May 2016 Legislative Summary
Dozens of health care bills have been moving through the California Legislature in the second half of the 2015-16 legislative session. As of this writing, many of the bills are on temporary hold in the Suspense files of the Senate and Assembly Appropriations Committee pending further action. The two fiscal committees tag bills with state costs above a certain level and then consider all the bills at one hearing to better assess the combined cost implications. The fiscal committees will consider Suspense items this Friday, May 27, 2016.
Assembly bills
AB 1568 (Bonta/Atkins) – Federal §1115 Medicaid Waiver
Implements California’s newly approved §1115 federal Medicaid waiver, Medi-Cal 2020. The waiver allocates more than $6.2 billion to specific pilot and demonstration programs aimed at redirecting Medi-Cal beneficiaries from costly inpatient and emergency room services to coordinated outpatient primary, preventive and specialty care services. (Status: Assembly Appropriations Committee)
AB 2024 (Wood) – Critical Access Hospitals
Permits federally certified critical access hospitals in rural areas to employ physicians and charge for professional services rendered by those physicians. With certain limited exceptions in law, California prohibits hospitals from employing physicians. (Status: Pending referral in Senate)
AB 2077 (Burke) – Health Coverage Transitions: Medi-Cal and Covered California
Enacts eligibility, administrative and notice requirements to ensure that individuals whose eligibility fluctuates between Medi-Cal, Covered California and other health care coverage programs do not experience a break in coverage. Establishes a 30-day grace period after an individual is no longer eligible for Medi-Cal so they can apply for and enroll in Covered California or other health coverage without a coverage break. (Status: Assembly Appropriations Committee)
AB 2216 (Bonta) – Teaching Health Center Program
Establishes the Teaching Health Center Primary Care Graduate Medical Education Fund to support primary care residency programs. Modeled after a limited federal program included in the federal Affordable Care Act (ACA). (Status: Assembly Appropriations)
AB 2308 (Hernandez, R.) – Health Care Enrollment Assistance
Requires the California State University and California Community College campuses to screen every student for health insurance and offer enrollment assistance through partnerships with local organizations. Extends until January 1, 2024 the requirement that California public schools provide parents and guardians with information about health care coverage options and assistance. (Status: Assembly Appropriations)
AB 2436 (Hernandez, R.) – Prescription Drug Cost Transparency
Requires health plans in California to provide consumers with specified information on the costs of prescription drugs, including the consumer’s potential out-of-pocket costs. (Status: Assembly floor)
Senate Bills
SB 10 (Lara) – Coverage for Undocumented Immigrants: Federal Waiver
Requires the Secretary of Health and Human Services to apply for a federal ACA §1332 waiver allowing undocumented immigrants to buy coverage through Covered California, California’s state-based ACA exchange. Federal funds would not be available to subsidize the coverage. (Status: Assembly floor)
SB 815 (Hernandez) – Federal §1115 Medicaid Waiver
Implements California’s newly approved §1115 federal Medicaid waiver, Medi-Cal 2020. The waiver allocates more than $6.2 billion to specific pilot and demonstration programs aimed at redirecting Medi-Cal beneficiaries from costly inpatient and emergency room services to coordinated outpatient primary, preventive and specialty care services. (Status: Senate Appropriations)
SB 908 (Hernandez) – Health Insurance Premiums: Consumer Notice
Requires health plans to notify individuals or small businesses if state regulators find a proposed premium rate “unreasonable” or “unjustified.” Department of Managed Health Care and California Department of Insurance conduct mandatory premium rate reviews for health plans under their jurisdiction according to ACA rules and implementing California law. (Status: Senate Appropriations)
SB 993 (Hernandez) – Oversight of Mergers and Acquisitions
Requires prior approval by the Department of Managed Health Care for mergers between health plans and other organizations and prohibits specified provisions in health plan provider contracts. (Status: Senate Appropriations)
SB 997 (Lara) – Coverage for Undocumented Children
Authorizes undocumented children eligible for full-scope Medi-Cal coverage, who are enrolled in low-cost coverage through Kaiser Permanente or another Medi-Cal managed care plan, to be enrolled in full-scope Medi-Cal with the same health plan. (Status: Senate Appropriations)
SB 1010 (Hernandez) – Prescription Drugs: Transparency
Requires health plans to provide regulators reviewing health care premium filings with specified information relating to prescription drug spending. In addition, this bill requires drug manufacturers to notify state purchasers of health care services when drug prices increase by more than 10% or when manufacturers introduce new drugs costing more than $10,000 per course of treatment to the market. (Status: Senate Appropriations)
SB 1139 (Lara) – Health Professions Grants and Loans
Provides educational grants and loans to undocumented students seeking training as a health professional. (Status: Senate Appropriations)
SB 1159 (Hernandez) – Health Care Cost and Quality
Requires the Secretary of Health and Human Services to convene an advisory committee and develop the parameters for a health care cost and quality database. Enacts related reporting and regulatory authority requiring health plans to provide health care utilization and cost information to the Secretary. (Status: Senate Appropriations)
SB 1418 (Lara) – Medi-Cal Coverage for All
Extends eligibility for full-scope Medi-Cal to all individuals 19 years of age and older, regardless of immigration status. (Held in Senate Health Committee)