California health care legislation

california legislature capitolCalifornia legislation of 2014 addressing the Affordable Care Act — the federal Patient Protection and Affordable Care Act — and its many changes to the health insurance landscape. Bills are from the 2014 legislative session unless noted. Also selected federal bills. (Names in parenthesis are key sponsors.)

Assembly Bill 1246: Would mandate that health insurance offered to members of the Legislature must be provided by Covered California. Applies to legislators elected to or serving in office after Jan. 1, 2015. Rejected by the Rules Committee in a 4-7 vote of Jan. 17. (Nestande)

AB 1553: Would prohibit sellers of long-term care insurance policies from charging a different premium based on the sex of the consumer. Targets new new long-term care insurance products with gender-based pricing. “Held without recommendation” by Insurance Committee on May 7. (Yamada)

AB 1829: Would have barred Covered California from hiring people to do enrollments if they have been convicted of financial crimes. Rejected by the Health Committee in a 6-12 vote of April 22. (Conway)

AB 1877: Would create a standalone vision care program similar to the state Obamacare operation. To be called the California Vision Care Access Council. Approved by the Assembly Health Committee on April 8. Approved by the Assembly on May 28. Approved by the Senate Health Committee in a unanimous vote of June 25. (Cooley)

AB 1962: Would require specialized dental health care service plan contracts and specialized dental health insurance policies to comply with rules requiring 80 percent to 85 percent of premiums to be spent on patient care. Current requirements apply to general health insurers. (Skinner)

AB 2533: Would require health care providers that cannot provide “timely access” to services via its network to arrange for care by non-contracted providers. Requires the California Department of Insurance “to adopt new timely access standards.” Approved by the Health Committee in a 12-6 vote of April 29. Approved by the full House in a 44-28 vote of May 28. (Ammiano)

Senate Bill 20: Changes the open enrollment period for Covered California health insurance policies to Nov. 15 through Feb. 15. (Previously Oct. 1 through March 31.) For enrollment years, the open enrollment period is set for Oct. 15 through Dec. 7. Changes made to comply with federal regulations. Approved May 6 by the Assembly Health Committee in a 14-4 vote. Approved by the full Assembly in a 56-20 vote of May 28. Approved by the Senate Health panel May 29. Approved by the full Senate June 5. Signed by the governor on or about June 16. (Hernandez)

SB 964: Would expand the requirements on managed care plans for surveying and reporting on access to care. Seeks to have Department of Managed Care more closely monitor physician networks. Would require Medi-Cal-managed care plans to comply with reporting requirements imposed on other commercial health plans. Approved by the Senate Health Committee in a 5-1 vote of April 30. Approved by the full Senate in a 22-10 vote of May 27. Approved by the Assembly Health Committee in a 14-5 vote of June 24. Approved by Assembly Appropriations in a 12-3 vote of Aug. 18. (Hernandez)

SB 972: Would expand requirements for Covered California board board members. Adds knowledge of marketing healthcare products and information technology as desirable characteristics in board members. Seeks to address low Latino enrollment issue: “Priority to cultural and linguistic competency.” Amended (number of board members) and approved by the Senate Health Committee in a 6-1 vote of April 30. Approved by the full Senate in a 33-0 vote of May 15. Approved by the Assembly Health Committee in a unanimous vote of June 10. Approved by the full Assembly in a 68-2 vote of June 19. Signed by the governor July 21. (Torres)

SB 1005: Would extend eligibility for Covered California insurance to people previously barred because of immigration status — illegal residents. Also “full scope” Medi-Cal benefits. Creates the California Health Trust Fund For All Californians. Approved by the Senate Health Committee in a 6-1 vote of April 30. Approved by Appropriations in a unanimous vote of May 19. (Lara)

SB 1034: Prohibits group health insurers from imposing a separate waiting or affiliation period in addition to any waiting period imposed by an employer. Clarifies 90-day waiting period under Affordable Care Act in state. Approved by the Senate Health Committee on April 9. Unanimous Senate approval May 1. Approved by the Assembly Health Committee on June 10. Unanimous Assembly approval June 30. Senate sign-off Aug. 4. Signed into law by governor Aug. 15. (Monning)

