ENSURING CALIFORNIANS GET THE COVERAGE THEY NEED
* AB 43 (Monning) EXPANDING MEDI-CAL: Expands Medi-Cal eligibility to persons under 133% of the Federal Poverty level who are not pregnant, don’t have dependent children, and are under the age of 65, effective January 1, 2014.
* SB 677 (Hernandez) MEDI-CAL RULES: Implements changes to Medi-Cal required by the ACA including eliminating the asset test and changing income standard to MAGI, effective January 1, 2014.
* AB 1296 (Bonilla) STREAMLINING ELIGIBILITY AND ENROLLMENT: Establishes a single application form and related renewal procedures for Medi-Cal, the Healthy Families Program, and the Exchange, and county programs.
* AB 714 (Atkins) PRE-ENROLLMENT: Requires existing programs such as MRMIB and Family PACT as well as hospitals to provide information about the California Health Benefits Exchange to their members for the purpose of pre-enrolling them into th Exchange to receive subsidized coverage in January 2014.
* AB 792 (Bonilla) AUTOMATIC ENROLLMENT: Ensures continuous coverage through life circumstances such as divorce or unemployment by requiring that consumers receive information about the Exchange when filing for divorce, unemployment, etc. Would also require insurers to provide this enformation to individuals dropping off coverage after 2014.
NEW COVERAGE OPTIONS
* SB 222 (Alquist) COUNTY-RUN HEALTH INSURANCE OPTIONS: Allows counties, county special commissions, or county health authorities that govern, own, or operate a local initiative health plan or county-organized health system to form joint ventures to offer health plans to individuals and groups.
* AB 1066 (Perez) MEDI-CAL WAIVER AND LOW INCOME HEALTH PROGRAMS: Implements the expansion of Medi-Cal as authorized by the Affordable Care Act and the 1115 Medicaid Waiver.
*AB 922 (Monning) PROVIDING CONSUMER ASSISTANCE: Creates an Office of Health Consumer Assistance responsible for providing outreach and education about health care coverage to consumers, also authorizes contracting with community organizations to consumer assistance.
CONSUMER PROTECTIONS AND INSURER OVERSIGHT
* SB 51 (Alquist) MEDICAL LOSS RATIO: Ensures that premium dollars go to patient care rather than administration or profit. Requires (per the Affordable Care Act) that insurers who do not spend the specified percentage of premium dollars on patient care provide refunds to patients.
* AB 52 (Feuer) RATE REGULATION: Provides authority to the Department of Managed Health Care and the Department of Insurance to approve or deny health insurance rate increases.
* AB 1334 (Feuer) STANDARDIZING BENEFITS: Requires plans to categorize all products offered in the individual market into five tiers according to the actuarial value and would require disclosure of this and other information.
* SB 155 (Evans) MATERNITY CARE: Phases in maternity care benefit mandate by requiring new health insurance policies submitted after January 1, 2012 to provide coverage for maternity services. Federal law will require coverage of maternity care starting in 2014.
* AB 185 (Hernandez) MATERNITY CARE: Phases in maternity care benefit mandate by requiring new health insurance policies submitted after January 1, 2012 to provide coverage for maternity services. Federal law will require coverage of maternity care starting in 2014.
* AB 154 (Beall) MENTAL HEALTH PARITY: Expands the existing mendal health parity coverage requirement for certain health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2012, to include diagnosis and treatment of a mental illness of a person of any age.
* AB 151 (Monning) GUARANTEED ISSUES FOR SENIORS ON MEDI-GAP: Assures that those previously covered by MedicareAdvantage have guaranteed issue for Medi-Gap coverage.
* AB 1083 (Monning) REFORMING THE SMALL GROUP MARKET: Conform and phase-in new insurance market rules for small businesses, particularly so that small employers don’t get additional premium spikes based on the health of their workforce.
* AB 36 (Perea) DEPENDENT COVERAGE: Modifies the tax code to exclude employer contributions toward dependent coverage (dependents up to age 26) from parents’ taxable income.
* AB 242 (Perea) TAX CONFORMITY: Provides additional modified conformity to specified provisions of the federal Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 relating to simple cafeteria plans for small businesses, health care benefits of indian tribe members, free choice vouchers,therapeutic discovery project grants, student loan repayment programs, and deduction for self-employment taxes.
* AB 441 (Monning) ACTIVE TRANSPORTATION, HEALTHY COMMUNITIES: Requires that transportation planning include health criteria in order to foster healthier communities.
* AB 727 (Mitchell) HEALTHY AND SUSTAINABLE FOOD: Creates nutrition standards to govern the foods purchased for all state departments, agencies, and state-run institutions in accordance with the federal dietary guidelines. Also creates guidelines for sustainable purchasing practices and procedures that encourage purchasing from local vendors, farms, and manufacturers when feasible.