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2018 Legislation
2018 Year in Review (PDF)
2018 Legislative Scorecard (PDF)
2018 Bills:
Stop the Trump Sabotage
Health Care Costs, Quality, and Equity
Expanding Health Care Access
Improving Health Care Affordability
- Increased Affordability Assistance in Covered California
- SB 1255 (Hernandez), AB 2459 (Friedman), AB 2565 (Chiu)
- California Voter Survey: Health Care Affordability Assistance
Prescription Drugs
- SB 1021 (Wiener) Prescription Drug Co-Pays and Formularies*
- California Bills Target Prescription Drug Costs
* = bill signed into law by Governor Brown
More Information:
- Care4All California Legislative Priorities/li>
- Health Access Tracked Legislation (find all fact sheets and sample support letters here)
- Increased Affordability Assistance in Covered California
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2017 Legislation
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2016 Legislation
Bills of Interest to Consumer Advocates
Health Access California sponsors, supports, and tracks legislation impacting health care consumers and implementation of the Affordable Care Act.
2016 Legislative Scorecard (PDF)
2016 Bill Tracking Matrix (PDF)
- Updated bill matrix is posted every Monday
2016 Patient’s Rights Agenda (PDF)
- AB 72 (Bonta, Bonilla, Dahle, Gonzalez, Maienschein, Santiago, and Wood) Stop Surprise Bills
- SB 10 (Lara) Health4All: Expanding Access to Covered California to All Californians, Regardless of Immigration Status
- SB 1135 (Monning) Timely Access and Language Access
- SB 908 (E. Hernandez) Notice of Unreasonable or Unjustified Rates
- SB 1418 (Lara) Health4All: Expanding Full-Scope Medi-Cal to Undocumented Adults
- SB 923 (Hernandez) Preventing Mid-Year Cost-Sharing Increases
Take Action Here
- See recent action alerts where you can contact your legislators about important consumer protection and transparency bills
Health Access Sponsored Legislation
AB 72 (Bonta, Bonilla, Dahle, Gonzalez, Maienschein, Santiago, and Wood) Stop Surprise Bills
Ensures that if consumers do the right thing by visiting in-network hospitals or facilities, they will pay in-network charges and co-pays for all the providers they encounter during their visit. The total amount of cost-sharing will also count toward patient’s out-of-pocket maximum.
- AB 72 signed into law! Read the fact sheet detailing California’s new law to protect consumers from surprise medical bills.
- Fact Sheet on AB 72 legislation (1-page)
- Sample letter of support
- Bill language and status
- Stories of consumers hit by surprise bills
SB 10 (Lara) Health4All: Expanding Access to Covered California to All Californians, Regardless of Immigration Status
Expands health care coverage to all Californians, regardless of immigration status, by premiting the state to apply for a federal waiver that would allow undocumented immigrants and their non-US born children to buy coverage through Covered California using their own money.
SB 1135 (Monning) Consumers Deserve to Know Rights: Where to Complain, Timely Access, Language Access
Requires health plans and insurers to notify consumers and health care providers about patients’ right to timely care and language assistance.
SB 908 (Hernandez) Let the Market Work: Give Consumers Notice of Unreasonable or Unjustified Rates
Requires individuals and small business owners to be notified if regulators have found the premium for a plan they choose is “unreasonable” or “unjustified” and be given an open enrollment period to find another plan.
SB 1418 (Lara) Health4All: Expanding Full-Scope Medi-Cal to Undocumented Adults
Extends eligibility for full-scope Medi-Cal benefits to individuals 19 years of age or older, regardless of immigration status.
SB 923 (Hernandez) Preventing Mid-Year Cost-Sharing Increases
Closes a loophole so that copays, deductibles, and other cost sharing changes only once a year, just like premiums.
Also visit our blog for the latest on our legislative initiatives.
To read the complete text of any bill, including amendments, please visit the California Legislature Bill Information website and search by bill number, author, or keywords.
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2015 Legislation
Bills of Interest to Consumer Advocates
Health Access California sponsors, advocates for, and tracks legislation impacting health care consumers and implementation of the Affordable Care Act. Green=the bill is moving through the process. Red=the bill is stalled or postponed to next year. Check out our Bill Tracker (updated November 2015)…
Health Access Fact Sheets and Analysis
- Legislative Scorecard for the 2015 Session (Revised March 2016).
- Health Consumer Bills for the 2015 Session (November 2015). A Health Access California matrix of sponsored or co-sponsored, prioritized, supported bills. Check back for regular updates and links to helpful tools.
- AB533 (Bonta) Surprise Bills: No More ‘Gotcha’ Bills If Consumers Visit In-Network Facility. A Health Access fact sheet (October 2015).
- AB339 (Gordon) Health Care Coverage-Outpatient Drugs: Protecting Patients from Discriminatory Benefit Design.A Health Access fact sheet (October 2015).
- SB137 (E. Hernandez) Accurate Provider Directories – A CPEHN, Health Access, and Consumers Union fact sheet (March 2015).
- AB1305 (Bonta) Limitations on Cost Sharing: Family Coverage – a Health Access fact sheet (October 2015).
- AB248 Health Care Minimum Value (R. Hernández). A Health Access Fact Sheet (October 2015).
- Patient Protection Legislation to Limit Out-of-Pocket Costs & Stop Surprise Bills(July 2015). A Health Access Fact Sheet.
- Also visitour blogfor the latest on our legislative initiatives.
Sample Support Letters for Partners
- SB4 “Health For All” Act (support letter by author-sponsor), posted 9/25/15.
- SB137 Accurate Provider Directories, posted 9/25/15.
- AB339 Prescription Drug Cost Sharing, posted 9/25/15.
- AB248 Minimum Value Coverage, posted 9/25/15.
- AB1305 Limitations on Cost Sharing in Family Coverage, posted 9/25/15.
To read the complete text of any bill, including amendments, please visit the California Legislature Bill Information website. Here you can lookup information by bill number, author, or keywords.
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2014 Legislation
Health Access Analysis
See our Summary of Final Results on 2014 Legislation sponsored or tracked by Health Access.
