This week leading up to a Friday midnight deadline, the California Legislature wrapped up its 2011-2012 session and passed key consumer protections and other bills to implement the Affordable Care Act in California. These bills, if signed, will help ensure that California will be ready to adopt the scheduled reforms in 2014.
Governor Jerry Brown now has the month of September to sign or veto these bills. The Governor has also called for a special session of the legislature, beginning in December with a newly-elected Assembly and Senate, to deal with final health reform implementation issues prior to 2014.
The federal law provides new tools, resources, and a framework for historic improvements in our health care and coverage–but it’s up to the state to make reform real, so that Californians are no longer denied for pre-existing conditions, that new consumer protections are enforced, and that Californians are informed and enrolled in their new coverage options.
The legislation passed includes SB961(Hernandez) and AB1461(Monning), would ban denials or discrimination based on pre-existing conditions, and limit how much more insurers can charge older Californians in comparison to younger policyholders. Two other measures, SB951(Hernandez) and AB1453(Monning) would define an “essential benefits package” for health plans, so consumers have more confidence in their coverage.
Another set of bills will better inform Californians about their coverage options. AB792(Bonilla) would require that consumers are informed of their coverage options when losing coverage–such as during a job or other life change. SB970(DeLeon) would better integrate enrollment with human services, so people in need get the help to which they are entitled.
LATE EFFORT ON HEALTHY FAMILIES STALLS: A late effort to restore the Healthy Families program ultimately stalled in the final hours of the legislative session. A broader proposed deal between Democrat and Republican leaders, involving several tax measures, a middle-class scholarship program, and other items also included halting the transfer of children from Healthy Families to Medi-Cal coverage, a shift agreed to in the state budget approved earlier this year. Ultimately, the deal did not come together, and the Healthy Families restoration was not approved, nor was a continuation of a related tax on Medicaid managed care plans that raised $180 million for the state budget. As a result, children currently in the Healthy Families program will be transferred into Medi-Cal coverage over the course 2013, and advocates will be monitoring the transition mindful over issues such as continuity of care and access to providers.
Health Reform Bills On the Governor’s Desk
Here’s a list of health reform-related bills implementing the Affordable Care Act heading to the Governor’s desk for his consideration. This list is also available as a one-page fact sheet on the Health Access website. Supporters should letters to the Governor ASAP. The bills are:
Insurance Market Reforms and Consumer Protections
AB1453 (Monning) ESSENTIAL HEALTH BENEFITS: Protects consumers from underinsurance and junk insurance by requiring health plans regulated in the Health and Safety Code to cover a set of minimum essential health benefits equivalent to the Kaiser Small Group HMO.
SB951 (Hernandez) ESSENTIAL HEALTH BENEFITS: Protects consumers from underinsurance and junk insurance by requiring health plans regulated in the Insurance Code to cover a set of minimum essential health benefits equivalent to the Kaiser Small Group HMO.
AB1461 (Monning) REFORMING THE INDIVIDUAL MARKET: Prevents insurers from denying or discriminating for pre-existing conditions, and otherwise conforms the Health and Safety Code to the ACA and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits different premiums based on age to 3:1.
SB961 (Hernandez) REFORMING THE INDIVIDUAL MARKET: Prevents insurers from denying or discriminating for pre-existing conditions, and otherwise conforms the Insurance Code to the ACA and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits different premiums based on age to 3:1.
AB1083 (Monning) REFORMING THE SMALL GROUP MARKET: Conform to federal law and phase-in new insurance market rules for small businesses, particularly so that small employers don’t get additional premium spikes based on the health of their workforce.
AB1761 (Speaker Perez) DECEPTIVE MARKETING: Prohibits any individual or entity from falsely representing themselves as the California Health Benefits Exchange.
SB1410 (Hernandez) INDEPENDENT MEDICAL REVIEW: Improves the process by which consumers appeal denial of care decisions. Makes the process more transparent, including with race, ethnicity, and language data.
AB1526 (Monning) HIGH RISK POOL: Improves the Major Risk Medical Insurance Program (MRMIP) by eliminating annual and lifetime caps so that individuals with pre-existing conditions will be protected if they are in need of extremely costly care. Aligns program with the federally funded PCIP program.
AB792 (Bonilla) COVERAGE OPTIONS DURING LIFE CHANGES: Ensures that Californians can easily sign up for coverage during key life changes. Requires California consumers are provided information about the coverage options and subsidies at the new Exchange upon filing for divorce, separation, adoption, or when losing group coverage through job change or other life circumstances.
AB174 (Monning) SYSTEMS INTEGRATION: Establishes funding for the Office of Systems Integration to establish information sharing between the Franchis Tax Board, the Employment Development Department, specified health care agencies and county departments and agencies to verify eligibility for state health programs.
AB1580 (Bonilla) STREAMLINING ELIGIBILITY AND ENROLLMENT: A follow-up to AB1296 (Bonilla) which was signed into law last year to streamline eligibility and enrollment processes.
SB970 (DeLeon) ENROLLMENT INTEGRATION WITH HUMAN SERVICES: Helps individuals applying for public programs apply through an integrated no wrong door approach, whether applicants are interested in social services or health programs.
AB441 (Monning) ACTIVE TRANSPORTATION, HEALTHY COMMUNITIES: Requires that transportation planning include health criteria in order to foster healthier communities.
Governor Brown now has until the month of September to sign or veto these measures. Health Access California asks those who support the implementation of health reform in California to call or write to the Governor to urge him to sign these important bills.
For more information about these bill, visit the Health Access website, or contact the author of this report, Linda Leu, at firstname.lastname@example.org.