Appropriations Passes Key Bills; Floor Votes This Week!

HEALTH ACCESS ALERT
Monday, May 30, 2011 * Memorial Day Edition

RATE REGULATION & OTHER KEY HEALTH REFORM IMPLEMENTATION BILLS PASS HEALTH COMMITTEES IN CALIFORNIA ASSEMBLY AND SENATE

* Heavily Debated Rate Regulation Measure, AB 52 (Feuer), Goes to Vote This Week
* AB1083 (Monning) on Small Buisness Coverage Passes Assembly Floor Vote
* Other Key Bills on Eligibility, Enrollment, and Other Issues Face Floor Vote This Week

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Important health legislation heads for crucial floor votes this week, after being passed in key California Senate and Assembly Appropriations Committees on Thursday and Friday of last week. Bills have until this Friday, June 3rd, to be passed out of one house of the legislation, or they are stalled for the year.

Also last week, Budget Subcommittees on Health in both legislative houses reviewed the Governor’s May Revision of the California Budget, including a much-discussed proposal to eliminate the Managed Risk Medical Insurance Board and shift 900,000 children from the Healthy Families Program to Medi-Cal. The two committees agreed to the shift in concept, but adopted different timelines and transitions that will need to be reconciled in the weeks to come. More about the delibereations on the California budget will be reported on the Health Access blog.

But the big focus this week is on legislation, as both the Assembly and Senate face a deadline to pass their bills in order for them to proceed to the next house. The Appropriations Committee passed many–but not all–of the measues related to implementing and improving health reform, sending them to floor votes.

DEBATE ON RATE APPROVAL

The most debated measure, by far, was AB52 (Feuer), the bill to give state regulators the authority to reject unjustified rate increases. The bill, strongly supported by consumer and community groups, but opposed by insurers, caused an unusual discussion in Assembly Appropriations. While Chairman Fuentes and some members urged the committee to focus on simply the General Fund implications of the bill for the purposes of committee, other members were withholding their votes on making policy amendments as a condition of a vote out of Appropriations. Assemblymembers Calderon and Solorio pushed hard for the author to accept amendments, and while Feuer expressed a desire to work with them on language, he was hesitant to accept an amendment on the spot without more thoroughly exploring the potential impact. Only when an absent member returned to the committee were there enough votes to pass the bill, with Calderon and Solorio voting against the bill, and Assemblymember Hall abstaining. AB52 moved out of committee with the minimum 9 votes required. After some amendments to address concerns of the opposition and some Assemblymembers, AB52 will be heard on the Assembly floor this week.

ALERT: Please continue to contact Assemblymembers and urge their support on this critical consumer protection, AB52(Feuer), to allow state regulators to reject unjustified rate increases.

BILLS MOVING FORWARD

Assemblymember Fuentes opened the Appropriations suspense file on Friday with some opening statements setting the context for the day’s considerations. He said the both the number of bills before the committee and the total dollar amount of those bills were at a record low, but that in spite of the state’s fiscal situation, the committee would be recommending moving 62% of the bills forward in an effort to “keep ideas, hope, and creativity alive.”
He also said that his committee would be holding all benefit mandate bills until January in anticipation of federal guidance on the Minimum Essential Benefits Package, a position that the Senate Health Committee has asserted earlier in the session. That meant that the Assembly Appropriations Committee held AB154 (Beall), on mental health and substance abuse treatment coverage, and AB185 (Hernandez), on maternity coverage. (A similar bill on maternity coverage, SB155 by Senator Evans, is still active on the Senate side.)

Bills Moving to the Assembly Floor:

* AB43 (Monning) Expanding Medi-Cal eligibility to adults without dependent children up to 133% of the Federal Poverty level, with allowance for DHCS to phase in expanded eligibility.
* AB52 (Feuer) Giving regulators at the Department of Insurance and the Department of Managed Health Care the authority to reject unreasonable and unjustified rate increase proposed by insurers.
* AB242 (Perea) Conforming the state tax code to implement the Affordable Care Act.
* AB714 (Atkins) Seeking to pre-enroll Californians into coverage so they can take advantage of federal subsidies when they become available on January 1, 2014.
* AB792 (Bonilla) Providing automatic notification of Exchange eligibility upon specified life changes.
* AB922 (Monning) Consolidating and improving health consumer assistance programs.
* AB1296 (Bonilla) Streamlining eligibility and enrollment for Medi-Cal and other public programs.
* AB1334 (Feuer) Putting in place new requirements for disclosure and standardization of benefits offered by health plans.

Bills Moving to the Senate Floor

Earlier in the week, the Senate Appropriations Committee also released many bills, but held others. One of the bills held was SB677 (Hernandez), to conform Medi-Cal to the new eligibility rules under the ACA starting in 2014. That bill will be available to move January of next year. Other bills to be voted on the Senate floor include:

* SB51 (Alquist) Implementing the Medical Loss Ratio requiring that 80 or 85% of premium dollars be spent on health care.
* SB222 (Alquist) Authorizing local, county-based health plans to form regional joint ventures.
* SB155 (Evans) Requires insurers to include maternity coverage in plans sold on the individual market.
* SB703 (Hernandez) Creates a Basic Health Plan for Californian adults between 133% and 200% of the federal poverty level.

AB1083 PASSES ASSEMBLY

One bill that already passed the Assembly floor on Friday was AB1083 (Monning), a bill to conform California law to the requirements of the Affordable Care Act related to the small group insurance market. The bill would help small businesses have security and stability with their health insurance by giving them information about the Exchange, holding rates constant for 12 month periods, and prohibiting underwriting. Oddly, the debate about the bill had little to do with the substance, with six GOP Assemblymembers using the opportunity to attack the Affordable Care Act and health reform in general. Comments from members invoked other countries, ranging from Cuba to Canada and back, but with few exceptions, barely touched on the impact on small businesses. The bill passed the Assembly floor on a party line vote.

NEXT STEPS

More advocacy is needed to help these bills pass floor votes next week and then to move through the second house in the coming weeks.

Contact the author of this update, Linda Leu at Health Access (lleu@health-access.org), for more information on these bills or for a list of health reform related bills.

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