Here is a list of final Bill results tracked by Health Access:
- Insurance Consumer Protections
- AB 2088 (Roger Hernandez) Vetoed
- SB 964 (Ed Hernandez) Signed
- SB 959 (Ed Hernandez) Signed
- SB 1052 (Torres) Signed
- SB 1053 (Mitchell) Signed
- Medi-Cal
- AB 2325 (Speaker Perez) Vetoed
- SB 18 (Leno) Signed
- SB 1002 (De Leon) Vetoed
- SB 1089 (Mitchell) Signed
- SB 1124 (Hernandez) Vetoed
- SB 1341 (Mitchell) Signed
- Cost/Quality Transparency
- AB 1792 (Gomez) Signed
- AB 1962 (Skinner) Signed
- SB 1182 (Leno) Signed
- SB 1340 (Hernandez) Signed
- Hospital Oversight and Consumer Protections
- SB 204 (Corbett) Vetoed
- SB 1094 (Lara) Vetoed
- SB 1276 (Ed Hernandez) Signed
- Prevention
- SB 912 (Mitchell) Signed
- Other Bills
- AB 2731 (Perea) Signed
- SB 20 (Hernandez) Signed
- SB 1004 (Hernandez) Signed
- SB 1034 (Monning) Signed
- Insurance Consumer Protections
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2013 Legislation
Bills of interest to health care consumer advocates from the 2013 legislative session
Health Access California sponsors, advocates for, and tracks health consumer legislation in Sacramento. To see a fact sheet outlining our current position on the health care legislation we are following, click here: 2013 Legislation Impacting California Health Care Consumers.
To read the complete text of any bill including amendments, please visit the California Legislature Bill Information website to lookup information by bill number, author, or keywords.
2013 Session Health Consumer Bills:
(AB = Assembly Bill; SB = Senate Bill)
= Support
= Don’t Support
= Stalled
= Exploring
IMPLEMENTING THE AFFORDABLE CARE ACT (First Extraordinary Session – Health Care)
SBX 1.1 (Steinberg/Hernandez) / ABX 1.1 (Speaker Perez): MEDI-CAL EXPANSION AND SIMPLIFICATION – Expands Medi-Cal eligibility to over one million Californians in accordance with the Affordable Care Act, effective January 1, 2014; streamlines eligibility and enrollment processes to reducing barriers to enrollment such as the assets test.
SBX 1.2 (Hernandez) / ABX 1.2 (Pan): INDIVIDUAL MARKET REFORM – Implements individual market reforms preventing insurers from denying or discriminating for pre-existing conditions, and otherwise conforming and phasing-in new insurance market rules for individuals who purchase insurance on their own. Limits different premiums based on age to 3:1.
SBX 1.3 (Hernandez): BRIDGE PLAN – Allows a designated health plan within Covered California to provide coverage to low-income Californians transitioning between Medi-Cal and Exchange coverage for increased affordability and continuity of care. Health Access supports amendments to ensure increased affordability and that the Bridge Plan will utilize existing safety net providers.
IMPLEMENTING & IMPROVING THE AFFORDABLE CARE ACT
SB 639 (Hernandez): LIMITING COST SHARING (HAC Sponsor) – Implements elements of the ACA related to cost sharing, including standardizing plans, to make health care more affordable.
AB 880 (Gomez): EMPLOYER RESPONSIBILITY & ACCOUNTABILITY – Provides information on enrollees’ employment to DHCS and Exchange from Franchise Tax Board and Employment Development Department. (Sponsored by the California Labor Federation)
INSURANCE MARKET REFORMS AND CONSUMER PROTECTIONS
SB 189 (Monning): WELLNESS INCENTIVES – Establishes guidelines for wellness incentives in the employer based market, prohibiting incentives or penalties based on health status factors.
SB 353 (Lieu): DECEPTIVE MARKETING (HAC Sponsor) – Protects consumers from false advertising about the benefits and requirements of health reform by (1) requiring insurers that market in other languages to translate key documents in those languages; (2) gives the Insurance Commissioner the authority to authorize marketing materials.
ENSURING AFFORDABILITY AND VALUE
SB 161 (Hernandez): SMALL GROUP STOP LOSS COVERAGE – Provides protections to small business employees getting coverage through “self-insured” “stop loss” plans by requiring guaranteed issue, guaranteed renewability, and increasing the “attachment point” or employer liability to $95,000 for the entire firm and $19,000 per covered life.
SB 746 (Leno): LARGE GROUP RATE REVIEW – Gives regulators the authority to review rate increases in the large employer markets in order to determine whether increases are reasonable and justified.
AB 18 (Pan): STAND ALONE DENTAL PLANS – Proposed to be amended to examine how new regulations on health plans should apply to stand-alone dental plans, permits stand-alone dental plans to provide pediatric dental coverage.
AB 314 (Pan): UC STUDENT HEALTH PLANS – Require UC student health plan to eliminate annual and lifetime limits as well as limits on prescription drug coverage, and comply with standards set by the Affordable Care Act.
MEDI-CAL AND THE EXCHANGE
AB 617 (Nazarian): NOTICE AND APPEALS – Establishes a coordinated notice and appeal system for eligibility and application issues for the Exchange, Medi-Cal, and AIM.
AB 50 (Pan): MEDI-CAL ELIGIBILITY AND ENROLLMENT – Allows hospitals to determine presumptive eligibility for Medi-Cal and allows pre-population of application forms. This bill will also provide additional consumer protections to prevent steering.
SB 640 (Lara): MEDI-CAL PROVIDER RATES – Stops the 2011 Medi-Cal provider rate cuts from going into effect and exempts certain providers and facilities from the cut.
AB 209 (Pan): QUALITY AND ACCESSIBILITY OF MEDI-CAL MANAGED CARE PLANS – Requires DMHC to develop and implement a plan to monitor, evaluate, and improve the quality and accessibility of health and dental plans provided through Medi-Cal managed care.
AB 411 (Pan): MEDI-CAL MANAGED CARE PERFORMANCE INDICATORS – Requires analysis of HEDIS data to monitor and reduce racial and ethnic health disparities. (Sponsored by CPEHN.)
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 191 (Bocanegra): MEDI-CAL/EXCHANGE AND CalFRESH APPLICATIONS – Gives families information about Medi-Cal and the Exchange when they apply for CalFRESH, so that they can get information about both health and human services programs.
AB 505 (Nazarian): LANGUAGE ACCESS IN MEDI-CAL MANAGED CARE – Puts language access requirements for Medi-Cal Managed Care plans into state law. This allows for greater transparency and better enforcement. (Sponsored by CPEHN.)
AB 1263 (Speaker Perez): MEDI-CAL MANAGED CARE INTERPRETERS – Creates a nonprofit entity that will certify Medical Interpreters for the Medi-Cal Managed Care Plans and Fee For Service providers. Interpreters will have collective bargaining rights.
PREVENTION MEASURES
SB 768 (de Leon): TOBACCO TAX – Increases the per-cigarette tax by 10 cents to fund tobacco cessation programs and increased support to Medi-Cal.
SB 622 (Monning): SODA TAX – Taxes soda and other sugary drinks at a rate of one cent per fluid ounce to raise revenues for disease prevention programs.
