HEALTH ACCESS ALERT
Friday, June 3, 2011
CALIFORNIA LEGISLATURE VOTES TO MOVE FORWARD RATE REGULATION, OTHER KEY BILLS PASS TO IMPLEMENT AND IMPROVE NEW FEDERAL HEALTH LAW
* Assembly Passes AB52(Feuer), to Protect Consumers from Unjustified Rate Increases
* Other Insurance Oversight Bills Pass on Maternity Coverage, SB155(Evans), Small Business Health Coverage, AB1083(Monning), and a “Medical Loss Ratio,” SB51(Alquist), to Ensure Premium Dollars Go To Patient Care
* Several Bills Would Improve Eligibility and Enrollment–AB43(Monning), AB714(Atkins), AB792(Bonilla), AB1296(Bonilla)–So Californians Maximize Coverage and Federal Funds
Important California legislation to implement and improve upon the new federal health law passed full floor votes in the California Legislature today. The California Assembly passed high-profile, heavily-debated bills like AB52(Feuer), on rate regulation, so consumers are protected from unjustified rate hikes, and the California Senate passed other measures that will provide crucial consumer protections for Californians. Other bills seek to streamline and simplify eligibility and enrollment systems so that Californians get the coverage they want and need, and that the state maxmizes the number of people covered and the amount of federal funds coming into our health system.
These bills move forward to face scrutiny in the Health Committees, Appropriations Committees, and then on the floor of the second house.
SELECTED HEALTH REFORM BILLS THAT PASSED THE SENATE FLOOR
SB 51 (Alquist) MEDICAL LOSS RATIO: Ensures that premium dollars go to patient care rather than administration or profit. Requires (per the Affordable Care Act) that insurers who do not spend the specified percentage of premium dollars on patient care provide refunds to patients.
SB 155 (Evans) MATERNITY CARE: Phases in maternity care benefit mandate by requiring new health insurance policies submitted after January 1, 2012 to provide coverage for maternity services. Federal law will require coverage of maternity care starting in 2014.
SB 222 (Alquist) COUNTY-RUN HEALTH INSURANCE OPTIONS: Allows counties, county special commissions, or county health authorities that govern, own, or operate a local initiative health plan or county-organized health system to form joint ventures to offer health plans to individuals and groups.
SB 703 (Hernandez) BASIC HEALTH PLAN: Creates a Basic Health Plan for Californian adults between 133% and 200% of the federal poverty level, as allowed under the Affordable Care Act.
SB 728 (Hernandez) RISK ADJUSTMENT: Requires the new Health Insurance Exchange to set up risk adjustment, so insurers compete not based on who had sicker or healthier patients, but on cost and quality and other factors.
SELECTED HEALTH REFORM BILLS THAT PASSED THE ASSEMBLY FLOOR
AB 52 (Feuer) RATE REGULATION: Provides authority to the Department of Managed Health Care and the Department of Insurance to approve or deny health insurance rate increases.
AB 151 (Monning) GUARANTEED ISSUES FOR SENIORS ON MEDI-GAP: Assures that those previously covered by MedicareAdvantage have guaranteed issue for Medi-Gap coverage.
AB 242 (Perea) TAX CONFORMITY: Conforming the state tax code to implement the Affordable Care Act.
AB 714 (Atkins) PRE-ENROLLMENT: Requires existing programs such as MRMIB and Family PACT as well as hospitals to provide information about the California Health Benefits Exchange to their members for the purpose of pre-enrolling them into th Exchange to receive subsidized coverage in January 2014.
AB 792 (Bonilla) AUTOMATIC ENROLLMENT: Ensures continuous coverage through life circumstances such as divorce or unemployment by requiring that consumers receive information about the Exchange when filing for divorce, unemployment, etc. Would also require insurers to provide this enformation to individuals dropping off coverage after 2014.
AB 1083 (Monning) SMALL GROUP INSURANCE REFORM: Provides stability and security to small business purchasers of health coverage, so they don’t face additional spikes in their premiums due to the health of their workforce. Further limits the impact of the age of their workforce on their premiums, also in conformity to the Affordable Care Act.
AB 1296 (Bonilla) ELIGIBILITY AND ENROLLMENT: Streamlining eligibility and enrollment for Medi-Cal and other public programs.
AB 1334 (Feuer) STANDARDIZING BENEFITS: Requires plans to categorize all products offered in the individual market into five tiers according to the actuarial value and would require disclosure of this and other information.
More advocacy is needed as these bills pass face scruitiny in policy committees in the second house in the coming weeks.
***CORRECTION: AB 43 (Monning), which expanded Medi-Cal eligibility according to the rules under the Affordable Care Act, was originally reported as having passed. AB43 was actually moved to inactive at the request of the author, held on the Assembly floot as a two-year bill. (The rules don’t have to amended until 2013-14, and the bill will be available to move in January 2012.)