AB 1461 - An Act to Amend Sections 1363 and 1399.829 Of, to Amend the Heading of Article 11.7 (Commencing with Section 1399.825) of Chapter 2.2 of Division 2 Of, to Add Section 1399.836 To, to Add Article 11.8 (Commencing with Section 1399.845) to Chapter 2.2 of Division 2 Of, and to Repeal Section 1399.816 Of, the Health and Safety Code, and to Amend Section 10965.3 of the Insurance Code, Relating to Health Care Coverage.

Individual health care coverage. 2011-2012 Legislature. View bill details
Author(s):
Summary:
(1)Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for that… More
(1)Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for that coverage and to renew that coverage at the option of the plan sponsor or the individual. PPACA prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from imposing any preexisting condition exclusion with respect to that plan or coverage. PPACA allows the premium rate charge by a health insurance issuer offering small group or individual coverage to vary only by family composition, rating area, age, and tobacco use, as specified, and prohibits discrimination against individuals based on health status.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law requires plans offering coverage in the individual market to offer coverage for a child subject to specified requirements.

This bill would require a plan, on and after October 1, 2013, to offer, market, and sell all of the plan’s health benefit plans that are sold in the individual market to all individuals and dependents in each service area in which the plan provides or arranges for the provision of health care services, with coverage effective on or after January 1, 2014, as specified, but would require plans to limit enrollment in individual health benefit plans to specified open enrollment and special enrollment periods. The bill would prohibit these health benefit plans from imposing any preexisting condition upon any individual. Commencing January 1, 2014, the bill would prohibit a plan from conditioning the issuance or offering of individual health benefit plans on any health status-related factor, as specified, and would authorize plans to use only age, geographic region, and whether the plan covers an individual or family for purposes of establishing rates for individual health benefit plans, as specified. The bill would require a health care service plan to issue a specified notice at least 60 days prior to the renewal date of an individual grandfathered health plan to all subscribers of the plan. The bill would make certain of these provisions inoperative if the corresponding provisions of PPACA are repealed and would make other related conforming changes.

Because a willful violation of the bill’s requirements with respect to health care service plans would be a crime, the bill would impose a state-mandated local program.

(2)PPACA requires health insurance issuers to provide a summary of benefits and coverage explanation pursuant to specified standards to applicants and enrollees or policyholders.

Existing law requires health care service plans to use disclosure forms that contain specified information regarding the contracts issued by the plan, including the benefits and coverage of the contract, and the exceptions, reductions, and limitations that apply to the contract. Existing law requires health care service plans that offer individual or small group coverage to also provide a uniform health plan benefits and coverage matrix containing the plan’s major provisions, as specified.

This bill would authorize the Department of Managed Health Care to waive or modify those requirements for purposes of compliance with PPACA through issuance of all-plan letters until January 1, 2015.

(3)The bill would provide that it shall become operative only if SB 961 of the 2011–12 Regular Session is also enacted.

(4)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason. Hide
 
Status:
This bill was passed by both houses and vetoed by the Governor. It did not become law
Senate Committee on Appropriations Vote: Do pass as amended.

PASSED on August 16, 2012.

voted YES: 5 voted NO: 2
0 voted present/not voting

An Act to Amend Sections 1363 and 1399.829 Of, to Amend the Heading of Article 11.7 (Commencing with Section 1399.825) of Chapter 2.2 of Division 2 Of, to Add Section 1399.836 To, to Add Article 11.8 (Commencing with Section 1399.845) to Chapter 2.2 of Division 2 Of, and to Repeal Section 1399.816 Of, the Health and Safety Code, and to Amend Section 10965.3 of the Insurance Code, Relating to Health Care Coverage.

AB 1461 — 2011-2012 Legislature

Summary
(1)Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for that coverage and to renew that coverage at the option of the plan sponsor or the individual. PPACA prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from imposing any preexisting condition exclusion with respect to that plan or coverage. PPACA allows the premium rate charge by a health insurance issuer offering small group or individual coverage to vary only by family composition, rating area, age, and tobacco use, as specified, and prohibits discrimination against individuals based on health status.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a… More
(1)Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for that coverage and to renew that coverage at the option of the plan sponsor or the individual. PPACA prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from imposing any preexisting condition exclusion with respect to that plan or coverage. PPACA allows the premium rate charge by a health insurance issuer offering small group or individual coverage to vary only by family composition, rating area, age, and tobacco use, as specified, and prohibits discrimination against individuals based on health status.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law requires plans offering coverage in the individual market to offer coverage for a child subject to specified requirements.

