California lawmakers add PPACA coverage rules to state law

April 30, 2013 at 09:57 AM
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SACRAMENTO, Calif. (AP) — California state lawmakers have sent Gov. Jerry Brown, D, a pair of bills that will make some federal Patient Protection and Affordable Care Act (PPACA) health insurance product requirements part of state law.

The bills, ABx1-2 and SBx1-2, will give state agencies the power to enforce the PPACA ban on discrimination against health insurance applicants with pre-existing conditions and the PPACA restrictions on the difference between the rates health insurers charge their oldest insureds and the rates they charge their youngest adult insureds.

The Assembly passed ABx1-2 on a 49-20 vote, and the Senate passed SBx1-2 on a 27-9 vote.

The Assembly bill would change the insurance code.

The Senate bill would change the health and safety code.

The bills now go to the governor, who is expected to sign them. They were part of a special legislative session convened by Brown to implement national health care system changes in California.

The governor's office did not immediately respond to a request for comment Monday.

Sen. Joel Anderson, R-Alpine, said he was reluctant to vote against the bill but fears it will drive up health premiums for many individuals who buy their own insurance. He cited an actuarial report commissioned by Covered California that found that middle-income residents could see individual health premiums increase by an average of 30 percent.

"It pains me to oppose this because I know how hard everyone's been working," said Anderson, who voted no.

While premiums may go up for some people, many more will get better health coverage, said Sen. Ed Hernandez, D-Covina.

"What you won't hear about is all those individuals who are close to Medicare age with pre-existing conditions or were priced out of the market in the past," Hernandez said.

The bills also would allow the state's PPACA health insurance exchange, or Web-based insurance supermarket, to establish 19 geographic regions for determining individual premiums.

The bills would not let health insurers consider tobacco use in determining premium rates for Californians.

PPACA also encourages states to use federal money to expand access to Medicaid to people earning up to 138 percent of the federal poverty level, or about $15,400 a year for an individual.

Brown is still negotiating with members of his own party to expand Medicaid, which is known as Medi-Cal in California.

Some are predicting that expansion could add 1.2 million Medi-Cal enrollees by 2017.

The governor is trying to limit future state liabilities, but Democratic lawmakers say the benefits of expanding Medi-Cal outweigh the costs.

Under PPACA, the federal government will pay the full cost of expanding the low-income health program for the first three years, and then gradually reduce payments to 90 percent starting in 2020. The state is responsible for the remainder of that cost.

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