Measure Protecting Consumers From High Out of Pocket Costs Passes Assembly Health

Assembly Health Committee considered AB1800 today, a bill by Assemblymember Ma, which would help cap health care costs for ten million Californians with insurance, who are going into debt and facing tough economic choices between health care and costs of daily living.  Over 1.9 million Californians paid $3 billion dollars above and beyond their out of pocket maximums in 2011 alone. 
Melanie Rowan, a resident of San Francisco, spoke about what this has meant to her family.  Ms. Rowan suffers from Multiple Sclerosis, and just one medication she needed to maintain her functions of daily life and care for her family cost her over $800 per month.  Ms. Rowan spoke of going into credit card debt in order to feed the “bottomless pit of health care expenses” and living in relentless fear of fluctuating costs and uncertainty about when she would ever be able to dig her way out of debt.  This bill will implement limits on out of pocket costs that are part of the Affordable Care Act.  Further, the bill provides consumers with a better understanding of how much their insurance plan will require them to pay out of pocket by consolidating deductibles into one single deductible.
In urging support from Committee members, Assemblymember Ma called affordability an essential part of the momentous health care reform legislation.  No longer should Californians have to choose between paying for groceries to feed their families and the care necessary to preserve their own health.
AB1800 (Ma) passed with 12 votes and moves on to consideration by the Assembly Appropriations Committee.

Another health reform-related bill that was discussed was Assemblymember Gordon’s bill AB1846 related to CO-OPs, a new form of health plan allowable under the Affordable Care Act. Consumer advocates nationally and here in California have been concerned that such CO-OPs could circumvent requirements placed on other insurers, including ones that the state or the Health Benefits Exchange put in place to benefit California consumers. Assemblymember Gordon agreed in concept to amendments (including those proposed by Health Access California) to create a regulatory context to ensure that should a CO-OP come to California, there is adequate oversight and consumer protection. With amendments taken, the bill passed without opposition.

The Committee also heard AB1553 (Monning) related to the transition of seniors and persons with disabilities to Medi-Cal managed care.  The bill addresses some serious issues that have arisen from past budgetary action that required this transition. Some individuals with serious medical conditions, and who have relied upon specific providers to manage these conditions under a fee for service model, have had difficulty maintaining continuity of care during the transition. They will, under this bill, be able to receive a temporary exemption from the managed care requirement, as a needed consumer protection. AB1553 moves forward to Appropriations.  
The most contested bill of the hearing was AB1742(Pan), requiring health plans to accept assignment of benefits in PPO health plans when consumers go out-of-network. The bill was sponsored by the California Medical Association and opposed by insurers and Health Access California representing consumer groups. Chairman Monning sought significant amendments, as did Health Access, to require disclosure to consumers on estimated prices, to put limits on the financial exposure to consumers, and to ensure that the bill did not endanger existing consumer protections against balance billing. Given that the author and sponsor did not accept many of the amendments, Chairman Monning recommended a No vote. The bill got 8 votes, which was not enough to proceed.

Today was the last Assembly Health Committee hearing before the deadline to pass policy committee. Tomorrow, the Senate Health Committee also hears a range of bills related to health reform in it’s deadline week hearing.

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