SB 1446: Gives small businesses with non-grandfathered health plans option to renew for one year, instead of switching to Affordable Care Act-compliant policies by the end of 2014. Approved unanimously by the Senate Health Committee on May 7. Cleared by Appropriations on May 19. Approved by the full Senate in a unanimous vote of May 29. To the Assembly. “Urgency bill.” (DeSaulnier)

Federal legislation (2014)
House Resolution 3362: Would mandate weekly reports through March 31, 2015, on operation of government Affordable Care Act web site, consumer interactions, service center calls, etc. Billed as the Exchange Information Disclosure Act. (Terry)

HR 3811: Would require Health and Human Services to notify an individual of any unlawful access to personal data stored on a health insurance site operating under the Affordable Care Act within two business days of discovery. Approved by the House in a 291-122 vote of Jan. 10. Billed as the Health Exchange Security and Transparency Act of 2014. (Pitts)

Senate Bill 2446: Would require the Congressional Budget Office to annually report changes in direct spending and revenue associated with the Affordable Care Act. (Johnson, R.)

2013 California legislative session

ABX1-2: Would require insurers to sell health coverage to individuals without regard to health status as required by Affordable Care Act. Reforms current insurance market, limits premium rating factors, forbids pre-existing condition rejections, sets open enrollment periods. Also reforms small group insurance market rules. Approved by Health Committee in a 13-6 vote Feb. 20 and then by Appropriations in a 12-5 vote of Feb. 25. Approved by the Assembly in a 53-25 vote of Feb. 28. Various author amendments March 7-April 1. Approved by the The Senate Committee on Appropriations in a unanimous vote of April 15. Approved by the Senate in a 27-9 vote of April 25. Final approval by the Assembly via a 49-20 vote April 29. Signed into law by the governor May 9. Nearly identical to SBX1-2, below. (Pan)

SBX1-2: Approved by Health Committee in a 7-2 vote and then by Appropriations in a 5-2 vote, both taken Feb. 21. Approved by full Senate in a 26-10 vote Feb. 28. Amended by author March 7. Approved by the Assembly Health Committee in a 13-6 vote of April 10. Approved by Appropriations in a 13-6 vote April 17. Approved by the Assembly in a 51-25 vote April 25. Final Senate approval via a 27-9 vote April 29. Signed into law by the governor May 9. Nearly identical to ABX1-2, above. (Hernandez)

ABX1-1: Makes changes to Medi-Cal eligibility process to “simplify and streamline” in compliance with Affordable Care Act. Also expands Medi-Cal eligibility to all adults under 138% of the federal poverty level. Numerous other changes. Approved by the Health Committee in a 13-6 vote of Feb. 19. Approved by Appropriations in a 12-5 vote of Feb. 25. Approved by the Assembly in a 54-22 vote of March 7. Approved by the Senate Health Committee in a 7-2 vote of June 12. Approved by the Senate in a 28-8 vote of June 15, with Senate changes approved by Assembly. Signed into law by the governor June 27. (Perez)

SBX1-1: Nearly identical to ABX1-1, above. Approved by the Senate in a 24-7 vote of March 7. Approved by the Assembly Health Committee in a 13-5 vote of June 11. Approved by the Assembly on June 15. Senate OK’d Assembly changes in a 29-8 vote of June 15. Signed into law by the governor June 27. (Hernandez)

AB 18: Would state the intent of the Legislature to enact legislation that would reform individual health care coverage to be consistent with the Affordable Care Act. Amended and approved by the Health Committee in a 12-4 vote of June 4. (Pan)

SB 18: Same as AB 18, above. Approved by the Health Committee on May 2. Approved by the Senate in a 34-9 vote of May 9. To the Assembly. (Hernandez)

AB 50: Would overhaul current process of informing Medi-Cal enrollees of their options for care. Allows hospitals to make initial determination of eligibility. Approved by the Health Committee in a 13-5 vote of May 7. Approved by Appropriations in a 12-5 vote of May 24. Approved by the Assembly in a 54-24 vote of June 14.(Pan)

