The Board did take action on five items, including approval of the previous Board Meeting notes and approval of the 2013/14 Covered California Budget. Additionally, the Board approved a 90 day extension of the Quality Health Plan Regulations (QHP) that had been previously voted on by the Board on November 14, 2012 and approved by the Office of Administrative Law on January 17, 2013. Finally, the Board moved to approve the Covered California Program Regulations, specifically around eligibility and enrollment and the assisters program.
· Pediatric Dental
The presentation on pediatric dental coverage resulted in what was probably one of the more heated discussions items of the day. The Covered California staff announced that “dental is different”. Recent federal guidance does not require all consumers in the Exchange to buy pediatric dental, even though it is one of the ten essential health benefits.
As Health Access and other advocates said in public testimony, this is most unfortunate. It treats pediatric dental as a supplement benefit, not an essential health benefit. It drives up the cost of pediatric dental significantly because only some families will buy dental, creating price spiral upward that will worsen adverse selection.
According to the staff, “any standalone dental plan can be purchased with any Qualified Health Plan” and “every Covered California Health Plan (is) required to partner with a pediatric dental plan.” The Exchange staff said that purchase of pediatric dental would not be required of consumers purchasing in the Exchange but would be required outside the Exchange. Pediatric dental plans and rates will be announced on June 25th.
The goal of the Board is to have the site centers in Rancho Cordova and Contra Costa staffed by 695 people by Oct 1, 2013. The Rancho Cordova site center will be up and running beginning July 1, 2013 on one floor and on August 1, 2013 on another floor. The Contra Costa site center will be up and running beginning August 1, 2013. Because the Contra Costa site center is a county run center, they did not experience any delays due to background check legislation pending in the State Legislature. A site center has not been identified in Fresno, but the goal is to have a site center up and running by November 2013.
The CalHEERS Update and System Demonstration segment of the agenda was also informative in that it was a real live demonstration of what the “user” experience will be beginning in October, 2013.
· Plan-based Enrollment
Other notes of interest:
The small employer health option plans and rates are scheduled to be announced August 1.
The Board would provide webinars on the navigator program, SHOP regulations and health benefit exchange marketing material.
During his Executive Director’s report, Lee noted a press release that was sent out today announcing the Health Exchange’s partnership with the Health Consumer Alliance to expand consumer assistance.
During his Legislative Update, David Panusch went over a handful of bills, but highlighted the passage of the Medi-Cal expansion bill and characterized it as a “historic” moment in time.