This bill would require a plan, on and after October 1, 2013, to offer, market, and sell all of the plan’s health benefit plans that are sold in the individual market to all individuals and dependents in each service area in which the plan provides or arranges for the provision of health care services, with coverage effective on or after January 1, 2014, as specified, but would require plans to limit enrollment in individual health benefit plans to specified open enrollment and special enrollment periods. The bill would prohibit these health benefit plans from imposing any preexisting condition upon any individual. Commencing January 1, 2014, the bill would prohibit a plan from conditioning the issuance or offering of individual health benefit plans on any health status-related factor, as specified, and would authorize plans to use only age, geographic region, and whether the plan covers an individual or family for purposes of establishing rates for individual health benefit plans, as specified. The bill would require a health care service plan to issue a specified notice at least 60 days prior to the renewal date of an individual grandfathered health plan to all subscribers of the plan. The bill would make certain of these provisions inoperative if the corresponding provisions of PPACA are repealed and would make other related conforming changes.

Because a willful violation of the bill’s requirements with respect to health care service plans would be a crime, the bill would impose a state-mandated local program.

(2)PPACA requires health insurance issuers to provide a summary of benefits and coverage explanation pursuant to specified standards to applicants and enrollees or policyholders.

Existing law requires health care service plans to use disclosure forms that contain specified information regarding the contracts issued by the plan, including the benefits and coverage of the contract, and the exceptions, reductions, and limitations that apply to the contract. Existing law requires health care service plans that offer individual or small group coverage to also provide a uniform health plan benefits and coverage matrix containing the plan’s major provisions, as specified.

This bill would authorize the Department of Managed Health Care to waive or modify those requirements for purposes of compliance with PPACA through issuance of all-plan letters until January 1, 2015.

(3)The bill would provide that it shall become operative only if SB 961 of the 2011–12 Regular Session is also enacted.

(4)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason. Hide
Learn More
At LegInfo.ca.gov
Title
An Act to Amend Sections 1363 and 1399.829 Of, to Amend the Heading of Article 11.7 (Commencing with Section 1399.825) of Chapter 2.2 of Division 2 Of, to Add Section 1399.836 To, to Add Article 11.8 (Commencing with Section 1399.845) to Chapter 2.2 of Division 2 Of, and to Repeal Section 1399.816 Of, the Health and Safety Code, and to Amend Section 10965.3 of the Insurance Code, Relating to Health Care Coverage.
Author(s)
Bill Monning
Co-Authors
Subjects
  • Individual health care coverage
Major Actions
Introduced1/09/2012
Referred to Committee
Passed Assembly Committee on Health4/17/2012
Passed Assembly Committee on Appropriations5/25/2012
Passed Assembly5/29/2012
Passed Senate Committee on Health6/27/2012
Passed Senate Committee on Appropriations8/06/2012
Passed Senate Committee on Appropriations8/16/2012
Passed Senate8/29/2012
Passed Assembly8/31/2012
Presented to the governor (enrolled)9/13/2012
Vetoed by Governor9/30/2012
Vetoed by Governor9/30/2012
Bill History
Chamber/CommitteeMotionDateResult
select this voteAssembly Committee on HealthDo pass and be re-referred to the Committee on Appropriations.4/17/2012This motion PASSED the Assembly Committee on Health
13 voted YES 6 voted NO 0 voted present/not voting
select this voteAssembly Committee on AppropriationsDo pass.5/25/2012This motion PASSED the Assembly Committee on Appropriations
12 voted YES 5 voted NO 0 voted present/not voting
select this voteAssemblyAB 1461 MONNING Assembly Third Reading5/29/2012This bill PASSED the Assembly
50 voted YES 27 voted NO 3 voted present/not voting
select this voteSenate Committee on HealthDo pass, but re-refer to the Committee on Appropriations.6/27/2012This motion PASSED the Senate Committee on Health
6 voted YES 3 voted NO 0 voted present/not voting
select this voteSenate Committee on AppropriationsPlaced on Appropriations Suspense file.8/06/2012This motion PASSED the Senate Committee on Appropriations
7 voted YES 0 voted NO 0 voted present/not voting
currently selectedSenate Committee on AppropriationsDo pass as amended.8/16/2012This motion PASSED the Senate Committee on Appropriations
5 voted YES 2 voted NO 0 voted present/not voting
select this voteSenateAssembly 3rd Reading AB1461 Monning By Hernandez8/29/2012This bill PASSED the Senate
23 voted YES 12 voted NO 5 voted present/not voting
select this voteAssemblyAB 1461 MONNING Concurrence in Senate Amendments8/31/2012This bill PASSED the Assembly
51 voted YES 27 voted NO 2 voted present/not voting
ActionDateDescription
Introduced1/09/2012
1/09/2012Read first time. To print.
1/10/2012From printer. May be heard in committee February 9.
1/19/2012Referred to Com. on HEALTH.
4/09/2012From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.
4/10/2012Re-referred to Com. on HEALTH.
select this voteVote4/17/2012Do pass and be re-referred to the Committee on Appropriations.
4/18/2012From committee: Do pass and re-refer to Com. on APPR. (Ayes 13. Noes 6.) (April 17). Re-referred to Com. on APPR.
4/25/2012In committee: Set, first hearing. Referred to APPR. suspense file.
select this voteVote5/25/2012Do pass.
5/25/2012From committee: Do pass. (Ayes 12. Noes 5.) (May 25). Read second time. Ordered to third reading.
5/29/2012Read third time. Passed. Ordered to the Senate. (Ayes 50. Noes 27. Page 5039.)
5/29/2012In Senate. Read first time. To Com. on RLS. for assignment.
select this voteAssembly Vote on Passage5/29/2012AB 1461 MONNING Assembly Third Reading
6/07/2012Referred to Com. on HEALTH.
select this voteVote6/27/2012Do pass, but re-refer to the Committee on Appropriations.
6/28/2012From committee: Do pass and re-refer to Com. on APPR. (Ayes 6. Noes 3.) (June 27). Re-referred to Com. on APPR.
select this voteVote8/06/2012Placed on Appropriations Suspense file.
8/06/2012In committee: Referred to APPR. suspense file.
currently selectedVote8/16/2012Do pass as amended.
8/20/2012From committee: Do pass as amended. (Ayes 5. Noes 2.) (August 16).
8/21/2012Read second time and amended. Ordered to third reading.
8/24/2012Read third time and amended. Ordered to second reading.
8/27/2012Read second time. Ordered to third reading.
8/29/2012Read third time. Passed. Ordered to the Assembly. (Ayes 23. Noes 12. Page 4934.).
select this voteSenate Vote on Passage8/29/2012Assembly 3rd Reading AB1461 Monning By Hernandez
8/30/2012In Assembly. Concurrence in Senate amendments pending.
8/31/2012Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 51. Noes 27. Page 6748.).
select this voteAssembly Vote on Passage8/31/2012AB 1461 MONNING Concurrence in Senate Amendments
9/13/2012Enrolled and presented to the Governor at 12:15 p.m.
Vetoed9/30/2012Vetoed by Governor.
9/30/2012Consideration of Governor's veto pending.