AB 459 (Mitchell): HEALTHY AND SUSTAINABLE FOOD – Increases the requirement of healthy foods and drinks in vending machines in state buildings from 35% to 100%. (Sponsored by CPEHN.)
OTHER BILLS
AB 361 (Mitchell): HEALTH HOMES FOR “FREQUENT FLYERS” – Expands pilot projects that help acutely ill individuals who frequently seek care in emergency rooms through coordinated and intensive intervention.
AB 362 (Ting): TAX BENEFITS FOR DOMESTIC PARTNERS – Allows Californians to exempt expenses paid toward health benefits for a domestic partner from personal income taxes.
AB 975 (Wieckoski/Bonta): NONPROFIT HOSPITAL COMMUNITY BENEFITS AND CHARITY CARE – Require nonprofit providers to file standardized community benefits reports every two years, and standardizes the definition of community benefits and charity care.
SB 266 (Lieu): OUT OF NETWORK COVERAGE – Requires notice to individuals when they are about to be seen by out of network providers (often in in-network facilities) in accordance with the DMHC network adequacy requirements.
PROBLEMATIC LEGISLATION
AB 376 (Donnelly): REGULATIONS – Weakens consumer protections by hampering the regulatory process.
AB 1129 (Gaines): HEALTH SAVINGS ACCOUNTS – Allow, in accordance with federal tax code, deductions in connection with Health Savings Accounts.
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2012 Legislation
Bills of interest to health care consumer advocates from the 2012 legislative session
Health Access California sponsors, advocates for, and tracks health consumer legislation in Sacramento. To see a fact sheet outlining our current position on the health care legislation we are following, click here: 2012 Legislation Impacting California Health Care Consumers.
To read the complete text of any bill including amendments, please visit the California Legislature Bill Information website to lookup information by bill number, author, or keywords.
2012 Session Health Consumer Bills:
(AB = Assembly Bill; SB = Senate Bill)
= Support
= Don’t Support
= Stalled
= Exploring
CONSUMER PROTECTIONS AND INSURER OVERSIGHT
AB 1453 (Monning) / SB 951 (Hernandez): ESSENTIAL HEALTH BENEFITS – Protects consumers from underinsurance and junk insurance by requiring that health plans and health insurers cover a set of minimum essential health benefits. The bills set the minimum floor for benefits to be equivalent to the Kaiser small group HMO. Signed by the Governor on September 30, 2012.
AB 1461 (Monning) / SB 961 (Hernandez): REFORMING THE INDIVIDUAL MARKET – Prevents insurers from denying or discriminating for pre-existing conditions, and otherwise conforms and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits different premiums based on age to 3:1. VETOED by the Governor on September 30, 2012.
AB 1083 (Monning): REFORMING THE SMALL GROUP MARKET (HAC Co-Sponsor) – Conform 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. Signed by the Governor on September 30, 2012.
AB 1761 (Speaker Perez): DECEPTIVE MARKETING – Prohibits any individual or entity from falsely representing themselves as the California Health Benefits Exchange. Signed by the Governor on September 30, 2012.
SB 1410 (Hernandez): INDEPENDENT MEDICAL REVIEW – Improves the process by which consumers appeal denial of care decisions by making the process more robust and transparent. Also requires collection of race, ethnicity, and language data to help determine whether health equity issues need to be addressed. Signed by the Governor on September 30, 2012.
ENSURING CALIFORNIANS GET THE COVERAGE THEY NEED
AB 1580 (Bonilla): STREAMLINING ELIGIBILITY AND ENROLLMENT – A follow-up to AB1296 (Bonilla) which was signed into law last year to streamline eligibility and enrollment processes. Signed by the Governor on September 30, 2012.
AB 1526 (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, and brings the program in line with PCIP, the federally funded high risk pool. Signed by the Governor on September 30, 2012.
SEAMLESS, AUTOMATIC, EASY ENROLLMENT
AB 792 (Bonilla): NOTICE OF COVERAGE OPTIONS DURING LIFE CHANGES (HAC Sponsor) – Requires California consumers are provided information about their coverage options under the Exchange upon filing for job change, divorce, separation, adoption, or other life changes. Signed by the Governor on September 30, 2012.
SB 970 (De Leon): HORIZONTAL INTEGRATION OF ENROLLMENT 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. VETOED by the Governor on September 30, 2012.
AB 174 (Monning): SYSTEMS INTEGRATION – Establishes funding for the Office of System Integration to establish information sharing between the Franchise Tax Board and the Employment Development Department to specified health care agencies and county departments and agencies to verify applicant eligibility for state health care programs as well as claims data information. Signed by the Governor on September 30, 2012.
AB 1869 (Speaker Perez): HELP FOR VETERANS – Requires that in addition to programs like Medicare and Medi-Cal, the Office of the Patient Advocate also coordinate with veterans programs. Signed by the Governor on July 24, 2012.
PROMOTING HEALTH
AB 441 (Monning): ACTIVE TRANSPORTATION, HEALTHY COMMUNITIES – Requires that transportation planning include health criteria in order to foster healthier communities. Signed by the Governor on September 19, 2012.
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2011 Legislation
Bills of interest to health care consumer advocates from the 2011 legislative session
Health Access California sponsors, advocates for, and tracks health consumer legislation in Sacramento. To see a fact sheet outlining our current position on the health care legislation we are following, click here: 2011 Legislation Impacting California Health Care Consumers.
To read the complete text of any bill including amendments, please visit the California Legislature Bill Information website to lookup information by bill number, author, or keywords.
2011 Session Health Consumer Bills:
(AB = Assembly Bill; SB = Senate Bill)
= Support
= Don’t Support
= Stalled
= Exploring
COMPREHENSIVE HEALTH REFORM
SB 810 (Leno): SINGLE PAYER UNIVERSAL HEALTH CARE – Establishes a universal State Healthcare System. Creates State Healthcare Agency. Makes all residents eligible for specified health care benefits under the System, which would, on a single-payer basis, negotiate for or set fees for health care services provided through the system and pay claims for those services.
MEDI-CAL
AB 43 (Monning): MEDI-CAL ELIGIBILITY – Requires the applicable departments transition Medi-Cal to reflect the expanded eligibility requirements of the Patient Protection and Affordable Care Act effective January 1, 2014. Eligibility will include persons who are under 65 years of age, not pregnant, not entitled to, or enrolled for, benefits under Medicare Part A, or enrolled for benefits under Medicare Part B, and whose income does not exceed 133% of the poverty line.
SB 677 (Hernandez): MEDI-CAL RULES – Requires the applicable departments transition Medi-Cal to reflect the Patient Protection and Affordable Care Act effort effective January 1, 2014, including: Changes income standard to Modified Adjusted Gross Income (MAGI). Eliminates asset test. Makes other conforming changes.
