On January 24, 2013, Governor Jerry Brown called for a Special (or Extraordinary Session) to consider legislation that would facilitate the implementation of the Affordable Care Act (ACA). Legislation passed in the special session will take effect 91 days after the final adjournment of the special session. The Legislature has been directed to focus on three areas:
- California’s private health insurance market, rules and regulations governing the individual and small group market;
- California’s Medi-Cal program and changes necessary to implement federal law and;
- Options that allow low-cost health coverage through Covered California, to be provided to individuals who have income up to 200% of the Federal Poverty Limit (FPL).
On February 19, 2013, the first hearing of the extraordinary session occurred in the Assembly, focusing on changes to California’s Medi-Cal program. To brace for the impact, California is considering ABX1-1 (Perez), which expands Medi-Cal to include people under age 65 with income up to 138% of the FPL. This would decrease California’s mortality rate by increasing preventative care. The federal government will cover 85% of the expansion costs, which will benefit the community, providers and the economy. Passage of ABX1-1 will increase the Medi-Cal program by 1 million people by 2019, insuring those newly eligible and currently eligible but not enrolled. ABX1-1 received no opposition, and the Committee voted 13-6 in support of the measure. ABX1-1 also passed out of the Appropriations Committee on February 25, 2013.
On February 20, 2013, the Senate Health Committee held an extraordinary session to focus on how California can best proceed to implement the ACA with the individual and small group health market regulations. Senator Hernandez presented SBX1-2 (Hernandez), proposing 6 “Geographic Rating Regions” implemented in 2014, increasing to 13 in 2015, with an impact review of the “rating regions” to be completed by 2017. Additionally, SBX1-2 would require every health care insurer to offer a guarantee issue regardless of pre-existing conditions or health status. The Department of Insurance Commissioner, Dave Jones, disagreed with Senator Hernandez’s measure and proposed forming 18 regions, arguing that any more or less may increase rates by 25 percent. After much debate, Senator Hernandez spoke of the opportunity to move forward on this historical transition in California’s healthcare system. Although SBX1-2 received opposition by the Insurance Commissioner and the California Association of Health Plans, the measure passed as written 7-2. It also passed out of the Senate Appropriations Committee on February 21, 2013.