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Implementing Health Reform

As the summer warms up, California will be required to implement certain components of The Patient Protection and Affordable Care Act (aka “health reform”).

By July 1, 2010, a temporary, high-risk pool must be established to provide coverage to uninsured persons with pre-existing conditions that are not able to acquire coverage in the private or individual market. The pool will be in place until 2014, at which point insurance companies will be required to cover the care of pre-existing conditions for both adults and children.

Responsibility for establishing the pool will likely be given to the Managed Risk Medical Insurance Board; MRMIB will either incorporate this new task as part of the high risk pool that it already runs, or MRMIB will be tasked with running a separate program, most likely established through passage of AB 1887 (Villines).

Health reform also requires that by September 23, 2010:
• children be allowed to stay on their parents’ health plan until age 26;
• children can no longer be denied coverage for pre-existing conditions;
• insurance plans can no longer impose lifetime caps or annual limits on coverage; and
• new plans must provide free preventive services to all enrollees.

To implements this, California must first ensure these policies are passed into state law. Right now, there are a few active bills that include these polices, including SB 1088 (Price) and AB 1602 (Perez) which is also one of the two flagship bills that establishes the California Health Insurance Exchange.

A great resource: the Georgetown Center for Children and Families has listed key health reform implementation dates on a really helpful one-page factsheet.

Stay tuned to the ITUP blog for more information and updates about California’s early implementation of health reform.