Health Access Update

SACRAMENTO–As the deadline approaches at the end of this week to move bill out of policy committees, tomorrow’s Senate Health Committee includes a much anticipated vote on the pending rate regulation measure, AB52(Feuer), as well as a major bill to streamline eligibility and enrollment, AB1296(Bonilla). Health and consumer advocates are urging people to make calls to their Senators who sit on the Senate Health Committee.

In related news, Tuesday’s Assembly Health Committee meeting was the last opportunity for health-related bills originating in the Senate to move forward this year. The 5-hour hearing included extensive debate over several bills, but the bills related to implementing health reform agenda were among the less controversial.


MATERNITY: The committee approved SB 155 (Evans), a measure that would require health plans sold on the individual market to cover maternity services. California women have struggled to find plans that offer this basic health care service, and those options are diminishing every year. The Affordable Care Act requires that the federal government define a set of Minimum Essential Benefits to be covered in all health plans, and that list is to include maternity by 2014. So while other benefit mandates are being held in anticipating of federal action, this measure is being advanced alone as the only benefit mandate mandate bill, as a phase-in to 2014.


MEDICAL LOSS RATIO: Another important measure that implements federal health care reform is SB 51 (Alquist) to implement the Medical Loss Ratio in California. The Medical Loss Ratio is the provision in federal reform that requires insurers to spend 85% of premium dollars on the delivery of health care in the large group market, and 80% of premium dollars in the small group and individual markets. This measure protects consumers and the value and confidence in products, in ensuring dollars go to patient care, not administration and profit. This bill implements MLR requirements in California law and gives the state enforcement authority.


BASIC HEALTH PLAN: Another bill that got attention today was SB 703 (Hernandez), which would create a “Basic Health Plan” that would serve individuals between 133-200% of FPL in 2014 with the goal of providing a less expensive and better health benefit to the poorest individuals who would otherwise be served by the Exchange. While many parties agreed on the goals of the bill, the author, Committee, and advocates engaged in some discussion over the few available details. The key concern is the potential impact creating a separate program would have on the purchasing power of the Exchange. A proposed solution, that all parties agreed to continue discussing, was to continue to include the population as part of the Exchange purchasing pool while housing the eligibility, enrollment, and other administrative functions at the Department of Health Care Services with the Medi-Cal program, due to projections that some individuals may need to move between the BHP and Medi-Cal at high rates due to income fluctuations.


The passage of these bills out of committee brings the state one step closer to fulfilling the promise of health care reform in California.


Tomorrow’s Senate Health Committee hearing represents another important step. Remaining Assembly bills will face the scrutiny of that committee tomorrow at 1:30. Last minute calls to Senate Health Committee members are urgently needed to ensure the passage of AB 52 (Feuer) which would provide necessary relief to families and small businesses throughout the state who are at risk of losing health coverage because incessant and exorbitant premium increases are making health insurance unaffordable.

Contact the author of this update, Linda Leu at Health Access (, for more information on these bills or for a list of health reform related bills.




For more information, contact Health Access at,,, or:

Sacramento · 1127 11th Street Suite 234 · Sacramento · CA · 95814 · (916) 442-2308

Oakland · 414 13th Street Suite 450 Oakland · CA · 94612 · (510) 873-8787

Los Angeles · 1930 Wilshire Blvd, Suite 1210, Los Angeles, CA 90057 · (213) 413-3587


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