AB 1066 (Perez): MEDI-CAL WAIVER FOLLOW-UP & LOW INCOME HEALTH PROGRAMS – Implements the expansion of Medi-Cal as authorized by the Affordable Care Act and by the 1115 Medicaid Waiver. Signed by the Governor on July 13, 2011.
SB 485 (Hernandez): MEDI-CAL – Establishes a pilot program to reduce emergency room use by Medi-Cal eligible beneficiaries.
EASY ENROLLMENT
AB 1296 (Bonilla): STREAMLINING ELIGIBILITY AND ENROLLMENT – Requires the California Health and Human Services Agency to establish a standardized single application form and related renewal procedures for Medi-Cal, the Healthy Families Program, the Exchange, and county programs. Signed by the Governor on October 9, 2011.
AB 714 (Atkins): PRE-ENROLLMENT (HAC Sponsor) – Requires DHCS, MRMIB, FamilyPACT, and other programs as well as some hospitals to provide information about The California Health Benefits Exchange for the purpose of pre-enrolling them to be ready to obtain subsidized coverage in January 2014.
AB 792 (Bonilla): AUTOMATIC ENROLLMENT (HAC Sponsor) – Ensures that Californians can easily sign up for coverage during key life changes. Requires California consumers are provided information about the Exchange upon filing for divorce, separation, unemployment, adoption, or other life circumstances. After 2014, certain insurers and plans must also provide information about those dropping off coverage to the Exchange.
EASY NAVIGATION AND ASSISTANCE
AB 922 (Monning): PROVIDING CONSUMER ASSISTANCE (HAC Co-Sponsor) – Creates an Office of Health Consumer Assistance (replacing the Office of Patient Advocate), responsible for providing outreach and education about health coverage to consumers. Authorizes contracting with community organizations to provide consumer assistance. Signed by the Governor on October 7, 2011.
NEW COVERAGE OPTIONS
SB 222 (Evans/Alquist): MATERNITY SERVICES – Require every individual health insurance policy to provide coverage for maternity services for all insureds covered under the policy. Signed by the Governor on October 6, 2011.
SB 703 (Hernandez): BASIC HEALTH PLAN – Requires the Managed Risk Medical Insurance Board to establish a basic health plan, for Californians between 133-200% of the poverty level, pursuant to the federal Patient Protection and Affordable Care Act.
VALUE FOR PREMIUM DOLLAR
SB 51 (Alquist): MEDICAL LOSS RATIO – Ensures that premium dollars go to patient care rather than administration and profit. Codifies in state law the federal requirement that requires health insurers spend a specified percentage of premium dollars on providing health care, and to provide refunds to patients if those percentages are not met. Signed by the Governor on October 9, 2011.
AB 52 (Feuer): RATE REGULATION – Provides authority to the Department of Managed Health Care and the Department of Insurance to approve or deny increases in health care insurance premiums, co-payments, or deductibles.
STANDARDS FOR COVERAGE
AB 1334 (Feuer): STANDARDIZING BENEFITS – Requires plans and insurers to, commencing July 1, 2012, categorize all products offered in the individual market into five tiers according to actuarial value, as specified, and would require plans and insurers to disclose this value and other information.
AB 154 (Beall): MENTAL HEALTH PARITY – Expand the existing mental health parity coverage requirement for certain health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2012, to include the diagnosis and treatment of a mental illness of a person of any age.
AB 310 (Ma): PRESCRIPTION DRUGS: Requires certain health plans and insurers to cover the costs of outpatient prescription drugs and limits cost sharing to consumers.
ACCESS AND AFFORDABILITY FOR CALIFORNIANS WITH PRE-EXISTING CONDITIONS
AB 151 (Monning): SENIORS GUARANTEED ISSUE FOR MEDI-GAP – Assure that those who previously covered by Medicare Advantage plans have guaranteed issue for Medi-Gap coverage. Signed by the Governor on September 7, 2011.
AB 1083 (Monning): SMALL BUSINESS: REFORMING THE SMALL GROUP MARKET (HAC Co-Sponsor) – Conform 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.
PROTECTIONS FOR WORKERS
AB 59 (Swanson): FAMILY LEAVE – Expands the definition of families to reflect the state’s diversity and allow all families to help their loved ones recuperate from illness.
AB 400 (Ma): PAID SICK LEAVE – Requires employers to provide paid sick leave so that employees can take care of their health without compromising their income or job status.
CONFORMING AND IMPROVING TAX LAW
AB 36 (Perea): DEPENDENT COVERAGE – Modifies the tax code to exclude employer contributions toward dependent coverage (dependents up to age 26) from parents’ taxable income. Signed by the Governor on April 6, 2011.
AB 242 (Perea): TAX CONFORMITY – Provides additional modified conformity to specified provisions of the federal Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 relating to simple cafeteria plans for small businesses, health care benefits of indian tribe members, free choice vouchers, therapeutic discovery project grants, student loan repayment programs, and deduction for self-employment taxes. Signed by the Governor on October 9, 2011.
RAISING REVENUE TO PREVENT CUTS TO HEALTH AND OTHER VITAL SERVICES
SB 116 (De Leon): SINGLE SALES FACTOR – Revises the corporate tax code to mandate universal application of the single sales factor and repeals a corporate tax break enjoyed exclusively by large corporations in order to protect further cuts from health care and other vital services.
AB 1239 (Furutani): PERSONAL INCOME TAX – Reinstate income tax brackets for the highest income earners to address the state’s budget problems.
HOSPITALS
AB 62 (Monning) / SB 7 (Steinberg): QUALITY ASSURANCE FEE – Imposes a Quality Assurance Fee on general acute care hospitals and requires that fees collected be deposited into the Hospital Quality Assurance Revenue Fund in the State Treasury in order to make supplemental payments to specified hospitals.
SB 335 (Hernandez): QUALITY ASSURANCE FEE – Imposes a quality assurance fee to be paid by hospitals, for a specified period which would be used to increase federal financial participation in order to make supplemental Medi-Cal payments to hospitals and pay for health care coverage for children. Signed by the Governor on September 16, 2011.
AB 1360 (Swanson): PHYSICIAN EMPLOYMENT – Authorizes health care districts and clinics owned or operated by health care districts to directly employ physicians and surgeons if the health care district’s service area includes a Medically Underserved Area (MUA) or a Medically Underserved Population (MUP), or has been federally designated as a Health Professional Shortage Area (HPSA).
SB 408 (Hernandez): HOSPITAL LICENSURE – Requires a new license application to be filed when the holder of an existing license changes ownership. VETOED by the Governor on October 9, 2011.