AB 175: Seeks to create the Uncovered Worker Health Trust Fund for the purpose of providing health insurance coverage to those not eligible for coverage under the Affordable Care Act. “Undocumented” immigrants are barred from ACA services. Their employers would pay into the fund, as well as charities. (Perez)

AB 314: Would apply Affordable Care Act provisions and consumer protections to education institute-connected heath care providers (for students, faculty, etc.) that are privately funded. Approved by Health Committee in a 14-5 vote of March 19. Approved by Appropriations in a 12-5 vote of April 17. Approved by the Assembly in a 52-21 vote of May 2. Approved by the Senate Health Committee in a 6-2 vote of June 26. (Pan)

AB 369: Would give California Health Benefit Exchange officials more time to report on the issue of merging individual and small employer markets. Current deadline of Dec. 1, 2018, extended to March 1, 2019. (Pan)

AB 422: Would require information about Medi-cal and the Health Benefit Exchange services to be distributed by programs providing health care services to low-income individuals. Also to families of public-school students found ineligible for Medi-Cal free lunches. Approved by the Health Committee in a unanimous vote of May 7. Approved by the Assembly in a 71-2 vote of May 16. Approved by the Senate Education Committee in a unanimous vote of June 12. Approved unanimously by the Senate on Sept. 3. Signed into law by the governor Oct. 1. Effective Jan. 1, 2014.(Nazarian)

AB 578: Establishes a public disclosure and hearing process for those seeking to provide a health care service plan in California. Anticipates numerous applications under Affordable Care Act and seeks transparency in approvals by Department of Managed Health Care. Approved by the Health Committee in a 11-6 vote April 2. Approved by the Assembly in a 54-23 vote of May 29. To the Senate. (Dickinson)

AB 880: Would establish penalties for large employers with workers on Medi-Cal. The “employer responsibility fee” would be equal to the average cost of health coverage and would go to a new state health-care fund. Also would fine large employers for moving workers to part-time or independent contractor status to avoid these penalties. Amended by author in late March and mid-April. Approved by the Health Committee in a 13-5 vote of April 30. Approved by Appropriations in a 12-5 vote of May 24. Rejected by Assembly on June 27 (46-27 vote short of needed two-thirds approval). Motion to reconsider approved. aka “Wal-Mart bill” (Gomez)

AB 900: Would cancel 10 percent Medi-Cal rate cut to doctors, hospitals, “subacute care units” and other medical practitioners. (Rate cut was passed by 2011 Legislature.) Approved by the Health Committee in a unanimous vote of April 30. Approved by Appropriations in a unanimous vote of May 24. Approved by the Assembly on May 29 (urgency clause adopted). Approved by the Senate Health Committee in a unanimous vote of June 19. Same as SB 640, below. (Alejo)

AB 975: Would narrow definition of charity care under Affordable Care Act. Nonprofits would have to justify any profits over 10 percent of operating revenues to retain tax-exempt status. Requires nonprofits to provide community services. (Applies to private hospitals.) Amended and then approved by Health Committee in a 12-7 vote of April 2. Rejected by the Assembly in a 28-38 vote of May 30. Inactive. (Wieckowski, Bonta)

AB 1180: Makes technical changes to California Health Benefit Exchange law. Amended by author March 21. Approved by the Health Committee in a unanimous vote of April 23. Approved by Appropriations in a 16-1 vote of May 15. Approved by the Assembly in a 69-1 vote of May 24 (urgency clause adopted). Approved by the Senate on Sept. 9. Signed into law by the governor Oct. 1. (Pan)

AB 1428: Would require fingerprinting and federal background checks for Covered California staffers with access to the California health exchange’s private data from applicants. Approved by Appropriations on June 10. Approved by the Assembly on Aug. 8. Approved by the Senate Health Committee on Aug. 21. OK’d by the full Senate under urgency clause Sept. 3. Final sign-off by Assembly on Sept. 6. (All votes unanimous.) To the governor. (Conway)

SBX1-3: Would state California lawmakers’ intent to create a bridge option for low-cost health coverage within the state Health Benefit Exchange. Approved by the Health Committee in an 8-0 vote of March 20. Approved by Appropriations in a 7-0 vote of April 8. Approved by the Senate in a 37-0 vote of April 11. Amended and approved by the Assembly on June 27. Back to the Senate. (Hernandez)

