Legislature Reconvenes: Big Committee Votes Up in April

HEALTH ACCESS ALERT: Monday, April 6, 2015


* Key bills sponsored by Health Access California would prevent unfair out-of-pocket costs for consumers, including SB137(E. Hernandez) to ensure accurate provider directories; AB248(R. Hernandez) to prevent substandard employer coverage; AB339(Gordon) on limiting extreme cost sharing for specialty drugs; AB533(Bonta) to prevent surprise out-of-network provider bills from in-network facilities; and AB1305(Bonta) to limit individual deductibles in family coverage. SUPPORT LETTERS DUE ASAP.

* Bill List available on Health Access’ legislative portal, including other key priority support bills like SB4(Lara), to cover Californians without regard to immigration status, and several bills to oppose.

* WEBINAR THIS THURSDAY APRIL 9TH at 11AM ON COUNTY INDIGENT HEALTH CARE: Register for this overview of Health Access’ recent report on “Reorienting the Safety-Net for the Remaining Uninsured: County Indigent Care Programs After the ACA.”


The Legislature reconvenes today after Spring break, with many key health bills up for committee hearings and votes through the end of April. As California continues to implement and improve upon the Affordable Care Act, legislators will consider patient protections to prevent consumers from facing unfair out-of-pocket costs, and other key health reforms.

The beginning of May is the deadline for legislation to pass out of policy committees, and the health committees will be very busy with bills this week through the end of the month.

THIS WEEK: This Tuesday, Assembly Health Committee, chaired by Assemblymember Rob Bonta, will meet to discuss many bills, including AB248 (Hernandez), which is a Health Access sponsored bill which would prohibit sale of subminimum coverage by insurers to large employers. Another bill of interest is AB389 (Chau), sponsored by the California Pan-Ethnic Health Network, which would require a general acute care hospital to post its policy for providing language assistance services to limited-English proficient (LEP) individuals on their website. This bill would also require hospitals to submit electronically their language assistance plans to the Office of Statewide Health Planning and Development (OSHPD) and would require both OSHPD and the Department of Public Health (DPH) to post the hospital language assistance policies on their website. The committee will also discuss AB763 (Burke) which would raise the income level of the Aged and Disabled Medi-Cal program (A&D program) to 138% FPL, creating a “brightline” of income eligibility and parity for elderly and disabled Medi-Cal beneficiaries with other adults.

On Wednesday, the Senate Health Committee, chaired by Senator Ed Hernandez, will meet to take up SB140 (Leno) which would change the definition of tobacco to include e-cigarettes. Senator Wolk’s bill on end of life treatment and Senator Pan’s bill on vaccinations will also be up for consideration by the Senate Health Committee on Wednesday.

For more information on other bills of interest to health care advocates, including upcoming hearing dates, please view our Health Access Bill Matrix at the following link: http://www.health-access.org/legislation-budget/legislation/legislation-2015.html 

PREVENTING UNFAIR OUT-OF-POCKET COSTS: A particular focus for legislators and consumer advocates this year is out-of-pocket costs. Some practices by providers and health insurers unfairly burden patients with unmanageable cost-sharing, interfering with access to care people need.

As the statewide health care consumer advocacy coalition, Health Access California is sponsoring a package of bill that protect covered patients from unfair charges. For many patients, going out-of-network is prohibitively expensive. Two bills will prevent people from racking up out-of-network bills unwittingly: SB137 to create better standards for provider directories so folks know which doctors are in-network and which are not; another, AB533, to prevent out-of-network charges when a patient goes to an in-network hospital, lab or imaging center. Both are up next week in committee–meaning letters of support are due early this week.

Other bills include follow-up legislation from last year, AB339, which places limits on cost-sharing tied to specialty drugs, and another (AB248 mentioned above) which prevents large employers from offering substandard or ‘junk’ coverage that leaves workers exposed to most of the cost of care. A final bill, AB1305, would ensure that individual patients would not have to pay more than their out-of-pocket maximum, even if they are in a family plan.

Here is a list of the Health Access California sponsored bills that deal directly with the costs consumers directly bear:

SB137 (E. Hernández) AccurateProvider Directories: Standardizes provider directories and has more oversight on accuracy so people know whether their doctor and hospital are in network when they shop for coverage, when they change, or when they try to use their coverage to get care. Co-sponsored with Consumers Union and CPEHN.

AB248 (R. Hernández) Minimum Value Coverage: Prohibits sale of subminimum coverage by insurers to large employers. Such plans put workers in a double bind: with unmanageable costs for uncovered care ; and because they took up that coverage, they are automatically ineligible for premium subsidies through Covered California.

AB339 (Gordon) Prescription Drug Cost Sharing: Requires insurers to cover medically necessary prescription drugs, including those for which there is no therapeutic equivalent; Prohibits placing most or all of the drugs to treat a condition on the highest cost tiers of a formulary; Requires formularies to be based on clinical guidelines and peer-reviewed scientific evidence; and more.

AB533 (Bonta) Surprise Bills: Protects patients from “surprise” bills from out-of-network doctors when they did the right thing by going to an in-network hospital or imaging center or other facility. The bill would ensure that such a consumer only has to pay the in-network cost sharing.

AB1305 (Bonta) Limitations on Cost Sharing in Family Coverage: Ensures that an individual patient faces the ACA-set individual out-of-pocket maximum (now $6350), even if they are in a family plan (which has an overall family out-of-pocket max of $12,700). If it’s just one person in the family that got sick, they shouldn’t be penalized for being in a family plan rather than an individual one.

Health Access California is supporting and opposing other key bills, listed here on our website, along with fact sheets and sample letters.

COUNTY INDIGENT CARE PROGRAMS: Tomorrow, Tuesday morning, the Fresno County Board of Supervisors will vote on the future of their indigent care program, after more than a year of debate and discussion. Health Access will report on that, and developments in Sacramento and other counties about their health care safety-net, when we present on our recent report, “Reorienting the Safety-Net for the Remaining Uninsured: Findings from a Follow-Up Survey of County Indigent Health Programs After the Affordable Care Act.” at a California Endowment-sponsored webinar this Thursday, April 9th at 11am. You can register at this link.