Week In Review, at Covered California, the Budget, at the Bureaucracy…

Tuesday, May 28, 2013

WEEK IN REVIEW: Major Developments in the Implementation of Health Reform

  • Covered California Announces Health Plans and Rates
  • Appropriations Committees in the Assembly and Senate Move Key Legislation Forward
  • Senate Budget Committee Votes to Restore Medi-Cal Dental Benefits
  • THIS WEEK: Key Bills Up For Floor Votes

Last week in Sacramento was jam-packed with big news on health policy, the implementation of the Affordable Care Act, and decisions and announcements of interest for health care consumers. The Legislature moved key bills through its process, considered the importance of state safety-net programs when regarding the state budget, and announced premiums and plans in the new exchange, Covered California.

Thursday morning, Covered California announced the thirteen plans that were awarded contracts to serve consumers in the new health insurance marketplace starting in 2014. In all of the 19 designated regions, there are at least three and as many as six plans that will be offering coverage, and consumers can start to look at plans and rates by downloading the Plans and Rates Booklet from the Covered California website.

The plans who became qualified health plans included the four biggest insurers in the individual market, as well as regional plans and new entrants from the Medicaid managed care market. What got significant national attention was that the rates were significantly below what was predicted.
Thursday afternoon the Covered California Board met for their regularly scheduled meeting. The board heard updates on the Qualified Health Plans and Rates, the marketing and outreach plan, assisters, and background checks for individuals handling personal information.

Last week, Appropriations Committees in both houses released a selection of health consumer bills from their suspense files this week, allowing them to move forward for floor votes this week. These are the bills, largely supported by consumer advocates, that are up for floor votes this week, and for which floor alerts and letters of support are encouraged:

Senate Bills that Passed Out of Appropriations:
SB509 (DeSaulnier) Authorizing background checks for employees of the Exchange
* SB639 (Hernandez) Implementing the Affordability Protections of the Affordable Care Act and limiting out of pocket costs to consumers
SB800(Lara) Facilitates transitioning individuals enrolled in state health programs to Covered California
* SB353 (Lieu) Protects limited English proficient consumers from deceptive marketing by requiring plans to provide information in languages they market in, and allowing the Department of Insurance to Review and Approve marketing materials

Assembly Bills the Passed Out of Appropriations:
AB191 (Bocanegra) Makes Medi-Cal recipients categorically eligible for CalFresh
AB361 (Mitchell) Establishes Health Homes for “frequent flyers”
AB617 (Nazarian) Establishes an appeals process for consumers using the Exchange
* AB880 (Gomez) Penalizes large employers of low wage workers for shifting the responsibility of providing health care coverage to the tax payers.
AB900 (Alejo) Restores a 10% provider rate cut to certain Medi-Cal providers
AB975 (Wieckowski) Increases requirements for nonprofit hospitals to provide community benefits
AB1263 (Perez) Establishes an interpreter services program for Medi-Cal.

Unfortunately bills that did not move forward include the two revenue measures that Health Access is supporting to fund health programs, but these bills can move forward on a different schedule. They include a tobacco tax, SB768 (De Leon), and a sugar-sweeted beverage tax, SB622 (Monning). Another measure, SB189 (Monning) on instituting rules for the use of wellness incentives, stalled for the year.

Bills must pass out of their house of origin this week, by May 31, 2013, if they are going to move forward this year. So the bills that moved forward will be voted on next week on the Floor. If you would like to support these measures moving forward, floor alerts should be sent as soon as possible.

Additionally, the bill to encourage employers to offer coverage to their lower-wage workers, AB880(Gomez), requires a two-thirds vote, and we would especially appreciate support for this important bill. Legislative visits are planned for May 28, 29, and 30th. Please contact Linda Leu at lleu@health-access.org if you can participate.

Health Access California is a sponsor of two key bills crucial to the smooth roll-out of the Affordable Care Act SB539(Hernandez), to put in place standards on cost-sharing in and out of the Covered California exchange, and SB353(Lieu), to prevent deceptive marketing, especially to non-English speaking consumers. Sending floor alerts and making calls in support would be appreciated.


Budget committees and subcommittees have been meeting all week to consider the Governor’s proposed May Revision and other budget proposals.

The biggest news is both the Assembly and Senate have adopted the Medi-Cal expansion under the Affordable Care Act, which would provide coverage to over one million Californians around or below the poverty level. 

Friday afternoon the Senate Budget Committee approved a proposal to restore Medi-Cal adult dental benefits that were eliminated along with several other “optional benefits” in the 2009-2010 budget.  The Senate Budget Committee unanimously approved a full restoration of dental coverage for adults with Medi-Cal coverage. 

Because the Assembly Budget Committee did not act on this proposal, the Budget Conference Committee will decide on the matter next week when it meets to reconcile the actions of the two houses.

The Senate has also approved some other mental health services for funding beyond the Governor’s budget. The Health and Human Services Network and many others have suggested targeted restorations of other key programs, including of Medi-Cal provider rates–which are facing a 10% cut pending a lawsuit filed a few years ago, and which lost on appeal on Friday.

Another item of significant discussion in the Senate is the debate over funding for public hospitals, clinics, and other county public health services. As more Californians are covered, the Governor has sought to redirect $300 million and eventually up to $1.3 billion from the county safety-net and public health programs. Counties argue the Administration seeks too much money, too fast, and health advocates want to prevent money from taken prematurely, and rather should be tied in a formula to the remaining uninsured.

The debate over the budget, and particularly the safety-net, and whether California will ensure there is a medical home for the remaining uninsured, is expected to intensify in the next week.

Health Access California promotes quality, affordable health care for all Californians.