Today's Law As Amended


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SB-944 California Health Benefit Exchange: affordability assistance.(2021-2022)



As Amends the Law Today


SECTION 1.

 Section 100520.5 of the Government Code is amended to read:

100520.5.
 (a) The Health Care Affordability Reserve Fund is hereby created in the State Treasury.
(b) Notwithstanding any other law, the Controller may use the funds in the Health Care Affordability Reserve Fund for cashflow loans to the General Fund as provided in Sections 16310 and 16381.
(c) Upon the enactment of the Budget Act of 2021, and upon order of the Director of Finance, the Controller shall transfer three hundred thirty-three million four hundred thirty-nine thousand dollars ($333,439,000) from the General Fund to the Health Care Affordability Reserve Fund.
(d) Upon appropriation by the Legislature, the Health Care Affordability Reserve Fund shall be utilized, in addition to any other appropriations made by the Legislature for the same purpose, for the purpose of health care affordability programs operated by the California Health Benefit Exchange.
(e) (1)  The California Health Benefit Exchange shall,  has conducted,  in consultation with stakeholders and the Legislature, a study to  develop options for providing cost sharing reduction subsidies to reduce cost sharing for low- and middle-income Californians. On or before January 1, 2022, the Exchange shall report those developed options to the Legislature, Governor, and the Healthy California for All Commission, established pursuant to Section 1001 of the Health and Safety Code, for consideration in the 2022–23 budget process. health care affordability assistance. It is the intent of the Legislature in adding this subdivision to enable the Exchange to implement that affordability assistance. It is further the intent of the Legislature that the affordability assistance both maximize federal financial assistance and be in addition to that assistance. 
(2) In developing the options, the Exchange shall do all of the following:
(A) (1)  Include options for all Covered California enrollees with income up to 400 percent of the federal poverty level to  The affordability assistance provided by the Exchange shall  reduce cost sharing, including copays, deductibles,  coinsurance, and maximum out-of-pocket costs. costs, if enhanced federal premium subsidies consistent with the federal American Rescue Plan Act of 2021 (Public Law 117-2) are made available for the 2023 and 2024 calendar years, and shall eliminate deductibles for all benefits to the extent feasible. 
(B) Include options to provide zero deductibles for all Covered California enrollees with income under 400 percent of the federal poverty level and upgrading those with income between 200 percent and 400 percent, inclusive, of the federal poverty level to gold-tier cost sharing.
(C) Address any operational issues that might impede implementation of enhanced cost-sharing reductions for the 2023 calendar year.
(D) Maximize federal funding and address interactions with federal law regarding federal cost-sharing reduction subsidies.
(3) The Exchange shall make the report publicly available on its internet website.
(4) (2)  The Exchange shall submit the report in compliance with Section 9795 of the Government Code. adopt standard benefit designs consistent with this subdivision. 
(f) Upon order of the Department of Finance, a loan of six hundred million dollars ($600,000,000) is authorized from the Health Care Affordability Reserve Fund to the General Fund in the 2023–24 fiscal year. The loan shall be repaid in the 2025–26 fiscal year.

SEC. 2.

 Section 100800 of the Government Code is amended to read:

100800.
 (a) The Exchange shall administer a program of financial assistance to help low-income and middle-income Californians access affordable health care coverage through the Exchange.
(b) The program may  program, if funded through an appropriation in the annual Budget Act or an amount otherwise appropriated by the Legislature, shall  provide financial assistance to California residents with household incomes at or below 600 percent of the federal poverty level, and may shall  provide other appropriate subsidies designed to make health care coverage more accessible and affordable for individuals and households.
(c) Upon appropriation by the Legislature, the  The  Exchange shall adopt, and may amend, an annual program design for each coverage year to implement this section by resolution of the board of the Exchange. The resolution shall be adopted at a duly noticed meeting.
(1) A resolution adopted pursuant to this section shall not take effect until 10 days after  approved by the Director of Finance following 10 days  notification in writing to the Joint Legislative Budget Committee.
(2) The requirements of paragraph (1) may be waived by the joint  written consent of the Director of Finance and the  Chair of the Joint Legislative Budget Committee to adopt a resolution that is deemed urgent. A resolution adopted pursuant to this paragraph shall take immediate effect.
(3)  The Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code) shall not apply to the program design or a resolution adopted pursuant to this section.
(d) The program design adopted for a coverage year shall be based on funds appropriated to the program for that coverage year. An appropriation made for the program shall contain provisional language directing the Exchange to provide a certain proportion of the funds to specified income ranges as determined by the Legislature and may provide other parameters guiding the design of the program.
(1) Pursuant to the Budget Act of 2023, the program shall be funded at an amount up to eighty-two million five hundred thousand dollars ($82,500,000) for coverage year 2024.
(2) It is the intent of the Legislature, beginning in the 2024–25 fiscal year, to appropriate up to one hundred sixty-five million dollars ($165,000,000) in the annual Budget Act to the program for each coverage year of the program after coverage year 2024.
(e) The Exchange shall provide appropriate opportunities for stakeholders and the public to consult in the design of the program.