Bars abortion on an
unemancipated
minor until 48 hours
after her physician notifies her parent or legal guardian,
except in medical emergency or with parental or judicial
waiver.
Establishes a discount prescription drug program for
Californians at or below 300 percent of the federal
poverty level. Drug company participation optional.
Provides for prescription drug discounts to Californians
at or below 400 percent
Requires a health care service plan that covers outpatient
prescription drug benefits to provide coverage for inhaler spaces,
nebulizers, and peak flow meters when medically necessary for the management
and treatment of pediatric asthma
Institute of
Governmental Studies
University of California Berkeley
The
November 2004 election ballot will include Proposition 72, a
referendum that seeks to repeal the Health Insurance Act of 2003 (SB2) passed by the legislature and
Governor Gray Davis (see
bill documents associated with SB2). The Health Insurance Act requires
companies with 200 or more employees to buy health insurance for
workers and their families by 2006. Firms with 50 to 199 employees
are required to buy coverage for their employees starting in 2007.
Click here for under 50 employees. A YES vote
on Proposition 72 will approve the Health Insurance Act, while a NO vote
will repeal it.
SB 2
- Resource Area - Calif. Health Care Foundation
Sorry, the links changed, you'll have to use THEIR search engine.
California lawmakers passed a groundbreaking health
insurance measure early Saturday that would require small businesses to
provide coverage to 1 million of the state's working poor, who now rely on
tax-supported programs for medical
care.
employers with fewer than 20 workers would be exempt.
strong support has come from doctors, insurance companies
and unions that argue that the insurance would save taxpayers $650 million
to $1 billion in costs they are now billed through
Medi-Cal, the state health program for the poor and disabled.
Advocates of the bill have forecast that the measure
would produce almost immediate savings for taxpayers and insurance
ratepayers because low-income people who now go to expensive emergency rooms
for care would have their own private insurance. Currently, taxpayers and
health-care providers pay the tab for virtually all those costs.
McClintock, who added that the bill would cost California
jobs.
The Legislature sent a bill to the governor that would
require many California employers to offer health insurance to their
workers. The bill, SB 2, can be read at http://www.senate.ca.gov. Here's
a look at some of the details of the bill:
• Employers with at least 20 workers, but fewer than 50, would have to
provide health insurance only if the Legislature also passed a 20% tax
credit for those firms.
• If they chose to provide coverage, employers would be required to pay at
least 80% of the cost of the policy, with the workers paying the rest.
The California Health Insurance Act of 2003 is historic legislation that
opens a new chapter in the discussion over how to provide health care
coverage for the uninsured. In accordance with our standard policy, the
California HealthCare Foundation did not take a position on the legislation.
To assist those interested, we have compiled the following fact sheet and
resources (see below). This resource area will grow as we track the course
of the new law and analyze its impact. To register for updates,
click
here.
For a print-friendly version of the following fact sheet,
click here.
The Health Insurance Act of 2003: An Overview of SB 2
The Health Insurance Act of 2003, or Senate Bill 2 (SB 2), is a "pay or
play" law that requires California employers to pay a fee to the state to
provide health insurance unless the employer provides coverage directly, in
which case the fee is waived. The bill was passed by the legislature on
September 12, 2003, and signed by Governor Davis on October 5, 2003.
Who Will Be Covered under SB 2?
Eligible employees are those who have worked for an employer for three
months, and work at least 100 hours per month.
Firms with 200 or more California employees are required to
participate beginning January 1, 2006; coverage is required for both
workers and their dependents.
Firms with 50 to 199 California employees are required to participate
beginning January 1, 2007; coverage is required for workers but not
dependents.
Firms with 20 to 49 employees are exempt unless the state of
California provides a tax credit to those firms equal to 20 percent of the
employer's net cost of the fee.
Firms with fewer than 20 employees are exempt.
How Does SB 2 Work?
Firms are required to pay a fee to a state fund for each eligible
worker. Firms offering coverage that meets the minimum requirements of the
bill will receive a credit against the fee.
The State Health Purchasing Fund will be newly created and
administered by the Managed Risk Medical Insurance Board (MRMIB), which
also manages California's Healthy Families program. MRMIB will set the fee
and establish enrollee cost-sharing requirements (deductibles,
co-insurance, and copayments).
