This week, the California Legislature is scheduled to vote on key pieces of legislation that will implement the Affordable Care Act (ACA) in California. Bills under consideration would enact key health insurance market reforms, including prohibiting denials of coverage for preexisting conditions and establishing an essential health benefits package for insurance plans, as well as require that individuals receive information about health insurance options in the event that they lose coverage. Votes this week are critical because the 2012 legislative session ends August 31, and passing these reforms during this session will be vital to preparing for the ACA?s major coverage expansions that will begin on January 1, 2014. A list of pending California ACA implementation bills is at the end of the blog entry.
In addition, Sen. Mark DeSaulnier and Rep. Sandr? Swanson have written bills (SB301 and AB826, respectively) to stop the elimination of the Healthy Families program and prevent the transition of its beneficiaries into Medi-Cal. If the bills were to be enacted this year, they would still need to pass through the appropriate committees in each chamber and then pass in both houses?a heavy lift in one week. The bills resulted from concern among some legislators that the timeline for the Healthy Families transition was too rushed?scheduled to begin on January 1, 2013. Further, Republican legislators have said that they would only support preserving a tax on managed care organizations that is associated with Healthy Families if the program also survives.[1]
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The following is a list of ACA implementation bills that are scheduled for votes this week:
Insurance Market Reforms:
AB1461 (Monning) Reforming the Individual Market: Prevents insurers from denying or discriminating based on preexisting conditions, and otherwise conforms the Health and Safety Code to the ACA. The legislation also phases in new insurance market rules?for individuals who purchase insurance on their own, and limits premium variation based on age to 3:1.
SB961 (Hernandez)?Reforming the Individual Market: Prevents insurers from denying or discriminating based on preexisting conditions, and otherwise conforms the Insurance Code to the ACA.?Phases in new insurance market rules?for individuals who purchase insurance on their own, and limits premium variation based on age to 3:1.
AB1083 (Monning) Reforming the Small Group Market: Conforms state laws to?federal law?and phases in new insurance market rules for small businesses, particularly so that small employers will not experience additional premium spikes based on the health of their workforce.
SB1431 (DeLeon) Self-Insurance in the Small-Group Market:?Ensures consumer protections for workers and an affordable small-group market for small businesses by?limiting a loophole allowing?small employers?to ?self-insure? in order to evade requirements of the small group market.
Defining Essential Health Benefits:
AB1453 (Monning): Protects consumers from underinsurance and junk insurance by requiring health plans regulated in the Health and Safety Code to cover a set of minimum essential health benefits equivalent to the Kaiser Small Group HMO.
SB951?(Hernandez): Protects consumers from underinsurance and junk insurance by requiring health plans regulated in the Insurance Code to cover a set of minimum essential health benefits equivalent to the Kaiser Small Group HMO.
Informing Consumers about Health Insurance Options:
AB792 (Bonilla) Coverage Options after a Loss of Coverage: Ensures that Californians will be able to easily sign up for coverage during key life changes. Requires that California consumers are provided information about the coverage options and subsidies at the new Health Benefits Exchange upon filing for divorce, separation, adoption,?or?when losing group coverage through job change?or other life circumstances.
Improving Access to Services:
SB970 (DeLeon) Enrollment Integration with Human Services: Individuals applying for public programs will be able to apply through an integrated, ?no wrong door? approach, whether applicants are interested in social services or health programs.
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Health Access California has been tracking legislative activity on its website; click on the link below to view more detailed material about this topic.
http://www.health-access.org/item.asp?id=202
[1] Gorn, D. California Healthline. August 28, 2012. Available at: http://www.californiahealthline.org/capitol-desk/2012/8/11th-hour-bid-to-keep-healthy-families-intact.aspx
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