California: Wow! State legislature passes a whole slew of ACA protection/ACA 2.0 bills! (updated)

2018 MIDTERM ELECTION

Time: D H M S

UPDATE: Thanks to Anthony Wright, Executive Director of Health Access California, for clarifying a few things on some of these bills.

A couple of months ago Louise Norris of healthinsurance.org gave me a heads up about a half-dozen or so healthcare bills, mostly ACA-related, pending in the California state legislature. Some were in the state Senate, some in the state Assembly; some were more along the lines of protecting the ACA from sabotage efforts while others were about expanding upon the law.

Well, today a whole bunch of those bills (as well as a few I didn't even know about earlier) made it a major step further along the line to becoming law. Courtesy of the Health Access CA Twitter feed:

BREAKING: California Senate passes #SB1375 (@DrEdHernandez) on a bipartisan 27-11 vote, to prevent the expanded use (as proposed by the Trump Administration) of "junk insurance" known as Association Health Plans. #HCR

— Health Access CA (@healthaccess) May 29, 2018

This is the companion to SB 910 (which outlawed short-term plans in California), which passed the state Senate last week. Assuming both SB 910 and 1375 get signed into law, California will have effectively cancelled out both halves of Donald Trump's #ShortAssPlans sabotage effort.

BREAKING: The California Senate passes #SB1021 to continue California's co-pay cap on prescription drugs. Would prevent cost-sharing of over $250/month for needed medications. #HCR

— Health Access CA (@healthaccess) May 29, 2018

This is just the extension of an existing law.

BREAKING: California Senate passes SB1255 (@DrEdHernandez) to provide greater affordability assistance in the individual insurance market and #CoveredCA. Strong vote gives momentum for proposals to come out of #CABudget Conference Committee. #Care4AllCA

— Health Access CA (@healthaccess) May 29, 2018

This is actually the most interesting one to me--if I'm reading it correctly, it would basically give the Covered California exchange the authority to provide additional financial subsidies to those earning more than 200% of the Federal Poverty Level or whose healthcare premiums are more than 8% of their household income. It woudln't, however, actually allocate the funding itself--it sounds like that would require a different bill (AB 2459) to be passed, although that one wasn't voted on today. This relates to #7 on my "If I Ran the Zoo" wish list.

UPDATE: Wright clarified that SB1255 is actually a mirror of AB 2459 as well as a couple of other similar bills; it wouldn't actually require them to be passed. However, it would still depend on actually being funded in the state budget itself.

BREAKING: California Assembly passes on a bipartisan unanimous 63-0 vote #AB2430 (@drarambulaAD31) to fix the "senior penalty" in Medi-Cal, raising the eligibility of Medi-Cal for seniors and people with disabilities to 138% FPL to align with other adults. #Care4AllCA

— Health Access CA (@healthaccess) May 30, 2018

I didn't know about this one...apparently right now, the income cut-off point for Medicaid ("Medi-Cal" in California) is only 100% FPL for seniors, which means someone enrolled in Medicaid via ACA expansion can actually lose eligibility once they turn 65, which I think most people admit is kind of stupid (I gotta figure that even those opposed to expanding Medicaid would agree that your income eligibility shouldn't go down once you hit 65...though they'd presumably argue that it should be the other way around: Lower the FPL cap to 100% for those under 65...)

UPDATE: Wright clarifies that the current "senior penalty" actually doesn't kick in until seniors hit 123% FPL, not 100%, so it's a pretty small group of people who are impacted...but it's still a good thing to line them up at the same level.

BREAKING: CA Assembly votes 62-7 to pass #AB2472 (@JimWoodAD2), to explore a "public option," and encouraging Medi-Cal plans to be an option in #CoveredCA, especially in rural areas. #Care4AllCA

— Health Access CA (@healthaccess) May 30, 2018

As exciting as this may sound, it's important to note that 1) it's simply to "explore" the idea and 2) it would still require a waiver approval from Trump's HHS Dept.

Assemblymember @JimWoodAD2 presents #AB2502 to implement a California Health Care Payments Database: a "first step in a data driven health care reform efforts." The bill passes the CA Assembly 63-0.

— Health Access CA (@healthaccess) May 30, 2018

I don't know anything about this one.

BREAKING: CA Assembly votes 45-23 on #AB2517 (@JimWoodAD2) to create a universal, publicly financed system in California. "This bill creates the map and the path we need." Vote count shows support for an advisory panel to explore single-payer. #HCR

— Health Access CA (@healthaccess) May 30, 2018

No, California isn't giving up on Single Payer at the state level. It likely won't go anywhere but at least it keeps the legislative embers from dying out.

BREAKING: CA Assembly passes our #AB2499, by Assemblyman @drarambulaAD31 to ensure at least 80%-85% of premium dollars go to patient care, rather than administration and profit--resisting Trump Administration efforts to lower the standard. #Care4AllCA

— Health Access CA (@healthaccess) May 30, 2018

This falls into the "protect current ACA provisions" category.

UPDATE: There was some confusion last night about the exact percentages (the bill wording made it sound like large group would be bumped up to 90% and individual market to 85%, but Wright clarified this morning that eveyrthing would be locked in at current ACA thresholds.

Whew! I assume most/all of these still have to pass the other chamber, and of course they'd each still have to be signed by Gov. Jerry Brown, but even so...that's a whole lot of legislative action for one day.

UPDATE: Wright also clarified the timing/deadlines on these bills: They have to be passed out of one of the two houses of the state legislature by this Friday, but have until the end of August to pass out of the second house. Gov. Brown then has until September to either sign or veto each of them. HOWEVER, he also clarifies that any of the bills which would require funding (i.e., SB 1255) would have to be passed out of both houses by June 15th, since that's when the state budget has to be passed.