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0 Organizations Supported and 0 Opposed

Organizations that took a position on
An Act to Amend Sections 1363 and 1399.829 Of, to Amend the Heading of Article 11.7 (Commencing with Section 1399.825) of Chapter 2.2 of Division 2 Of, to Add Section 1399.836 To, to Add Article 11.8 (Commencing with Section 1399.845) to Chapter 2.2 of Division 2 Of, and to Repeal Section 1399.816 Of, the Health and Safety Code, and to Amend Section 10965.3 of the Insurance Code, Relating to Health Care Coverage.: Do pass as amended.

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0 organizations opposed this motion

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Includes reported contributions to campaigns of Senators in office on day of vote, from interest groups invested in the vote according to MapLight, January 1, 2009 – December 31, 2012.
Contributions data source: FollowTheMoney.org

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Elaine AlquistDCA-13$0$0
Joel AndersonRCA-36$0$0
Tom BerryhillRCA-14$0$0
Sam BlakesleeRCA-15$0$0
Ron CalderonDCA-30$0$0
Anthony CannellaRCA-12$0$0
Ellen CorbettDCA-10$0$0
Lou CorreaDCA-34$0$0
Kevin De LeonDCA-22$0$0
Mark DeSaulnierDCA-7$0$0
Bob DuttonRCA-31$0$0
Bill EmmersonRCA-37$0$0
Noreen EvansDCA-2$0$0
Jean FullerRCA-18$0$0
Ted GainesRCA-1$0$0
Loni HancockDCA-9$0$0
Tom HarmanRCA-35$0$0
Ed HernandezDCA-24$0$0
Bob HuffRCA-29$0$0
Christine KehoeDCA-39$0$0
Doug La MalfaRCA-4$0$0
Mark LenoDCA-3$0$0
Ted LieuDCA-28$0$0
Carol LiuDCA-21$0$0
Alan LowenthalDCA-27$0$0
Gloria Negrete McLeodDCA-32$0$0
Alex PadillaDCA-20$0$0
Fran PavleyDCA-23$0$0
Curren PriceDCA-26$0$0
Michael RubioDCA-16$0$0
Sharon RunnerRCA-17$0$0
Joe SimitianDCA-11$0$0
Darrell SteinbergDCA-6$0$0
Tony StricklandRCA-19$0$0
Juan VargasDCA-40$0$0
Mimi WaltersRCA-33$0$0
Lois WolkDCA-5$0$0
Rod WrightDCA-25$0$0
Mark WylandRCA-38$0$0
Leland YeeDCA-8$0$0

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