Today's Law As Amended

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AB-2565 Affordability assistance: cost sharing.(2017-2018)



SECTION 1.

 Section 100504.2 is added to the Government Code, to read:

100504.2.
 (a) The board shall provide enhanced premium assistance to individuals who enroll in health care coverage through the Exchange and who, under federal law, would be eligible for premium tax subsidies.
(b) The enhanced premium assistance shall be in addition to applicable federal premium tax subsidies and shall not replace those subsidies.
(c) For the purposes of this section, income shall be determined at the time of application, based on modified adjusted gross income, as defined in the federal act for premium tax credits.
(d) The enhanced premium assistance shall be based on the adjusted monthly premium for the applicable second lowest cost silver level health care coverage with respect to the individual. Consistent with federal law, the assistance may be applied to the purchase of other health care coverage.
(e) The board shall require that the applicable percentage of income to be spent on premiums for any individual whose income is within an income tier specified in the following schedule shall increase on a sliding scale and in a linear manner from the initial premium percentage to the final premium percentage set forth in the schedule for that income tier:
(1) If the household income is less than 139 percent of the federal poverty level, the premium shall be zero.
(2) If the household income is between 139 percent and 149 percent of the federal poverty level, the premium scale shall begin at 0.08 percent and end at 0.95 percent.
(3) If the household income is between 149 percent and 199 percent of the federal poverty level, the premium scale shall begin at 0.95 percent and end at 5.00 percent.
(4) If the household income is between 199 percent and 249 percent of the federal poverty level, the premium scale shall begin at 5.00 percent and end at 6.56 percent.
(5) If the household income is between 249 percent and 299 percent of the federal poverty level, the premium scale shall begin at 6.56 percent and end at 8.16 percent.
(6) If the household income is between 299 percent and 400 percent of the federal poverty level, the premium shall not exceed 8.16 percent.
(f) For the purposes of this section, the term “silver level” has the same meaning as set forth in Section 1367.009 of the Health and Safety Code, and Section 10112.295 of the Insurance Code.
(g) This section is operative only to the extent that funding is provided, by express reference, to cover the cost of the state subsidy in the annual Budget Act or in another statute making an appropriation for this purpose. Administrative costs incurred by the board in providing the state subsidy pursuant to this section shall be paid from the California Health Trust Fund.