HEALTH ACCESS UPDATE: Monday, April 23, 2012

BUSY WEEK AHEAD IN CALIFORNIA HEALTH REFORM IMPLEMENTATION

LEGISLATIVELY AND ADMINISTRATIVELY

* Health Committees pass major bills to set an essential health benefits standard, reform the individual health insurance market, and more.

* Legislative committees head into deadline week with other health reform implementation bills pending, including bills to cap out-of-pocket costs, and prevent deceptive marketing.

* Department of Health Care Services briefs stakeholders on Medicaid waiver, Low-Income Health Programs, eligibility and enrollment, and other health reform implemention efforts.

* Health Benefits Exchange holds Thursday board meeting, with a focus on small business.

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This upcoming week showcases the diversity of work being undertaken by California to implement and improve the federal Affordable Care Act, both legislatively and administratively.

KEY BILLS PASSED: In the last few weeks, the Assembly and Senate committees have passed key bills related to health reform, including two to set a standard for essential health benefits for health insurance, and two others to reform the individual insurance market and ban the practice of denying care to those with pre-existing conditions.

Health Access’ blog (http://blog.health-access.org) features full reports on each of the past several hearings of Assembly and Senate Health Committees: in March in the Assembly, and in the Senate, in April when the committees passed the essential health benefit bills, and also legislation on wellness programs (in the Assembly) and bills to streamline enrollment for health and human services (in the Senate), and finally last week, with the individual market and other bills in the Assembly, and then in the Senate.

In addition, the blog also has a report on last Monday’s Assembly Budget Subcommittee on Health, which heard the Governor’s proposal on the future of the Healthy Families. The committee did vote to approve only the portion of the proposal to directly implement health reform, approving a shift of those children at or under 133% of the poverty level from Healthy Families into Medi-Cal. Other issues were tabled.

DEADLINE WEEK: Health Committees will be busy this week, the final week for bills that were introduced in 2012 to pass out of the first policy committee, by April 27th.

Related to health reform implementation are bills like AB1800(Ma), to put in place the ACA’s cap on out-of-pocket costs and other consumer protections, pending in Assembly Health Committee on Tuesday. Another measure of strong interest is SB1313(Lieu), to prevent deceptive marketing practices, up for a vote in Senate Health Committee on Wednesday. Several other measures–including ones that raise concerns and even opposition from consumer advocates–are also pending.

A list of the many bills that are pending to fulfill the promise of the federal health reform is available on the Health Access website, including those that have already advanced part-way through the legislative process last year.

DHCS AND EXCHANGE MEETINGS: The work of health reform implementation is not just in the legislature–in many areas, the main action is administrative, at the Department of Health Care Services and the Health Benefits Exchange, as well as elsewhere. Stakeholders, including health, consumer, and community groups, will get public briefings this week on the progress of health reform in California

The Department of Health Care Services has expanded the scope of their Stakeholder Advisory Committee, originally focused on the Medicaid waiver, to include all aspects of health reform implementation. The Committee meets nearly all day Monday, April 23rd, with briefings on Low-Income Health Programs, the transfer of seniors and people with disabilities into managed care, eligibility and enrollment , and DHCS’ relationship with the Exchange. Meetings are public, with a limited opportunity for public comment at the end.

The Exchange will have its own board meeting and forum for providing public updates on Thursday, April 26th, and accepting public comments, both in person and over the phone/webcast. On the agenda includes an update on Exchange planning, and a more in-depth review of the development of the small business health exchange. Meetings are public.

Here’s a quick preview of the upcoming week:

Monday, April 23rd, 10:00am-3:30pm

* Department of Health Care Services, Stakeholder Advisory Committee

Sacramento Convention Center

Public listen-only call in number: 1-877- 953-7991; Participant Code: 6532559

* The agenda includes reports on Medicaid waiver and health reform implementation issues, including targeted discussions on presumptive eligibility and provider gateways, Low-Income Health Programs, and transitions seniors, people with disabilities, and dual-eligibles into managed care.

Tuesday April 24, 1:30pm

* Assembly Health Committee

Meetings are held in Room 4202 of the State Capitol.

* Among the pending bills is AB1800 (Ma), sponsored by Health Access California and the MS Society, to limit cost sharing for consumers, and creates a single deductible so that consumers do not have to meet separate deductibles for health care, pharmacy, etc.

Wednesday April 25, 1:30pm

* Senate Health Committee

Meetings are held in Room 4203 of the State Capitol.

* Among the pending bills is SB1313 (Lieu), sponsored by California Pan-Ethnic Health Network, California Immigrant Policy Center, and Consumers Union, which seeks to prevent efforts to mislead consumers, as health care reform brings more options to consumers.

Thursday, April 26, 12:30pm open session

* Health Benefits Exchange, Board Meeting

Employment Development Department, 722 Capitol Mall

* The meeting is webcast. The agenda includes a reports on personnel, legislation, contracting, federal exchange regulations, and overall Exchange planning. There will also be a more specific panel of presentations on the planning for the small business Exchange.

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