PREVENTION AND WELLNESS
AB 441 (Monning): ACTIVE TRANSPORTATION, HEALTHY COMMUNITIES – Requires that transportation planning include health criteria in order to foster healthier communities.
AB 727 (Mitchell): HEALTHY AND SUSTAINABLE FOOD – Creates nutrition standards to govern the foods purchased for all state departments, agencies, and state-run institutions in accordance with the federal dietary guidelines. Also creates guidelines for sustainable purchasing practices and procedures that encourage purchasing from local vendors, farms, and manufacturers when feasible.
AB 70 (Monning): COMMUNITY TRANSFORMATION GRANTS – Requires the California Health and Human Services Agency to apply for federal grant opportunities available under the Patient Protection and Affordable Care Act and the Healthy Hunger Free Kids Act.
AB 916 (Perez): PROMOTORES – Requires the State Department of Public Health to assess the grants to promote positive health behaviors and outcomes available pursuant to the federal Patient Protection and Affordable Care Act for funding opportunities related to the use of Promotores in medically underserved communities.
SB 616 (De Saulnier): WELLNESS INCENTIVES: Directs the Department of Health Care Services to apply for federal grants for wellness incentives in Medi-Cal.
OTHER
AB 272 (Monning): STREAMLINING REPORTING – Repeals obsolete requirements that various state agencies report to the Legislature, including various requirements of MRMIB, DMHC, and CDI.
STEPS BACKWARDS
SB 122 (Price): ROLLING BACK DEPENDENT COVERAGE – Exempts retiree health plans from requirements under the Affordable Care Act and SB 1088 that mandate insurers to cover dependents up to age 26.
AB 895 (Halderman): PHYSICIAN TAX CREDITS – Provides for tax credits for physicians providing care in acute hospital settings and/or in community clinics.
AB 726 (Morrell): HEALTH SAVINGS ACCOUNTS – Amends the Personal Income Tax Law. provides an exclusion from gross income for moneys removed from a specified savings plan and deposited directly into a health savings account. Waives that penalty tax for early distribution.
AB 854 (Garrick): HEALTH SAVINGS ACCOUNTS – Allow, in accordance with federal tax code, deductions in connection with Health Savings Accounts.
SB 615 (Calderon): BROKERS – Requires any person who solicits, negotiates, or sells health care service plan contracts, specialized health care service plan contracts, Medicare Advantage Plans under Medicare Part C, or Medicare supplement contracts to be licensed as an accident and health agent.
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2010 Legislation
Bills of interest to health care consumer advocates from the 2010 legislative session
Health Access California sponsors, advocates for, and tracks health consumer legislation in Sacramento. To see a fact sheet outlining our current position on the health care legislation we are following, click here: 2010 Legislation Impacting California Health Care Consumers. (Updated – October 5, 2010)
To read the complete text of any bill including amendments, please visit the California Legislature Bill Information website to lookup information by bill number, author, or keywords.
2010 Session Health Consumer Bills:
(AB = Assembly Bill; SB = Senate Bill)
= Support
= Don’t Support
= Stalled
= Watching
COMPREHENSIVE HEALTH REFORM
SB 810 (Leno): CALIFORNIA HEALTHCARE SYSTEM – Would establish the California Healthcare System, a single-payer health care system in the state that would enable all residents to obtain health coverage.
IMPLEMENTING FEDERAL HEALTH REFORM
AB 1602 (Perez): CREATING A NEW EXCHANGE: Would specify the operations of the California Health Benefit Exchange which would be an independent state agency tasked negotiating for the best prices and values for consumers and providing information regarding health benefit products. Signed by the Governor on September 30, 2010.
SB 900 (Alquist): RUNNING A NEW EXCHANGE: Would establish governance of the Exchange by a 5 member board appointed by the Governor and Legislature. The board will serve the public interest of the individuals and small businesses seeking health care coverage through the Exchange. Signed by the Governor on September 30, 2010.
SB 890 (Alquist): TRANSITIONING TO A MORE TRANSPARENT & STANDARDIZED MARKET: Standardizes and simplifies the individual insurance market, so that consumers can understand their coverage choices, make compare based on actuarial value, and have the security that coverage does not have lifetime and/or annual caps. VETOED by the Governor on September 30, 2010.
AB 2287 (Monning): PREVENTION & WELLNESS (HAC Sponsor) – Would implement those elements of federal health reform that provide community transformation grants to promote wellness and prevention. These grants will fund evidence-based, community prevention activities to reduce chronic disease rates and address health disparities.
AB 2345 (De La Torre): COVERING PREVENTIVE SERVICES: Requires insurers to eliminate costsharing for some preventive services such as pap smears, mammograms, other cancer screenings, and immunizations. Signed by the Governor on September 30, 2010.
EXPANDING COVERAGE OPTIONS
SB 56 (Alquist): FACILITATING PUBLIC HEALTH INSURANCE OPTIONS: Would authorize county-organized health plans and other health benefits programs to form joint ventures in order to create integrated networks of public health plans that pool risk and share networks, subject to the requirements of the Knox-Keene Act.isk and share networks, subject to the requirements of the Knox-Keene Act. VETOED by the Governor on September 29, 2010.
SB 1088 (Price): ALLOWING YOUNG ADULTS TO STAY ON THEIR PARENTS’ COVERAGE: Would require group health, dental, and vision plans to allow dependent children to continue on their parents’ coverage through age 26. Signed by the Governor on September 30, 2010.
SB 838 (Strickland): CAL-COBRA EXTENSION – Would require Cal-COBRA health plans provide notice of the availability of an extension of premium assistance for qualified individuals who experience were involuntarily terminated from their job between January 1, 2010, and February 28, 2010 through the federal Department of Defense Appropriations Act. Signed by the Governor on June 3, 2010.
MEDI-CAL AND FEDERAL MEDICAID WAIVER
AB 342 (Perez) / SB 208 (Steinberg): MEDI-CAL WAIVER: The state’s 1115 Medicaid Waiver would draw down up to $2 billion in federal funding to assist our safety net providers to expand coverage to new medically indigent populations. The waiver would also move seniors and people with disabilities to Medi-Cal managed care. The waiver is intended as a bridge between the existing Medi-Cal program and the full access expansion that will happen in 2014 as a result of federal reform. Signed by the Governor on October 19, 2010.
AB 2352 (Perez): ORGAN TRANSPLANTATION ANTI-REJECTION MEDICATION – Would allow a Medi-Cal beneficiary to remain eligible for coverage of anti-rejection medication for up to two years following an organ transplant, unless during that period the beneficiary becomes eligible for Medicare or private health insurance that would cover the medication. Signed by the Governor on September 30, 2010.
