The Assembly Health Committee met for the last time on Tuesday before the July recess and the deadline for bills passing out of policy committees. Our Health Access colleague Nancy Xiong provides an update:
The Committee heard a number of bills that would move healthcare reform forward to full implementation by 2014. California has been the leading pioneer in implementing the Affordable Care Act. Last week’s Supreme Court decision to uphold the ACA was referenced several times in the discussion, as the Committee advanced bills to continue to move forward in making sure that millions of Californians get the health coverage they need.
While several bills had relation to the ACA, two were instrumental for a successful implementation in California:
SB No. 951 (Hernandez) requires health plans to establish Essential Health Benefits (EHB) benchmark plans. This bill would require individual and small group health plans, both inside and outside of the Exchange, to cover essential benefits beginning January 1, 2014. Some of the services in EHB benchmark plans include but not limited to, behavioral health treatment, preventive and wellness services, rehabilitative and habilitative services, and prescription drugs.
Insurers raised concerns that this bill has a definition of “habilitative services” is too broad, as a newer concept. Proponents said that habilitative services are required to be part of essential benefits in the ACA, and while it was not defined in the ACA, there are definitions in Medicaid law and being developed by the NAIC. Assemblyman Nestande asked about the development of whether the 10 essential health benefits will be defined and established by 2014 when the health exchange opens. Hernandez states that the 10 essential health benefits will need be established in 2013, when plans are negotiated to be offered in the Exchange.
SB No. 961 (Hernandez) will implement provisions of the ACA and reform California’s individual insurance market. This bill will largely protect consumers in the individual market operating in the Exchange and outside of the market. The reform will limit which factor plans can use to determine premium rates, eliminate the use of preexisting condition denials or exclusions, and require plans to issue and renew policies for anyone willing to purchase.
Those that support the bill state that it will prevent individuals with pre-existing conditions from being locked to their job in fear of losing their health insurance. Insurers that oppose the bill state that this bill should excatly mirror the federal law by allowing health plans to charge higher premiums rates based on tobacco use–even though proponents argue that such a surcharge would make insurance unaffordable for such patients, and thus deny some the benefit of smoking cessation and other services to deal with their addiction and its impacts.
Both bills passed out of committee, and move on to Appropriations after the recess.
Senator Hernandez and other members thanked Assemblyman Monning in what is likely his last time chairing Assembly Health Committee (he is running for Senate this November). In turn, Assemblyman Monning thanked the Committee staff and others working to improve health care in California.