By Len Feldman
CTA and a coalition of public interest groups have won the passage of several state measures that will improve health care protections for educators, students and their families. These measures build upon a platform established by the landmark federal health care reform package, signed into law on March 23, whose passage in Congress was spearheaded by the Obama administration.
The seven CTA-backed measures that were signed into law this session both implement and improve provisions of the federal Patient Protection and Affordable Care Act, and will be in force on Jan. 1, 2011.
The California Legislature passed the first-in-the-nation state legislation to create a state exchange, a key element of the new federal health care reform, through AB 1602, by Assembly Speaker John Perez (D-Los Angeles), and SB 900, by Senate Health Committee Chair Elaine Alquist (D-San Jose) and Senate President Pro Tem Darrell Steinberg (D-Sacramento).
The bulk purchasing power provided by this Health Insurance Exchange will enable millions of Californians to afford coverage, and beginning in 2014 will allow consumers and businesses “one-stop” shopping on health care plans.
As of Sept. 23, the federal law sets a clear standard to prevent any insurer from rescinding coverage based on problems in a patient’s initial health questionnaire. AB 2470, by Assembly Member Hector De La Torre (D-Los Angeles), goes beyond federal law by clearly allowing review by regulators of each case of rescission. To conform with federal law, Assembly Member De La Torre also authored AB 2345, which prohibits health insurance from charging co-payments for some preventive services, such as pap smears, mammograms, other cancer screenings, and immunizations.
The federal law prohibits insurers from denying coverage for children up to age 19 due to pre-existing conditions, or denying treatment associated with pre-existing conditions. An estimated 576,500 children in California have pre-existing conditions that could have led to denial of coverage. CTA-backed AB 2244, by Assembly Member Mike Feuer (D-Los Angeles), improves upon this protection by limiting the ability of an insurer to charge those children more than twice the premiums of healthy children, with the cost difference phased out by 2014, when insurers will be required to charge everyone the same, regardless of health status.
CTA-supported SB 1163, by Sen. Mark Leno (D-San Francisco), is designed to increase the transparency in rate increases and coverage denials. The bill requires health care plans to provide clear, understandable reasons for any denials of coverage. It also requires plans to give consumers advance notice of planned premium increases and to have actuarial reviews to assure the increases are justified and needed. The bill, in addition, requires providers to give state regulators information about premium increases so that the information will be made public. The implementation of this bill will give local associations new tools to challenge health insurance rate hikes and takes large strides towards better rate regulation.
In alignment with federal health care legislation, Sen. Curren Price (D-Los Angeles) authored SB 1088, which provides coverage for young adults up to age 26 on their parents’ coverage.