HEALTH ACCESS UPDATE
Friday September 9, 2011
KEY HEALTH CONSUMER BILLS NOW ON GOVERNOR’S DESK
Key Measures to Implement and Improve Health Reform Passed CA Legislature;
Governor Brown to Sign or Veto by October 9th
Bills on Governor’s Desk Include:
* AB1296 (Bonilla) on Streamlining Eligibility and Enrollment
* AB922 (Monning), to Improve Consumer Assistance
* SB222 (Evans/Alquist) & AB210 (Hernandez) to Require Maternity Coverage
* SB51 (Alquist) to Implement the Medical Loss Ratio, Requiring Insurers to Devote 80-85% of Premium Dollars on Patient Care, Not Administration or Profit
* ABx1 21 & ABx1 30 (Blumenfield), to Extend “MCO Tax” to Fund Healthy Families
Already Signed by the Governor: AB151(Monning), Guaranteed Issue for MediGap Plans
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The California Legislature ended their session Friday after passing a handful of health consumer protection measures among hundreds of others bills. If signed by the Governor, these health bills will implement and improve some provisions of federal health care reform law, preparing California for a health system of the future.
Health bills now headed to the Governor include crucial consumer protections for Californians, from a requirement that maternity services are covered in all health plans, to a reorganization and expansion of consumer assistance for California patients, to the streamlining of eligibility and enrollment systems so that Californians get the coverage they want and need. Another key bill, implementing the new federal health law, would limit the amount of our health insurance premium dollar that goes to administration and profit, rather than patient care.
Not all health reform-related measures this year advanced to the Governor’s Desk. Notably, high-profile rate regulation legislation, AB52 (Feuer), was held by the author because there was not enough support in the Senate at this time. Other health reform implementation measures–AB714 (Atkins) and AB792 (Bonilla) to easily enroll people into coverage starting in 2014, and AB1083 (Monning) to reform the small group market aligned with federal rules–will also not move forward this year. These “two-year” bills will be considered next year, along with several other measures that will need to be passed next year, to be ready for 2014 implementation of the federal Affordable Care Act.
But some key bills did pass and are now on the desk of Governor Brown. The passage of this legislation would provide real benefit to California consumers, and cement California’s position as a leader in the implementation of health care reform. He has a month, until October 9th, to decide to sign or veto the hundreds of bills on his desk.
Getting Californians Coverage: Two bills sought to reform and streamline the key system to help consumer get enrolled, and get assistance with questions and complaints.
* STREAMLINING ELIGIBILITY AND ENROLLMENT: AB1296 (Bonilla) requires the California Health and Human Services Agency to establish a standardized single application form and related renewal procedures for Medi-Cal, the Healthy Families Program, the Exchange, and county programs. This is a crucial piece of legislation that sets a framework so that millions of Californians gain meaningful and easy access to coverage as the Affordable Care Act is implemented.
* IMPROVING CONSUMER ASSISTANCE: AB922 (Monning) improves the Office of Patient Advocate to provide better assistance to California health care consumers by providing a central, enhanced center to handle questions and complaints, and for them to be triaged to thappropriate agencies, whether regulatory or administrative, state or federal, etc. The bill also transfers the Office of Patient Advocate, and the Department of Managed Health Care, to the Health and Human Services Agency.
Improving Consumer Protections and Insurer Oversight: Two more measures adopting consumer protections that are, or will be, required by the federal Affordable Care Act.
* GUARANTEEING MATERNITY COVERAGE: SB222 (Evans/Alquist) & AB210 (Hernandez) requires that health plans sold in the individual and small group markets, respectively, stop discriminating against women and provide as a basic benefit, maternity care and maternity-related care, starting in July 2012. This would get Californians needed care and prevent them from falling onto taxpayer-funded programs, but also would allow for a smoother phase-in to the federal requirement that maternity be included in an essential benefits package in 2014.
* REQUIRING PREMIUM DOLLARS TO BE SPENT ON HEALTH CARE: SB51 (Alquist) implements the Medical Loss Ration provision of the Affordable Care Act that requires insurers in the large group market to spend 85% of premium dollars on health care and insurers in the small group and individual markets to spend 80% of health care dollars on actually providing health care rather than for administration or profit.
Also Of Interest: Some budget-related bills of interest to health advocates included:
* COVERAGE FOR KIDS, ABx1 21 and ABx1 30 (Blumenfield) are budget trailer bills that would maintain funding for children’s coverage by extending a Managed Care Organization (MCO) tax, which in turn will help bring down federal dollars to fund Healthy Families. These bills also prohibit, for one year, the immediate shift of the Healthy Families population into Medi-Cal, a budget proposal by the Governor that raised some concerns, especially if implemented hastily.
As of this writing, also pending the in Senate late Friday night was SB202 (Hancock) which would, as a policy going forward for ballot measures not yet scheduled, place initiatives on general election ballots in November, rather than primary elections where far fewer Californians vote. The measure also would delay a vote on a “spending cap/rainy day fund” previously placed on the June 2012 ballot by the Legislature. Under the bill, the vote on “spending cap” constitutional amendment, opposed by Health Access California and other health advocates since it would force cuts in key programs, would be pushed back for two years to 2014, given the ongoing budget issues including the need to pay down debt.
For a broader list of legislation introduced this year impacting health care consumers, or a more specific list of this year’s bills related to implementing the Affordable Care Act in California, visit the Health Access California website.