HEALTH ACCESS UPDATE:
Wednesday, February 13, 2013
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SPECIAL LEGISLATIVE SESSION TO HEAR BILLS ON MEDI-CAL AND INDIVIDUAL INSURANCE MARKET REFORMS NEXT WEEK
* First Special Session Hearings Next Week, Health Committees in the Senate and Assembly
* AB/SB x1 1 Would Expand and Streamline Medi-Cal
* AB/SB x1 2 Would Ban Pre-Existing Condition Denials & Reform Individual Insurance Market
* Deadline for Support letters TODAY and THIS WEEK
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Next week, the California Legislature will begin hearing legislation being considered as part of the Special Session to implement the Affordable Care Act. Last month, Governor Brown’s proclamation on the Special Session called for key health reform legislation, including bills to expand and streamline Medi-Cal, and to provide new consumer protections in the individual insurance market.
Bills in the special session will operate on a faster timeline, and once passed and signed, go into effect in 90 days after the session, rather than waiting until January 2014 for their enactment, as would legislation in the normal session.
The schedule for these bills to be considered in the policy committee in the first house is:
Assembly Health Committee
Tuesday February 19, 2013 1:30pm, Room 4202
ABX1 1 Medi-Cal Eligibility
Letters Due ASAP
ABX1 1 Medi-Cal Eligibility
Letters Due ASAP
Assembly Health Committee
Wednesday February 20, 2013 10:00am, Room 4202
ABX1 2 Individual Insurance Market
Letters Due Wednesday February 13
Wednesday February 20, 2013 10:00am, Room 4202
ABX1 2 Individual Insurance Market
Letters Due Wednesday February 13
Senate Health Committee
Wednesday February 20, 2013 1:30pm, Room 4203
SBX1 2 Individual Insurance Market
Letters Due Wednesday February 13
Senate Health Committee
Wednesday February 27, 2013 1:30pm, Room 4203
SBX1 1 Medi-Cal Eligibility
Letters Due Wednesday February 20
The two topics of reforming Medi-Cal and the individual insurance market, which will be tackled in the upcoming hearings, will increase access and security for millions of Californians. Health Access California encourages letters of support for this legislation.
Key Medi-Cal Issues
The expansion of Medi-Cal made possible through the Affordable Care Act could mean two million more Californians become eligible for the program. Additionally, federal law requires simplification and streamlining that will help new and already eligible individuals get and stay enrolled more easily. Some important changes from this legilation that we look forward to include:
- Expanding Medi-Cal to low-income adults without children at home.
- Setting the benefit standard that will be covered for the newly-eligible.
- Self-attestation of age, family size, income, and residency to be verified electronically through the new federal hub.
- Elimination of the asset test to simplify the application process and encourage savings.
- Incorporating income disregards for child care and other costs.
- Shifting to 12-month coverage to align with Exchange open enrollment.
The bills are expected to move through the committees in the first legislative house without amendment, with the expectation of negotiations for changes occurring in the second house. The Brown Administration has proposed significant amendments to the Medi-Cal bills currently in print, including ones that would maintain some administrative and paperwork barriers, and would shift some Californians from Medi-Cal to Exchange coverage with more cost-sharing.
Key Individual Market Issues
Traditionally, individuals who have purchased insurance on their own in the individual market have paid the highest prices and had the fewest consumer protections. These bills ban denials for pre-existing condition and otherwise take important strides toward changing that, but some issues remain:
- SBX1 2 and ABX1 2 prohibit insurers to charge more based on health status, and limit how much more insurers can charge based on age, geography, and family composition.
- The bills provide individuals guaranteed access to coverage only during open enrollment periods, as described by the federal regulations. SBX1 2 and ABX1 2 conceed to federal regulation allowing open enrollment periods but end lock-in, thus allowing consumers to change carriers and products.
- The bills defines the number and contours of the geographic regions in California. Consumer advocates are seeking a smaller number of larger regions, for more transparency for consumers and less opportunity for redlining by insurers.
- Only annual rate increases will be allowed, so consumers will be able to plan their annual expenses for health coverage, without the constant fear of mid-year rate hikes.
- An ongoing concern are the grandfathered plans and closed block plans now used by 800,000 Californians that won’t benefit from the consumer protections required by the Affordable Care Act.
Consumer and community groups are seeking letters this week, and turnout to the hearing next week. Voices on behalf of consumers are crucial as the Legislature begins to consider these important changes to the state’s health care system.
For more information or sample letters, contact the author of this update, Linda Leu of Health Access, at lleu@health-access.org.
Health Access California promotes quality, affordable health care for all Californians.