AB 2477 (Jones): CONTINUOUS ELIGIBILITY FOR CHILDREN – Removes the requirements for Mid-Year Status Reports for children to allow continuous eligibility for children in teh Medi-Cal program.
INDIVIDUAL INSURANCE MARKET REFORMS
AB 786 (Jones): INSURANCE MARKET STANDARDS (HAC Sponsor) – Sorts health insurance policies into a number of categories, based on benefit comprehensiveness and cost-sharing. Standardized plan categories and terminology enables consumers to better compare plans.
SB 1163 (Leno): PROVIDING SUNSHINE ON RATES (HAC Sponsor) – Would require health plans to provide to the public information about their rate methodology, and show actuarial soundness. Signed by the Governor on September 30, 2010.
AB 2578 (Jones): RATE APPROVAL – Would require approval by the Department of Managed Health Care or the Department of Insurance of an increase in the amount of premium, copayment, coinsurance, deductible, or other charges under a health plan.
AB 2110 (De La Torre): PREMIUM GRACE PERIODS (HAC Sponsor) – Would extend the grace period for premium payments from 10 or 31 days up to 50 days for most plans regulated by the Department of Insurance.
AB 2042 (Feuer): ANNUAL RATE HIKES, ANNUAL CHANGES IN PRODUCT (HAC Sponsor) – Prohibits insurers and HMOs from increasing premiums, cost sharing, or benefits more often than once year. VETOED by the Governor on September 29, 2010.
AB 2244 (Feuer): ACCESS AND AFFORDABILITY FOR CHILDREN WITH PRE-EXISTING CONDITIONS (HAC Sponsor) – Requires guaranteed issue, eliminates all pre-existing condition exclusions, and limits premium increases based on health status, phasing in modified community rating for children under age 19 in the individual market. Signed by the Governor on September 30, 2010.
AB 2470 (De La Torre): REGULATING RESCISSIONS AND MEDICAL UNDERWRITING: Set standards for rescission, the insurance industry’s practice of terminating coverage as if the coverage had never been issued. Signed by the Governor on September 30, 2010.
AB 591 (De La Torre): RATE MORATORIUM – Protects consumers by (1) imposing a 90-day moratorium on rate increases above average increases in the medical care consumer price index; (2) allow such increases if plans apply to DMHC or CDI to justify such increases; and (3) prohibiting insurers from raising rates more than once per 12-month period.
INSURANCE BENEFIT MANDATES
AB 1825 (De La Torre): ENSURING MATERNITY CARE: Would phase-in a requirement that all health plans to cover maternity services. VETOED by the Governor on September 30, 2010.
AB 1600 (Beall): REQUIRING MENTAL HEALTH PARITY: Would require most health plans to provide coverage for the diagnoses and treatment of a mental illness.VETOED by the Governor on September 29, 2010.
SB 1104 (Cedillo): DIABETES DISEASE MANAGEMENT – Would require health plans to provide coverage for the diagnosis and treatment of diabetes-related complications.
INSURANCE MARKET OVERSIGHT AND CONSUMER PROTECTIONS
AB 1521 (Jones): BROKER COMPENSATION (HAC Sponsor) – Would place limits on how health insurance brokers are compensated by insurers.
AB 1759 (Blumenfield): PREMIUM RATE CHNAGES – Would prohibit health insurers from using a change in demographics or enrollment as the basis for a premium rate change during the length of a contract for group coverage.
AB 1826 (Huffman): PAIN TREATMENT PRESCRIPTION DRUGS – Would prohibit an insurer from requiring a patient to use a pain treatment drug other than the one prescribed to them prior to authorizing the treatment prescribed by the health care provider.
PROVIDER OVERSIGHT AND CONSUMER PROTECTIONS
AB 1503 (Lieu): EMERGENCY ROOM PHYSICIAN FAIR PRICING (HAC Sponsor) – Would limit the amount that emergency room physicians and surgeons can charge an uninsured or underinsured patient with income below 350% of the federal poverty level. Signed by the Governor on September 29, 2010.
AB 1653 (Jones): HOSPITAL QUALITY ASSURANCE FEE – Would impose a “quality assurance fee” on all non-exempt general care hospitals as a condition of participation in state health programs, with the funds used to increase Medi-Cal reimbursements to hospitals and for children’s coverage. Signed by the Governor on September 8, 2010.
AB 2787 (Monning): FEDERAL GRANTS FOR STATE OMBUDSMAN PROGRAMS – This bill would establish the Office of the California Health Ombudsman and require the ombudsman to, among other things, educate consumers on their rights and responsibilities with respect to health care coverage, assist consumers with enrollment in health care coverage, and resolve problems with obtaining specified premium tax credits.
AB 2275 (Hayashi): DENTAL COVERAGE: An effort by dentists to prevent dental plans from offering discounts on services that are not covered by the dental plan. The bill lacks consumer input. Signed by the Governor on September 30, 2010.
MRMIB PROGRAMS: HEALTHY FAMILIES PROGRAM AND MRMIP HIGH-RISK INSURANCE POOL
SB 227 (Alquist): FUNDING FOR MRMIP – Creates fee on insurers to support California’s high-risk pool.
Signed by the Governor on June 30, 2010.
AB 1887 (Villines): FEDERAL FUNDING FOR MRMIP – Would authorize MRMIB to apply for federal funding for the purpose of extending the MRMIP program to more applicants. Signed by the Governor on June 30, 2010.
PUBLIC HEALTH, PREVENTION, AND QUALITY
AB 1640 (Evans): BREAST AND CERVICAL CANCER SCREENING – Would express the intent of the Legislature that the demand for the breast and cervical cancer screening program for low-income women be met, and that at least 90-day notification be made to the Legislature before any change in eligibility requirements is made. VETOED by the Governor on September 29, 2010.
SB 1200 (Leno): TIMELY SCHOOL-BASED CARE FOR CHILDREN – Would add timeliness of care for school-age children who must receive medically necessary services during school hours as one of the indicators of timeliness in the timely access to care standards adopted by the Department of Managed Health Care.
AB 542 (Feuer): NO PAY FOR NEVER EVENTS: Creates a process for ending Medi-Cal payments for never events (events that should never happen, such as surgery on the wrong body part), and requires insurers to stop paying for never events. VETOED by the Governor on September 29, 2010.
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2009 Legislation
Bills of interest to health care consumer advocates from the 2009 legislative session
Health Access California sponsors, advocates for, and tracks health consumer legislation in Sacramento. To see a fact sheet outlining our position on 2009 health care legislation, click here: 2009 Session Health Consumer Bills (November 13, 2009)
To read the complete text of any bill including amendments, please visit the California Legislature Bill Information website to lookup information by bill number, author, or keywords.
