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AB-3148 Health care affordability assistance: cost sharing.(2017-2018)

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Date Published: 04/13/2018 04:00 AM
AB3148:v97#DOCUMENT

Amended  IN  Assembly  April 12, 2018
Amended  IN  Assembly  March 23, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 3148


Introduced by Assembly Member Arambula
(Coauthors: Assembly Members Wood, Chiu, and Friedman)

February 16, 2018


An act to add Section 100504.1 to the Government Code, relating to health care coverage, and making an appropriation therefor.


LEGISLATIVE COUNSEL'S DIGEST


AB 3148, as amended, Arambula. Health care affordability assistance: cost sharing.
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA required each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers.
Existing state law establishes the California Health Benefit Exchange, also known as Covered California, within state government. Existing law specifies the powers and duties of the board governing Covered California, and requires the board to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers. Existing law establishes the California Health Trust Fund and continuously appropriates moneys in the fund for these purposes.
This bill would require the board to ensure that no one below 250% of the federal poverty line enrolls in bronze level coverage, as defined, and would require the board to offer additional cost sharing financial assistance to those who are otherwise eligible for premium tax credits and who have incomes determined to be below 400% of the federal poverty level, as specified. By requiring the board to offer this additional assistance, this bill would make an appropriation.
Vote: MAJORITY   Appropriation: YES   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 100504.1 is added to the Government Code, to read:
100504.1.

(a)The board shall ensure that no one whose income is determined to be below 250 percent of the federal poverty level enrolls in a bronze level of coverage.

(b)

100504.1.
 (a) The board shall offer additional cost sharing financial assistance to those who are otherwise eligible for premium tax credits and who have incomes determined to be below 400 percent of the federal poverty level, as follows:
(1) Individuals with incomes between 200 percent and 299 percent of the federal poverty level shall be offered products with an actuarial value of 87 percent. The benefit design for this product shall be consistent with the benefit design for cost sharing reduction benefits offered to those with incomes between 150 percent and 200 percent of the federal poverty level.
(2) Individuals with incomes between 300 percent and 400 percent of the federal poverty level shall be offered products with an actuarial value of 80 percent. The benefit design for this product shall be consistent with the benefit design for a gold level of coverage.

(c)

(b) The board shall take steps to maximize enrollment in benefit designs set forth in subdivision (b) (a) and minimize enrollment in benefit designs with lower actuarial value, especially bronze and catastrophic coverage. Steps shall include qualified health plan requirements, marketing, outreach, Web design, education of assisters and agents, and other steps as the board may determine appropriate.

(d)

(c) For the purposes of this section, “bronze level” and “gold level” have the same meanings as set forth in Section 1367.009 1367.008 of the Health and Safety Code and Section 10112.295 of the Insurance Code.