HEALTH ACCESS ALERT
Monday, April 25, 2011
CALIFORNIA’S EFFORTS TO IMPLEMENT AND IMPROVE HEALTH REFORM MOVE FORWARD AS NEW EXCHANGE BOARD HOLDS ITS FIRST MEETING; KEY BILLS COMING UP THIS WEEK IN LEGISLATIVE COMMITTEES, FROM RATE REGULATION TO STREAMLINING ENROLLMENT
* Exchange Board Began Multi-Year Effort to Create Purchasing Pool by 2014.
* Key Bills Up to Implement New Federal Rules and Consumer Protections in State Law
* Some Seek to Improve Eligibility and Enrollment So More Californians Get Care
* Rate Regulation, AB52(Feuer), Would Allow Denial of Unjustified Rate Hikes
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* Last week’s historic 1st meeting of the Exchange was live-tweeted and blogged by us!
SACRAMENTO–California’s efforts to implement and improve upon the federal Affordable Care Act are moving forward, as evidenced this week with many key bills up in Assembly Health Committee on Tuesday, and in Senate Health Committee on Wednesday. Bills to be considered include measures to streamline eligibility and enrollment to maximize the number of Californians who will benefit from expanded coverage, as well as proposals to place new oversight on insurance companies, from rate regulation to new consumer protections to ensure premium dollars go to patient care.
FIRST EXCHANGE MEETING: Even last week, during a legislative recess, there was progress made with the first meeting of the California Health Benefits Exchange, beginning a multi-year effort to create a subsidized purchasing pool that will offer affordable & available coverage to millions of Californians starting in 2014. As live-tweeted at @HealthAccess, the board members were aware of the importance of their charge, as they began the basic work of starting to look for staff leadership, and in starting an application to draw down the needed federal funds. A full report is available on the Health Access blog.
KEY BILLS UP THIS WEEK: Important legislation to implement and improve upon the new federal health law is being heard in the California legislature. The federal law celebrated its one-year anniversary of enactment last month, and a recent Health Access report detailed how many Californians were taking advantage of the new benefits, options, and consumer protections.
While last year’s legislation put Caifornia ahead of many other states in making health reform a reality for our residents, additional legislation is needed to maximize the benefit for California and Californians, and to ensure a smooth glidepath leading to the full federal health reform implementation in 2014.
RATE REGULATION UP FOR VOTE TOMORROW: The most high-profile bill up this week would give regulators the explicit ability to approve or deny rates. A bill to institute rate regulation over health insurance, AB52(Feuer), which is supported by a range of consumer advocacy organizations, including Health Access California, is currently set to be heard and voted on tomorrow, Tuesday, April 25th, in Assembly Health Committee. Senator Feinstein, who has authored a similar federal proposal, recently came out in support of this state measure.. ACTION ALERT: Call Assembly Health Committee members to urge them to support AB52(Feuer), to protect Californians from unjustified and unreasonable insurance rate hikes.
BILLS TO BE VOTED ON IN COMMITTEES TUESDAY AND WEDNESDAY, THIS WEEK AND NEXT: Health Committees in both the State Senate and Assembly will see a flury of activity this and next week, as dozens of health consumer bills are up for votes before the legislative deadline to pass the measures through policy committees. For a full list of legislation impacting health care consumers, visit our full bill list on the Health Access website.
LEGISLATION ON ACA IMPLEMENTATION: Several of the bills up in the next two days are those specifically related to implementing the Affordable Care Act in California. One big category are bills to ensure that Californians get the care and coverage that they need, through streamlined, simplified eligibility, enrollment, and consumer assistance systems in the state. Another category is a range of bills to implement and provide better consumer protections and insurer oversight. Contact the author of this update, Linda Leu at Health Access (firstname.lastname@example.org), for sample letters on some of these bills or for a list of health reform related bills.
Below are selected measures up in the next week, highlighted from health bills that are intended to implement and improve certain provisions in the federal health reform law and prepare the state for other provisions contained in the law. The full implementation list is regularly updated and can be found at www.health-access.org. (The Health Access website also has a broader bill list of interest for health care consumers.)
** ASSEMBLY HEALTH COMMITTEE ON TUESDAY, APRIL 26th: Selected Health Reform Bills
* AB 43 (Monning) EXPANDING MEDI-CAL: Expands Medi-Cal eligibility to persons under 133% of the Federal Poverty level who are not pregnant, don’t have dependent children, and are under the age of 65, effective January 1, 2014.
* AB 52 (Feuer) RATE REGULATION: Provides authority to the Department of Managed Health Care and the Department of Insurance to approve or deny health insurance rate increases.
* AB 151 (Monning) GUARANTEED ISSUES FOR SENIORS ON MEDI-GAP: Assures that those previously covered by MedicareAdvantage have guaranteed issue for Medi-Gap coverage.
* AB 714 (Atkins) PRE-ENROLLMENT: Requires existing programs such as MRMIB and Family PACT as well as hospitals to provide information about the California Health Benefits Exchange to their members for the purpose of pre-enrolling them into th Exchange to receive subsidized coverage in January 2014.
* AB 792 (Bonilla) AUTOMATIC ENROLLMENT: Ensures continuous coverage through life circumstances such as divorce or unemployment by requiring that consumers receive information about the Exchange when filing for divorce, unemployment, etc. Would also require insurers to provide this enformation to individuals dropping off coverage after 2014.
** SENATE HEALTH COMMITTEE ON WEDNESDAY, APRIL 27th: Selected Health Reform Bills
* SB 51 (Alquist) MEDICAL LOSS RATIO: Ensures that premium dollars go to patient care rather than administration or profit. Requires (per the Affordable Care Act) that insurers who do not spend the specified percentage of premium dollars on patient care provide refunds to patients.
* SB 155 (Evans) MATERNITY CARE: Phases in maternity care benefit mandate by requiring new health insurance policies submitted after January 1, 2012 to provide coverage for maternity services. Federal law will require coverage of maternity care starting in 2014.
* SB 222 (Alquist) COUNTY-RUN HEALTH INSURANCE OPTIONS: Allows counties, county special commissions, or county health authorities that govern, own, or operate a local initiative health plan or county-organized health system to form joint ventures to offer health plans to individuals and groups.
* SB 677 (Hernandez) MEDI-CAL RULES: Implements changes to Medi-Cal required by the ACA including eliminating the asset test and changing income standard to MAGI, effective January 1, 2014.
* SB 810 (Leno) SINGLE-PAYER UNIVERSAL HEALTH CARE: Establishes a universal single-payer health care system in California, where all residents would get specified health benefits. Sets up a California Healthcare Agency to manage such a system, and a California Healthcare Premium Commission to recommend needed financing.
** ASSEMBLY HEALTH COMMITTEE ON TUESDAY, MAY 3rd: Selected Health Reform Bills
* AB 1083 (Monning) REFORMING THE SMALL GROUP MARKET: Conform and phase-in new insurance market rules for small businesses, particularly so that small employers don’t get additional premium spikes based on the health of their workforce.
* AB 1334 (Feuer) STANDARDIZING BENEFITS: Requires plans to categorize all products offered in the individual market into five tiers according to the actuarial value and would require disclosure of this and other information.