2009 Session Health Consumer Bills:
(AB = Assembly Bill; SB = Senate Bill)
= Support
= Don’t Support
= Stalled
= Watching
INSURER REGULATIONS Insurance Oversight & Market Reform
AB 786 (Jones): INSURANCE MARKET STANDARDS – Would sort health insurance policies into a number of categories, based on benefit comprehensiveness and cost-sharing. Organization of plans into these categories and standard terminology would enable consumers to better track premium, benefits and cost-sharing, and assist consumers in making comparisons across plans.
AB 1521 (Jones): BROKER COMPENSATION – Would place limits on how health insurance brokers are compensated by insurers.
AB 1218 (Jones): HEALTH INSURANCE RATE APPROVAL – Requires HMOs and health insurer to get approval for increases in premiums and cost-sharing from DMHC and DOI, respectively.
AB 119 (Jones): GENDER RATING – Would prohibit insurers from charging different premium rates based on gender. Signed by the Governor on October 11, 2009.
AB 29 (Price): DEPENDENT COVERAGE – Would allow individuals up to age 27 to remain on a private insurance policy as a dependent, but employers are not required to contribute to the cost of coverage for dependents over 23.
SB 316 (Alquist): CAPPING ADMINISTRATION AND PROFIT – Would set a minimum medical loss ratio – requiring every insurer to spend at least 85 percent of premiums on patient care.
AB 722 (Lowenthal): PRE-EXISTING CONDITION EXCLUSION – Would prohibit individual insurance plans from denying coverage due to a pre-existing condition.
AB 812 (De La Torre): MEDICAL-LOSS RATIO REPORTING – Would require health plans to submit annual reports on their medical-loss ratio to the state, and requires the state to establish uniform medical-loss ratio reporting standards.
SB 92 (Aanestad): OMNIBUS HEALTH REFORM MEASURE – Narrows definition of medical necessity; allows association health plans; Health Savings Accounts for CalPERS, commercial HMOs and insurers, and Medi-Cal; allows sale of health insurance across state lines, voiding state consumer protections and financial solvency requirements; weakens utilization review requirements; eliminates mandates for pap smears, mammograms, childhood immunizations, diabetes supplies and numerous other protections but only for those below 350%FPL; changes Medi-Cal to defined contribution plan, including for persons with disabilities; and numerous other provisions.
AB 326 (Garrick): HEALTH SAVINGS ACCOUNTS – Would allow a tax deduction for health savings accounts to be used with high-deductible health plans.
SB 353 (Dutton): HEALTH SAVINGS ACCOUNTS – Would allow a tax deduction for health savings accounts to be used with high-deductible health plans.
Recissions
AB 2 (De La Torre): INDEPENDENT REVIEW – Would create an independent review process when an insurer wishes to rescind a consumer’s health policy, create new standards and requirements for medical underwriting, and requires state review before plan approval. Also raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history. VETOED by the Governor on October 11, 2009.
AB 730 (De La Torre): POSTCLAIMS UNDERWRITING – Would impose fines on insurers unlawfully engaging in post-claims medical underwriting. VETOED by the Governor on October 11, 2009.
AB 108 (Hayashi): TIME LIMIT – Would impose a 24-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. Signed by the Governor on October 11, 2009.
Benefit Mandates
AB 98 (De La Torre): MATERNITY COVERAGE – Would require all individual insurance policies to cover maternity services. VETOED by the Governor on October 11, 2009.
AB 214 (Chesbro): DURABLE MEDICAL EQUIPMENT – Would require most health plans to offer coverage for durable medical equipment, (e.g. wheelchairs and shower seats).
AB 244 (Beall): MENTAL HEALTH PARITY – Would require most health plans to provide coverage for all diagnosable mental illnesses. VETOED by the Governor on October 11, 2009.
Improved Insurance Options
SB 227 (Alquist): HIGH-RISK POOL – Would require insurers to accept members of the high-risk pool at the rate set by MRMIP or pay a fee used to fund MRMIP. Would also increase the tobacco tax funds dedicated to fund MRMIP.
SB 57 (Aanestad): HIGH-RISK POOL – Allows insurers to sell policies with “riders” that exclude coverage for a medically uninsurable condition. Creates a “rider” pool for applicants. Increase eligibility barriers for MRMIP, deletes cap on cost-sharing, requires MRMIP to include option compatible with Health Savings Accounts, increase the annual benefit limit in MRMIP plans to $150,000, and increase the tobacco tax funds dedicated to fund MRMIP.
HEALTH CARE PROVIDERSTransparency: Cost and Quality Data
SB 196 (Corbett): HOSPITAL CLOSURES – Requires public notice of hospital closure or reduction/elimination of emergency medical services. VETOED by the Governor on October 11, 2009.
Doctor and Hospital Oversight
AB 542 (Feuer): HOSPITAL-ACQUIRED CONDITIONS – Creates regulations around non-payment of hospital-acquired conditions, and bans hospitals from billing patients or insurers for such conditions.
AB 171 (Jones): 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. Signed by the Governor on October 11, 2009.
Hospital Transactions
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. Signed by the Governor on October 11, 2009.
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.
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.
Balance Billing
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.
COVERAGE EXPANSIONMedi-cal
AB 963 (Ammiano): ELIGIBILITY PROCESSES – Would update and streamline Medi-Cal administrative computer systems and enrollment/renewal processes.
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. Signed by the Governor on October 11, 2009.
AB 1037 (Lowenthal): MANDATORY MANAGED CARE FOR SENIORS AND PERSONS WITH DISABILITIES – But only in Riverside and San Bernardino Counties.
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. Signed by the Governor on October 11, 2009.
Unemployed Workers
AB 23 (Jones): Cal-COBRA – Would require insurers to provide notice to individuals eligible for Cal-COBRA that federal funds are available to assist with Cal-COBRA premiums. Signed by the Governor on May 12, 2009.
SB 727 (Cox): Cal-COBRA – Would require a health insurer to offer continuation coverage to a person covered under a group plan if the employer terminates the plan and does not provide a successor group benefit plan to its employees.
SB 796 (Alquist): Cal-COBRA – Would delete the requirement that COBRA coverage must be exhausted in order for an individual to qualify for access to individual health coverage under HIPAA.
Children’s Coverage
AB 1422 (Bass): HEALTHY FAMILIES FUNDING – Restores funding for Healthy Families by re-imposing a voluntary assessment on Medi-Cal managed care plans. It would also increase the premiums paid by families for Healthy Families coverage. Signed by the Governor on September 22, 2009.
