Rural Health Advocacy Alert

The Governor and State Legislature are moving toward the next step in shaping the 2010-11 state budget. One of the major issues they are having to grapple with is the projected $19 billion revenue deficit within a $92+ billion state budget.

The Assembly and Senate Budget Committees, and their budget subcommittees, have completed their work on the budget.

The next step is for five state Senators and five Assembly members to be selected to serve on the joint budget Conference Committee. The Conference Committee’s job is to rectify the proposed state budget issues between the two houses. The deadline of finding a state budget agreement is suppose to be June 15, but the size of the ongoing deficit will most likely complicate and lengthen the timeline for finding a budget solution the Legislature can pass with a 2/3rds vote and which the Governor can also support.

The lucky Legislators chosen for the Conference Committee are: Senators Denise Moreno Ducheny, D-San Diego, who will chair the body; Mark Leno, D-San Francisco; Alan Lowenthal, D-Long Beach; Bob Dutton, R-Rancho Cucamonga; and Bob Huff, R-Diamond Bar; and Assembly Members Bob Blumenfield, D-Woodland Hills; Connie Conway, R-Tulare; Felipe Fuentes, D-Sylmar; Jim Nielsen, R-Gerber, and Nancy Skinner, D-Berkeley. The schedule for the Conference Committee public meetings will be announced the week of June 7th.

In the midst of Federal Healthcare Reform, CSRHA would like to keep you, our members, well informed on key reform bills within California. Below are summaries of both SB 900 and SB 890. CSRHA is very interested in your feedback on any of these bills or if any other bills are of interest to you. Please contact CSRHA's Policy Director, Steve Barrow with any concerns or comments.

Federal Healthcare Reform State of California Implementation Legilsation
Health Care Coverage

Federal Health Care reform requires health insurance providers to accept every individual and employer in the state that applies for coverage. In addition, it requires health insurance issuers to offer coverage that includes a specified essential benefits package. The premiums for coverage may vary only based on the rating area, age, tobacco use and whether the coverage is for an individual or family.

SB 890 requires insurers to offer standard a benefit package to individuals in accordance with federal requirements. Selling and offering of any benefit plan other than the standard benefit plan designs would be prohibited after July 2011. Policyholders may choose to transfer to a new benefit plan of equal or lesser value on their policy’s annual renewal date. The standard benefit plans are required to provide medically necessary health care coverage and may not impose annual or lifetime limits on basic health care services (excluding Medi-care supplements, CHAMPUS supplements, and TRICARE supplements).

The bill also creates an Individual Insurance Market Reform Commission, made up of 9 voting and 3 non-voting member to review and suggest changes to standard benefit plan designs. In addition, the bill places limits on annual premium rate increases and requires at least 30-day notice for changes in premium rate or coverage with a written explanation.

The bill has passed Senate and is currently in the Assembly waiting to be assigned to a Committee. For more information Click Here.

Federal Healthcare Reform State of California Implementation Legilsation
California Health Benefits Exchange (CHBE)- Insurance Program

Federal health care reform (Patient Protection and Affordable Care Act) requires states to establish a health care (insurance) exchange program. The program is designed to provide health care coverage for individuals who do not have access to employer provided coverage, public programs (e.g. Medi-Cal), and cannot afford health care on their own. The exchange is also open to qualified small businesses. The Senate Bill (SB) 900 is one of the main state legislation vehicles aimed to establish the California Health Benefits Exchange within the California Health and Human Services Agency. Currently the bill and companion bills (SB 890 and AB 1602) envision five levels of coverage ranging from basic to more complex list of benefits.

The state legislation calls for the Exchange to be governed by a new independent board, whose members are appointed by the Governor and the Legislature and are suggested to serve four years. The responsibilities of this new Board would be to negotiate and enter into contracts with health plans; much like what takes place in the children’s health coverage program Healthy Families. The Exchange that will function similar to CalPERSand MRMIB could affect as many as 8.4 million Californians eligible to benefit from the Exchange.

Although the Federal government would award states with grants to cover the costs of the Exchange beginning in 2011, the Exchange is required to be self-sustained by 2015. Through providing tax credits and subsidies, the Exchange would facilitate enrollment for small employers in qualified health plans offered in small group market within the state.

“Navigators,” who would conduct public education on enrollment in the Exchange would be awarded grants from the Exchange.

In addition, the bill requires a reduction in maximum limits for out-of-pocket expenses for those that fall into 100% to 400% of Federal Poverty Level.

The bill has passed Senate and is currently in the Assembly waiting to be assigned to a Committee. For more information Click Here.

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California Public Employee’s Retirement System that provides retirement, health and financial programs to individuals and employers. For more information Click Here.

Managed Risk Medical Insurance Board administers three health care programs: Access for Infants and Mothers (AIM), The Healthy Families Program (HFP), and the Major Risk Medical Insurance Program (MRMIP). For more information Click Here.