In Final Week of 2012 Session, California Legislature Passes ACA Implementation Legislation, Effort to Restore Healthy Families Fails
|September 3, 2012||Posted by John Connolly under Blog, Insurance Exchange, Legislation Policy News, Legislation/Policy, Medi-Cal, Public Coverage, State||
Last week was the final week of the 2012 legislative session, and the California Legislature passed several key pieces of health reform legislation. Many of the bills implement central elements of the Affordable Care Act (ACA) in California. Governor Brown will have the month of September to decide whether to sign or veto the bills.
The legislation that the Governor is considering prohibits exclusions of coverage of preexisting conditions, defines the required essential health benefits package, and limits the amount that insurers can vary premiums based on age. An additional bill requires that consumers must receive information about their coverage options in the event that they lose coverage as a result of a job loss or life change. Governor Brown has also called for a special session in December with a newly elected Legislature to consider additional health reform legislation to further prepare for ACA implementation.
In addition, a late effort to preserve the Healthy Families program and an associated tax on managed care organizations ultimately failed. The elimination of the program and transition of its beneficiaries into Medi-Cal will take place as scheduled, beginning in January 2013.
The following is a list of passed health reform legislation:
Insurance Market Reforms and Consumer Protections
AB1453 (Monning), Essential Health Benefits: Protects consumers by requiring health plans regulated in the Health and Safety Code to cover minimum essential health benefits equivalent to the Kaiser Small Group HMO.
SB951 (Hernandez), Essential Health Benefits: Protects consumers by requiring health plans regulated in the Insurance Code to cover minimum essential health benefits equivalent to the Kaiser Small Group HMO.
AB1461 (Monning) Reforming the Individual Market: Prevents insurers from denying coverage or discriminating based on pre-existing conditions, and otherwise conforms the Health and Safety Code to the ACA and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits premium variation based on age to 3:1.
SB961 (Hernandez) Reforming the Individual Market: Prevents insurers from denying coverage or discriminating based on pre-existing conditions, and otherwise conforms the Insurance Code to the ACA and phases-in new insurance market rules for individuals who purchase insurance on their own. Limits premium variation based on age to 3:1.
AB1083 (Monning) Reforming the Small Group Market: Conforms to federal law and phases-in new insurance market rules for small businesses, particularly so that small employers will not face premium spikes based on the health of their workers.
AB1761 (Speaker Perez) Deceptive Marketing: Prohibits any individual or entity from falsely representing itself as the California Health Benefits Exchange.
SB1410 (Hernandez) Independent Medical Review: Improves the process by which consumers appeal denials of care. Makes the process more transparent, including with race, ethnicity, and language data.
AB1526 (Monning) High-Risk Pool: Improves the Major Risk Medical Insurance Program (MRMIP) by eliminating annual and lifetime caps so that individuals with pre-existing conditions will be protected if they require extremely costly care. Aligns the program with the federally funded PCIP program.
AB792 (Bonilla) Coverage Options during Life Changes: Ensures that Californians can easily sign up for coverage during key life changes. Requires that California consumers will be provided information about their coverage options and subsidies at the new Exchange upon filing for divorce, separation, adoption, or when losing group coverage through job change or other life circumstances.
AB174 (Monning) Systems Integration: Establishes funding for the Office of Systems Integration to establish information sharing between the Franchise Tax Board, the Employment Development Department, specified health care agencies, and county departments and agencies to verify eligibility for state health programs.
AB1580 (Bonilla) Streamlining Eligibility and Enrollment: A follow-up to AB1296 (Bonilla), which was signed into law last year to streamline eligibility and enrollment processes.
SB970 (DeLeon) Enrollment Integration with Human Services: Helps individuals applying for public programs apply through an integrated, “no wrong door” approach, regardless of whether applicants are interested in social services or health programs.
AB441 (Monning) Active Transportation, Healthy Communities: Requires that transportation planning include health criteria to foster healthier communities.
Health Access California has been monitoring legislative developments. For more information about these and other pieces of legislation, visit their website by clicking on the link below.