SB 1 (Steinberg): UNIVERSAL CHILDREN’S COVERAGE – Expands Healthy Families to 300% FPL and creates a Healthy Families buy-in for children in higher income families.
SB 114 (Liu): FOSTER YOUTH – Would smplify the Medi-Cal renewal process for youth in foster care.
Universal Coverage
AB 1314 (Jones): COMPREHENSIVE COVERAGE – Would require the California Health and Human Services Agency to engage with stakeholders to develop a plan to enact broad-based reforms to the state’s health care system, and to present the plan to the Legislature no later than April 1, 2010.
SB 56 (Alquist): COMPREHENSIVE COVERAGE – Would create the California Health Benefits Services Program for the purpose of expanding cost-effective public health coverage options to the uninsured and purchasers of health insurance.
SB 810 (Leno): SINGLE PAYER SYSTEM – Would establish a single-payer health care system in California that would enable all residents to have health coverage.
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2007-2008 Legislation
Bills of interest to health care consumer advocates from the 2007-2008 legislative session
Health Access California sponsors, advocates for, and tracks health consumer legislation in Sacramento.
To see the final status of health care legislation we followed in 2007-2008, click here.2007-2008 Session Health Consumer Bills:
(AB = Assembly Bill; SB = Senate Bill)
INSURER REGULATIONS
Insurance Oversight & Market Reform
AB 2292 (Garrick) Would allow Californians who have Health Savings Accounts, linked to high deductible health plans, to qualify for state personal income tax deduction.
AB 2842 (Berg) Would protect Californians from insurance agents trying to sell them private Medicare plans through cold calls and bait-and-switch tactics.
SB 972 (McClintock) Would create organizations of small businesses that could purchase unregulated and substandard health insurance products.
SB 1522 (Steinberg): Would sort health insurance policies into five coverage 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.
SB 1440 (Kuehl): Would set a minimum medical loss ratio – requiring every insurer to spend at least 85 percent of premiums on patient care.
SB 1603 (Calderon) Would give discount healthcare plans legitimacy in the state by allowing the Department of Managed Health Care to license and regulate such products.
SB 1669 (McClintock) Would allow insurance companies to exclude coverage of conditions for which an individual policyholder has received medical advice, a diagnosis, treatment, or prescription drugs at any point in the previous 10 years.
Recissions
AB 1150 (Lieu): Outlaws the industry practice of paying bonuses to insurance company employees when they rescind policies, for setting targets for rescinded policies, and/or setting financial goals based on savings on health care claims.
AB 1945 (De La Torre): Would establish an independent DMHC/DOI review process if an insurer wants to rescind coverage, and raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history.
AB 2549 (Hayashi) Would impose an 18-month limit in which insurers are allowed to rescind health policies for fraud once consumers’ applications are accepted.
AB 2569 (DeLeon): Would require insurers to continue to cover family members if one family member rescinded and would also impose duty of honesty and accuracy on brokers who assist individuals in buying coverage.
SB 1379 (Ducheny) Would use a portion of the fines levied on insurers for improper rescissions to subsidize MRMIP and repay loans for physicians working in underserved areas.
Benefit Mandates
AB 1887 (Beall): Would require health plans to provide coverage for all diagnosable mental illnesses.
AB 1962 (De La Torre): Would require all individual insurance policies to cover maternity services.
SB 1198 (Kuehl): Would require group health plans and insurers to offer coverage for durable medical equipment, such as wheelchairs and shower seats.
Improved Insurance Options
AB 2 (Dymally): Would reform the Managed Risk Medical Insurance Program, which provides coverage for “un-insureables” who have “pre-existing conditions.” Efforts would make the high risk pool more affordable and available.
SB 1379 (Ducheny) Would use a portion of the fines levied on insurers for improper rescissions to subsidize MRMIP and repay loans for physicians working in underserved areas.
HEALTH CARE PROVIDERS
Transparency: Cost and Quality Data
AB 2821 (Feuer) Would limit drug company gifts to doctors to no more than $250 annually, require disclosure of non-gift payments made to doctors and require annual public disclosure of any gifts higher than $50.
AB 2967 (Lieber): Would require public reporting of cost and quality by hospitals, HMOs, and others in the health care industry.
SB 1300 (Corbett): Would prohibit confidentiality clauses, which keep secret information on pricing and health care quality from consumers, in contracts between providers and insurers.
Doctor and Hospital Oversight
AB 2146 (Feuer): Would ban providers 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.
SB 1633 (Kuehl): 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.
Hospital Transactions
AB 2400 (Price): Would require public notice before closing a hospital.
AB 2697 (Huffman): Would require so-called “boutique hospitals” to assess their impact on a community’s health system annually, specifically whether they siphon doctors, workers, providers from hospitals caring for less affluent populations.
AB 2741 (Torrico): Would require for-profit hospital sales to undergo health impact analyses to gauge the transaction’s effects on the affected community, health care services, and the community’s public interest.
Balance Billing
AB 1203 (Salas) would prevent emergency departments – which do not have a contract with a patient’s insurance company – from directly billing the patient for treatment provided after a patient has been stabilized. Requires the hospital to seek payment directly from insurers.
SB 981 (Perata) Would prevent emergency physicians – who do not have a contract with a patient’s insurance company – from directly billing the patient, requiring providers to seek reimbursement directly from insurers.
UNDERSERVED COMMUNITIES
AB 1472 (Leno) Would establish the California Healthy Places Act, and require state agencies to work together assess and reduce health disparities in underserved communities.
COVERAGE EXPANSION
Working Disabled
AB 851 (Brownley): Would increases eligibility for those working with disabilities to buy Medi-Cal coverage through the Medi-Cal California Working Disabled Program. Also extends the program, set to sunset September 2008.
Children’s Coverage
AB 1 (Laird/Dymally): Would expand children’s coverage, including the Healthy Families program, to all children in families up to 300% of poverty ($49,800 for a family of three).
SB 32 (Steinberg): Would expand children’s coverage, including the Healthy Families program, to all children in families up to 300% of poverty ($49,800 for a family of three).
SB 973 (Simitian): Would create a statewide public insurer, connecting existing regional, county-based health care plans, to compete with private health care plans and provide consumers more affordable coverage choices.
SB 1168 (Runner): Would allow adult dependent children, who are still covered under their parents’ health plan, to stay on that coverage even if the child takes a medically necessary leave of absence from school.
Universal Coverage
SB 840 (Kuehl): Would establish a single-payer health care system in California that would enable all residents to have health coverage.
SB 1014 (Kuehl) Would create a financing structure to pay for single-payer health care system.
Quality, Affordable Health Care for ALL Californians