Affordable Health Care Implementation Bills Go to Governor

Landmark legislation implementing the federal Affordable Care Act was approved by the California State Senate and sent to the Governor Thursday. Authored by California State Senator Ed Hernandez, O.D. (D – West Covina), the legislation establishes minimum health benefits and provides important consumer protections for all Californians purchasing health insurance.
SB 951 sets the minimum standards for health benefits that insurers offer, including doctor visits, hospitalization, prescription drugs, emergency-room treatment, mental health services and vision and dental care for children. SB 961 prevents insurance companies and health plans from denying coverage or charging excessive premiums on those who have preexisting health conditions, and requires that insurance premiums be based solely on age, geography, and family size.
These two bills implement in California law some of the most transformative and popular components to President Obama’s Affordable Care Act (ACA).
Under the ACA, states must designate a benchmark for all individual and small group health insurance plans incorporating ten broad categories of coverage, otherwise known as “Essential Health Benefits.” Senator Hernandez’ legislation, SB 951, creates this benchmark for California.
“SB 951 establishes a strong, baseline standard of care that balances affordability with coverage of vital health benefits important to all Californians” said Hernandez. “This bill will finally put an end to the sale of ‘junk insurance’ that is marketed as coverage but offers consumers little or no value.”
SB 961 reforms California’s health insurance market and implements strong consumer protections by eliminating the use of preexisting condition exclusions and establishing a “modified community rating.” This means the factors that can be used to establish premium rates are limited to age, geography and family size.
The bill also requires the guaranteed issue of health insurance, ending the practice of conditioning coverage and the cost of that coverage on a person’s medical history, genetic information or other factors. By incorporating these elements of the ACA into state law, SB 961 allows state regulators to enforce these protections for all Californians.
“SB 961 represents the heart of the consumer protections provided by the ACA,” Hernandez stated. “This bill improves access to health coverage for all Californians by preventing insurance companies from engaging in discriminatory practices and pricing that have kept people with preexisting conditions from getting health coverage.”
Both SB 951 and SB 961 now await Governor Brown’s signature. The Governor has signaled support for the Affordable Care Act reforms in the past, leaving Senator Hernandez hopeful the bills will be signed.
“California has embraced federal health care reform and leads the nation in the implementation of this landmark law,” Hernandez stated. “These bills make the ACA’s most critical reforms and protections a reality for all Californians. I am confident that they will have the Governor’s support.”

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