SB 28: Would implement various provisions of the Affordable Care Act regarding Medi-Cal eligibility and program simplification. Would prohibit the use of an asset test for individuals whose financial eligibility for Medi-Cal is determined based on the application of MAGI. Approved by the Health Committee in a 9-0 vote of April 25. Approved by Appropriations on May 6. Approved by the Senate on May 16. Approved by the Assembly in a 53-25 vote of Sept. 6. Approved by the Senate again on Sept. 9. Signed by the governor Oct. 1. (Hernandez, Steinberg)

SB 189: Would limit incentives, rebates and attendance requirements for future wellness programs established by insurers. Applies to wellness programs established Jan. 1, 2014, and up to Jan. 1, 2020. In accordance with Affordable Care Act rules. Approved by the Health Committee in a 5-2 vote of May 1. Rejected by Appropriations on May 23. (Monning)

SB 249: Seeks to authorize the State Department of Public Health to share health records of HIV/AIDS patients in connection with possible service eligibility benefits under the Affordable Care Act. Applies to individuals in Ryan White Act-funded programs. Hearing of April 10 canceled by sponsor. Approved by Health Committee in a 9-0 vote of April 24. Approved by Judiciary on April 30. Approved by Appropriations on May 23. Approved by the Senate in a unanimous vote of May 28. Approved by the Assembly Health Committee in a unanimous vote of June 25. Approved by the Assembly on Sept. 9. Signed into law by the governor Oct. 1. (Leno)

SB 264: Would require health care service plans to have a clinical laboratory testing
advisory board for diagnostics, disease management, pathology, etc. Two April hearings canceled by sponsor. (Pavley)

SB 332: Would require public disclosure of many aspects of the California health exchange’s set-up and operation, including “impressions, opinions, recommendations, meeting minutes, research, work product, theories, or strategy of the board or its staff.” Approved by the Health Committee in a unanimous vote of June 19. Approved by the Senate on July 8. OK’d by the Assembly Health Committee on Aug. 15. Approved by the Assembly on Sept. 6. Signed into law by the governor Oct. 1. (Emmerson, DeSaulnier)

SB 351: Would declare intent of Legislature to set limits on out-of-network hospital emergency care billing practices. Approved by Health in a 7-2 vote of May 1. (Hernandez)

SB 494: States intent of the Legislature to encourage that California Health Benefit Exchange providers use of physician assistants. Amended by author April 3. Approved by Health Committee in a 9-0 vote of April 24. Approved by Appropriations on May 23. Approved by the Senate on May 29. In the Assembly. (Monning)

SB 639: Addresses cost sharing (deductibles, co-payments) as contemplated by the Affordable Care Act. Establishes out-of-pocket limits on health plan enrollees. Would limit annual out-of-pocket costs to $6,350 per individual. Establishes small group deductibles. Applies to “non-grandfathered products.” Sets “metal levels” for coverage. Amended by author April 3. Approved by Health Committee in a 6-2 vote of April 17. Approved by Appropriations in a 5-2 vote of May 23. Approved by the full Senate in a 28-11 vote of May 29. Approved by the Assembly Health Committee in 13-5 vote of Aug. 13. (Hernandez)

SB 640: Would override 10 percent Medi-Cal rate cut affecting doctors, hospitals, “subacute care units” and other medical practitioners. Approved by Health in a unanimous vote of April 24. Amended by author May 24. Same as AB 900, above. (Lara)

SB 800: To facilitate outreach for health insurance, requires the Department of Health Care Services to provide Covered California with information about parents or caretakers of children enrolled in the Healthy Families program or the replacement targeted low-income Medi-Cal program. Transfers specified employees of the Managed Risk Medical Insurance Board to the health exchange or DHCS with full employee benefits. Approved by the Senate on May 29. OK’d by the Assembly in a 53-25 vote of Sept. 9. Approved by the governor Oct. 1. (Lara)

View the governor’s health care legislation signings of Oct. 1, 2013.