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Health Net's Legislative Update: Moving Forward on Reform

Jan 15, 2013


Health care and reform remain one of the most immediate challenges facing California Legislative leaders.  Here’s a summary of where things are for the state of California.


The federal Affordable Care Act takes effect in January 2014, when most Americans will realize the requirement to buy health insurance or pay a penalty. State lawmakers need to pass a series of rules that will clear the way for enrollment in a new state-run insurance market next fall. One such requirement is for insurers to cover consumers who have preexisting medical conditions and limits on how much they can charge based on age.


California has already laid much of the groundwork of the Affordable Care Act, being the first state to establish an insurance exchange after Congress passed the legislation in 2010. More than 30 other states are now seeking federal help to initate their state’s insurance exchange. Millions of Californians will be able to purchase coverage, with federal subsidies earmarked for families earning about $92,000 or less annually.


Governor Jerry Brown is likely to call a special session of the Legislature —  concurrent with the regular session — to ensure that the healthcare bills he signs can take effect within 90 days rather than the next year.


One of the most significant proposals will be an expansion of Medi-Cal, the state’s health insurance program for the poor. About 2 million low-income Californians would be newly eligible under the expansion, with the federal government subsidizing costs for the first three years. After that, the state would be responsible for a portion of the bill. California signed up more than 550,000 low-income people in a temporary program, and they are expected to automatically move into Medi-Cal in 2014.


Lawmakers will also consider legislation that would create a health plan for people who can’t  afford insurance on the open market, yet earn too much money to qualify for Medi-Cal. This option, known as the Basic Health Plan, would provide coverage for individuals with incomes between 133% and 200% of the federal poverty level, or between $15,000 and $21,800 a year.


Health Care Reform continues to take center stage for California lawmakers, and as they continue to enact legislation to move forward, we’ll keep you posted.


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