Dr. Pan’s bill, AB314, addresses a loophole in the Affordable Care Act that exempts self-funded student plans from some of the important consumer protections of federal health reform. Notably, there is no prohibition on annual or lifetime benefit caps, meaning students that have high health care costs could see their insurance “run out” once the plan has paid a certain dollar amount toward their care. This is exactly what happened to Kenya Wheeler, a UC Berkeley graduate student who was diagnosed with cancer. Wheeler was part way through his chemotherapy when UC’s student health plan stopped paying for his health care because he had reached his $400,000 lifetime limit. Students at the University of California represent two-thirds of all students in the country impacted by this loophole. Representatives from the UC System testified that they are not opposed to lifting lifetime limits in the student health plans, and are currently considering raising premiums in order to do so. While it would be nice for the University to make this change without legislation, that would also mean they would be free to change their minds at any time, and that they get to choose which provisions of the ACA they comply with. AB314 passed out of Assembly Health Committee on a 13-4 vote, it will be heard next in Assembly Appropriations Committee.
Today the Senate Health Committee met in Special Session to consider SBX1 3 (Hernandez). This bill creates a “Bridge Plan” that would cover people who, due to changes in income, might fluctuate or churn between being eligible for Medi-Cal and Covered California. The plan would allow individuals and families who move back and forth to stay on the same plans and keep the same providers in order to provide more continuity of care. The plans would use safety net providers and Medi-Cal managed care plan. The intent of the bill is also to provide more affordable options for individuals between 138 and 200% of the federal poverty level, the lowest income bracket eligible for Covered California, as many advocates are concerned that commercial plans sold in the exchange will still be too expensive. Though many advocates still have concerns over the details of the bridge plan and proposed amendments, there overwhelming support for moving this concept forward. The bill had no opposition and passed out of committee with unanimous support.