTION BILLS HEAD TO SECOND HOUSE
* Assembly & Senate Passed Bills on Insurance Regulation, from Gender Rating to MRMIP
* Legislation to Require a Minimum % of Premiums to Go to Patient Care Stalls in Senate
* Bills to Set Standards for Insurance, Prevent ER Overcharging Heads to Senate Health
* More Updates on the NEWLY REDESIGNED Health Access Blog: The Choice to Prevent Budget Cuts; Health Wonk Review; The Public Health Insurance Option
* Follow Health Access California on Twitter, at @healthaccess, or www.twitter.com/healthaccess for quick updates on budget and health reform issues.
Last week was the deadline for legislation to pass floor votes, in either the Assembly or the Senate, in order to proceed for the year.
Several key consumer and patient protections were passed in the past few weeks, including regulations limiting the retroactive denial of coverage; the setting of standards so insurers better label their coverage options; prohibitions on gender-based price discrimination; a reform of the state’s high-risk pool, and protections to prevent the overcharging of the uninsured in emergency rooms.
One bill that did not pass the Senate was the setting of medical loss ratios for insurance coverage, so that a minimum percentage of premiums would be required to go to patient care, rather than administration, marketing and profit. Since this is the first year of a two year session, this and other stalled bills will be available for continued movement in January of next year.
Below is a list of health consumer protection bills introduced in the 2009 session of the California State Legislature that have passed their house of origin and are now heading toward hearing by policy committees in the second house. A one-page summary of these bills, and a second page of those bills that have stalled for the year, is available on the Health Access website:
This list will be updated regularly through the year and available at www.health-access.org. Below are the active bill now moving to policy committees in the next few weeks, through late June and early July.
INSURANCE OVERSIGHT & MARKET REFORMS
AB 786 (Jones): INSURANCE MARKET STANDARDS: Would sort health insurance policies into six categories, ranging from “comprehensive” to “catastrophic.” Organization of plans into these categories would enable consumers to better track premium, benefits and cost-sharing, and assist consumers in making apples-to-apples comparisons between plans. Would weed out “junk” insurance by developing minimum benefit standards. Health Access California is the sponsor.
AB 1521 (Jones) BROKER COMPENSATION: Would require disclosure and place limits on how health insurance brokers are compensated by insurers. Health Access California is the sponsor.
AB 119 (Jones) GENDER RATING: Would prohibit insurers from charging different premium rates based on gender. Similar to SB 54 (Leno).
SB 54 (Leno) GENDER RATING: Would prohibit insurers from charging different premium rates based on gender. Similar to AB 119 (Jones).
SB 227 (Alquist) HIGH-RISK POOL: Would require insurers to accept members of the highrisk pool at the rate set by MRMIB or pay a fee used to fund MRMIP. Would also increase the tobacco tax funds dedicated to fund MRMIP.
AB 2 (De La Torre) INDEPENDENT REVIEW: Would create an independent, third-party review process when an insurer wishes to rescind a consumer’s health policy and also require state review before approval. Also raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history.
AB 730 (De La Torre) POST-CLAIMS UNDERWRITING FINES: Would impose fines on insurers unlawfully engaging in post-claims medical underwriting.
AB 108 (Hayashi) TIME LIMIT: Would impose an 18-month time limit in which insurers have to rescind, cancel, or limit individual health care policies or charge higher premiums because of fraud once a consumer’s application is approved.
INSURANCE BENEFIT MANDATES
AB 98 (De La Torre) MATERNITY COVERAGE: Would require most health plans to cover maternity services.
AB 244 (Beall) MENTAL HEALTH PARITY: Would require most health plans to provide coverage for all diagnosable mental illnesses.
MEDI-CAL ELIGIBILITY & RETENTION
AB 1142 (Price) PROOF OF ELIGIBILITY: Would require hospitals, as soon as they have proof of a person’s Medi-Cal eligibility, to provide all information regarding that person’s Medi-Cal eligibility to all other providers.
AB 1269 (Brownley) DISABLED WORKERS: Would allow, to the extent that federal financial participation is available, workers with disabilities who are otherwise eligible for Medi-Cal but are temporarily unemployed to elect to remain on Medi-Cal for a period up to 26 weeks.
DOCTOR AND HOSPITAL OVERSIGHT
AB 1503 (Lieu) EMERGENCY ROOM FAIR PRICING: Would limit the amount that emergency room physicians and surgeons can charge an uninsured or underinsured patient with income below 350% FPL. Health Access California is the sponsor.
AB 542 (Feuer) ‘NEVER EVENTS’: Bans hospitals from billing patients or insurers when they have made an avoidable mistake, such as operating on the wrong person, prescribing the wrong drugs, or leaving foreign objects inside a surgery patient.
AB 171 (Jones) DENTAL CONSUMER PROTECTIONS: Would prohibit dentists’ offices from offering high-interest loans to patients while they are under the influence of anesthesia. Would also prohibit dental offices from charging lines of credit before services have been rendered.
SB 196 (Corbett) PRICE TRANSPARENCY: Would prohibit confidentiality clauses, which keep secret information on pricing and health care quality from consumers, in contract between providers and insurers.
HOSPITAL FINANCING & WAIVER
AB 1383 (Jones) HOSPITAL COVERAGE DIVIDEND FEE: Would, per federal approval, impose a coverage dividend fee on hospitals for the purpose of increased reimbursement and children’s coverage expansion. Adopted with urgency. Watch
AB 342 (Bass) HOSPITAL WAIVER: Repeals the existing waiver authorization which expires September 2010 and acts as a placeholder for waiver discussions with the federal government. Adopted with urgency. Watch.
SB 208 (Steinberg) HOSPITAL WAIVER: Repeals the existing waiver authorization which expires September 2010 and acts as a placeholder for waiver discussions with the federal government. Adopted with urgency. Watch.