Bill Text: CA AB4 | 2023-2024 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Covered California: expansion.

Spectrum: Partisan Bill (Democrat 14-0)

Status: (Engrossed) 2024-08-15 - In committee: Held under submission. [AB4 Detail]

Download: California-2023-AB4-Amended.html

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Amended  IN  Senate  June 20, 2023

Amended  IN  Assembly  March 09, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 4

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Introduced by Assembly Member Arambula
(Principal coauthor: Assembly Member Cervantes)
(Principal coauthor: Senator Durazo)
(Coauthors: Assembly Members Addis, Juan Carrillo, Wendy Carrillo, Lee, McCarty, McKinnor, Ortega, and Santiago)
(Coauthors: Senators Gonzalez and Wiener)

December 05, 2022

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An act to amend Section 100522 of the Government Code, relating to health care.

LEGISLATIVE COUNSEL'S DIGEST

AB 4, as amended, Arambula. Covered California: expansion.

Existing federal law, the Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. Existing state law creates the California Health Benefit Exchange, also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law requires the Exchange to apply for a federal waiver to allow persons otherwise not able to obtain coverage through the Exchange because of their immigration status to obtain coverage from the Exchange.

This bill would require the Exchange, in consultation with stakeholders and the Legislature, to develop options for expanding access to affordable health care coverage to Californians regardless of immigration status. The bill would require the Exchange to report those options to the Legislature and Governor on or before February 1, 2024, and would require the Exchange to post the report publicly on its internet website.

Existing federal law, the Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. Existing state law creates the California Health Benefit Exchange, also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law requires the Exchange to apply to the United States Department of Health and Human Services for a waiver to allow individuals who are not eligible to obtain health coverage through the Exchange because of their immigration status to obtain coverage from the Exchange, by waiving the requirement that the Exchange offer only qualified health plans solely for the purpose of offering coverage to persons otherwise not able to obtain coverage by reason of immigration status. Existing law limits the waiver of that requirement to requiring the Exchange to offer only “California qualified health plans,” as specified, to those individuals. Existing law requires an issuer that offers a qualified health plan in the individual market through the Exchange to concurrently offer a California qualified health plan that meets prescribed criteria.

This bill would revise those provisions by deleting the requirement that limits coverage for the described individuals to the California qualified health plans. Contingent upon federal approval of the waiver, specified requirements for applicants eligible for the coverage described in the bill would become operative on January 1, 2025, for coverage effective for qualified health plans beginning January 1, 2026.

Digest Key

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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Bill Text

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

SECTION 1.

 The Legislature finds and declares all of the following:

(a) One of the state’s essential goals is to achieve health and mental health equity throughout California by reducing disparities in access to health care among vulnerable and underserved communities.

(b) Californians who have historically and systematically faced barriers to accessing health care include people of color and immigrants, both documented and undocumented.

(c) Despite the fact that collectively millions of undocumented Californians contribute approximately $3,700,000,000 in state and local taxes ever year, they are unable to access the same subsidized health care as other taxpayers in the state.

(d) Access to affordable health care coverage has been demonstrated to positively impact the health and well-being of people.

(e) It is the intent of the Legislature to ensure that all Californians have access to affordable health care coverage by removing immigration status as a barrier to eligibility.

SEC. 2.

 Section 100522 of the Government Code is amended to read:

100522.

 (a) (1) The Exchange shall apply to the United States Department of Health and Human Services for a waiver authorized under Section 1332 of the federal act as defined in subdivision (e) of Section 100501 in order to allow persons otherwise not able to obtain coverage by reason of immigration status through the Exchange to obtain coverage from the Exchange by waiving the requirement that the Exchange offer only qualified health plans solely for the purpose of offering coverage to persons otherwise not able to obtain coverage by reason of immigration status.

(2) The waiver of the requirement that the Exchange offer only qualified health plans as described in paragraph (1) shall be limited to requiring the Exchange to offer California qualified health plans consistent with this section only and shall not be construed to authorize the Exchange to offer any other nonqualified health plan.

(b) The Exchange shall require an issuer that offers a qualified health plan in the individual market through the Exchange to concurrently offer a California qualified health plan that meets all of the following criteria:

(1) Is subject to the requirements of this title, including all of those requirements applicable to qualified health plans.

(2) Is subject to the requirements of subdivisions (a), (b), and (d) of Section 1366.6 of the Health and Safety Code and subdivisions (a), (b), and (d) of Section 10112.3 of the Insurance Code in the same manner as qualified health plans.

(3) Is identical to the corresponding qualified health plan, except for the eligibility requirements set forth in subdivision (c).

(c) Persons eligible to purchase California qualified health plans shall pay the cost of coverage and shall not:

(1) Be eligible to receive federal advanced premium tax credit, federal cost-sharing reduction, or any other federal assistance for the payment of premiums or cost sharing for a California qualified health plan.

(2) Otherwise be eligible for enrollment in a qualified health plan offered through the Exchange by reason of immigration status.

(d) An applicant for coverage under this section shall be required to provide only the information strictly necessary to authenticate identity and determine eligibility under this section. Any person who receives information provided by an applicant under this section, whether directly or by another person at the request of the applicant, or receives information from any agency, shall use the information only for the purposes of, and to the extent necessary for, ensuring the efficient operation of the Exchange, including verifying the eligibility of an individual to enroll through the Exchange. That information shall not be disclosed to any other person except as provided in this section.

(e) (1) The Exchange, in consultation with stakeholders and the Legislature, shall develop options for expanding access to affordable health care coverage to Californians regardless of immigration status.

(2) On or before February 1, 2024, the Exchange shall report the options developed pursuant to paragraph (1) to the Legislature and Governor. The report shall be submitted in compliance with Section 9795. The Exchange shall also make the report publicly available on its internet website.

(e)

(f) Subdivisions (b) to (d), inclusive, shall become operative on January 1, 2018, for coverage effective for California qualified health plans beginning January 1, 2019, contingent upon federal approval of the waiver pursuant to subdivision (a).

SECTION 1.Section 100522 of the Government Code is amended to read:

100522.

(a)The Exchange shall apply to the United States Department of Health and Human Services for a waiver authorized under Section 1332 of the federal act as defined in subdivision (e) of Section 100501 in order to allow persons otherwise not able to obtain coverage by reason of immigration status through the Exchange to obtain coverage from the Exchange.

(b)Persons eligible to purchase qualified health plans under the waiver described in subdivision (a) and otherwise not able to obtain coverage by reason of immigration status shall pay the cost of coverage and shall not:

(1)Be eligible to receive federal advanced premium tax credit, federal cost-sharing reduction, or any other federal assistance for the payment of premiums or cost sharing for a qualified health plan.

(2)Otherwise be eligible for enrollment in a qualified health plan offered through the Exchange by reason of immigration status.

(c)An applicant for coverage under this section shall be required to provide only the information strictly necessary to authenticate identity and determine eligibility under this section. A person who receives information provided by an applicant under this section, whether directly or by another person at the request of the applicant, or receives information from any agency, shall use the information only for the purposes of, and to the extent necessary for, ensuring the efficient operation of the Exchange, including verifying the eligibility of an individual to enroll through the Exchange. That information shall not be disclosed to any other person except as provided in this section.

(d)Subdivisions (b) and (c) shall become operative on January 1, 2025, for coverage effective for qualified health plans beginning January 1, 2026, contingent upon federal approval of the waiver pursuant to subdivision (a).