Health and Human Services
For more information, contact Kelly Brooks at 916/327-7500, ext. 531, or kbrooks@counties.org, or Farrah McDaid Ting at 916/327-7500, ext. 559, or fmcdaid@counties.org.
Legislative Leadership Releases New Version of Health Care Reform
Legislative leaders Assembly Speaker Fabían Núñez and Senate President pro Tem Don Perata introduced a new version of a bill to implement health care reform in the Golden State on November 6.
Núñez and Perata introduced the special session bill, ABx1 1, in concept form at a press conference, with the full language expected to be released early next week. ABx1 1 differs in several key areas from AB 8, the leaders’ regular session health care reform bill that the Governor vetoed last month, but also contains several key provisions similar to the Governor’s October proposal.
On the funding side, ABx1 1 would help finance the health care insurance expansion in part through a $2 per pack tax increase on cigarettes as well as a mix of employer and hospital fees that would be placed on next November’s ballot. The fact sheet released by leadership indicates that the measure will also contains intent language for a county share of cost, but does not contain additional details.
The new bill borrows from the Governor’s proposal to create an individual mandate. However, the measure exempts people who cannot afford to purchase insurance from the mandate if the total cost of insurance 6.5 percent or more of income. ABx1 1 also gives the Managed Risk Medical Insurance Board (MRMIB) the task of setting minimum standards for insurance products that will meet the mandate and enforcement of the mandate. ABx1 1 offers a tax credit for those with incomes between 250 and 450 percent of the federal poverty level (FPL).
The measure also expands coverage to parents and caretaker relatives with family incomes at or below 300 percent of the FPL and expands coverage to single adults with incomes less than 250 percent FPL.
ABx1 1 also contains a “pay or play” mandate for employers. The employer’s fee would be based on a sliding scale tied to payroll, with employers with payrolls at or above $350,000 annually paying for or contributing 6.5 percent of payroll on health care expenditures. For those with payrolls of $100,000 to $250,000, it would be 4 percent, and for those below $100,000 payroll, the contribution would be 2 percent. The fee is separated into two categories: above $25,000 annual salary and below $25,000 annual salary. This was done to ensure that part-time workers receive coverage.
The Assembly Health Committee has scheduled a hearing on November 14 to hear the bill. CSAC continues to hold conversations with both the Governor’s staff and legislative staff to address our concerns regarding the county share of cost. Updates will be provided during next week’s CSAC Annual Meeting.
Healthy Families Wait Lists and Disenrollments Loom in the Absence of SCHIP Funding
The California Managed Risk Medical Insurance Board (MRMIB) passed emergency regulations on November 5 to allow the Healthy Families child health insurance program to implement waiting lists and possible disenrollment procedures as soon as December 31 if Congress fails to pass legislation to extend SCHIP (State Children's Health Insurance Program) funding.
Federal SCHIP funding provides $2 for every $1 California spends on the Healthy Families Program (HFP), which currently serves 835,000 poor children. The new emergency regulations will allow the HFP executive director of the program to begin disenrolling children December 31 and to develop two waiting lists: one for children who have been disenrolled from the program, and one for new applicants. Those on the first list would get priority for enrollment should funding become available.
The MRMIB Board voted to declare a funding emergency on November 5, but must meet again on December 5 to authorize the executive director to implement the emergency regulations. The Board and staff were still hopeful that a SCHIP resolution could be reached in advance of December, but went ahead and scheduled the December 5 implementation meeting anyway. Federal funding for SCHIP runs out on November 16.
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