The California Senate passed two bills on Tuesday, August 24 on the California Health Benefits Exchange to be implemented by January 1, 2014 under the federal health care reform law. S.B. 900 would establish the exchange as an independent public entity and sets forth provisions concerning its governing board, executive director, open meeting rules, and other significant administrative, personnel, and financial requirements. S.B. 900 indicates that the governing board may require the State Insurance Commissioner and the Director of Managed Health Care to develop and maintain a comprehensive electronic clearinghouse of all health coverage available in California’s individual and small employer insurance marketplace, if they determine that the federal Web portal now under development does not completely satisfy California’s objectives. A companion measure, A.B. 1602, further delineates the powers and duties of the board, including certification of qualified health plans, requirements that plans justify premium increases, and measures designed to make plans compete for consumers on the basis of price, quality, and service, and not on risk selection. Measures prescribed by A.B. 1602 to help California consumers make informed choices among competing plans include user-friendly coverage information, provider directories, premium cost calculators, and telephone hotlines.
Massachusetts and Utah launched state-based health exchanges before enactment of the federal health care reform law, but S.B. 900 and A.B. 1602 represent the most important state legislation of this kind since enactment of the federal health care reform law. Governor Schwarzenegger is expected to sign both bills.
About Tom Entrikin
A former policy specialist with the U.S. Health Care Financing Administration (now Centers for Medicare & Medicaid Services (CMS)), Tom Entrikin has vast experience providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; and Medicaid waiver programs.
Read More