Employers that prefer to "play" (offer coverage) may apply to the
Employment Development Department (EDD) for a credit against the fee.
Coverage offered through the Department of Managed Health Care (DMHC)
meets the requirement, as does coverage offered through the Department of
Insurance as long as maximum out-of-pocket costs do not exceed those
offered through DMHC-regulated preferred provider organizations (PPOs).
Accident-only, hospital indemnity, and other limited benefit plans do not
qualify.
Employers and employees are required to share the costs of coverage.
Employers are required to contribute at least 80 percent; workers must
contribute the remaining amount, up to 20 percent. Worker contributions
are capped at 5 percent of wages for low-income workers (defined as up to
200 percent of the Federal Poverty Level, about $18,000 for an individual
or $30,500 for a family of three).
MRMIB will coordinate coverage for those eligible for Medi-Cal and
Healthy Families.
A related law, AB 1528, establishes a Health Care Quality Improvement
and Cost Containment Commission that will report to the legislature by
January 1, 2005, and make recommendations for health care cost
containment.
Market rules currently in place in the small group market (2 to 50
workers) will be expanded to cover firms with 51 to 199 workers, though a
rate band of +/-15 percent will be applied rather than the +/-10 percent
bands which currently apply in the small group market. (Rate bands
restrict the range of prices health plans may charge based on the risk
profile of the employer group.) In addition, health insurers may offer
different products to firms with 51 to 199 workers than they offer to
firms with 2 to 50 workers.
How Will SB 2 Affect the Uninsured?
UCLA's Center for Health Policy Research
estimates that, of a total of 4.5 million uninsured Californians, the
legislation will affect 860,000 workers and dependents when implemented for
firms with 50 or more workers (about 18 percent of California 's uninsured).
If implemented among firms with 20 to 49 workers as well, the number of
Californians affected is estimated at 1.1 million.
How Will Firms Be Affected?
According to the Kaiser Family Foundation/Health Research Educational
Trust (KFF/HRET)
2002 survey of California firms, 94 percent of firms with 50 to 199 workers
and 99 percent of firms with 200 or more workers offered health insurance.
The remaining firms will be required to pay the fee if they choose not to
begin offering coverage.
Other firms already offer health insurance, but will be required to
increase their contribution in order to meet the 80 percent requirement.
About 80 percent of firms with more than 50 workers contribute at
least 80 percent of the premium for worker coverage. As a result of the
legislation, the remaining 20 percent would need to upgrade their
contribution to 80 percent (KFF/HRET).
Only about half of firms with 200 or more workers pay the required 80
percent premium share for family coverage; the other half of firms would
need to increase their premium share (KFF/HRET).
Estimates of the costs that may be incurred by firms in California as a
result of SB 2 vary from $1.3 billion (California
Medical Association) to $11.3 billion (Employment
Policies Institute). Labor market effects are uncertain. Opponents
predict that many employers not currently offering health insurance will lay
workers off or leave the state, while supporters argue that the majority of
those employers are in locally based service industries and that the new
requirement levels the playing field for firms already offering coverage.
What Happens Now?
MRMIB is planning for SB 2 implementation, but opponents of the
legislation may challenge it through one or more routes:
A state lawsuit that claims the "fee" is actually a tax that did not
receive the required two-thirds majority vote in the legislature.
A federal lawsuit that claims the law violates the Employee Retirement
Income Security Act of 1974 (ERISA), a federal law pre-empting states from
regulating employer benefit plans.
A referendum to repeal SB 2 may be presented to the California voters.
The California Chamber of Commerce has filed the required paperwork and
would need about 375,000 signatures in order to place the measure on the
ballot.
A coalition of business groups (including the California Chamber of
Commerce, the California Restaurant Association, and the California
Retailers Association) is seeking to overturn SB 2 by referendum. The
referendum will appear on the November 2004 voters ballot. Find out more
about this campaign at the Stop the
Healthcare Tax site - no longer up.
Public Opinion Polls
A January 23 survey by The Field Poll measured voter awareness and
opinion of SB 2. The poll found that while less than one in three voters
(31%) are aware of SB 2, a large majority (65%) supports the measure’s basic
provisions after they are described.
See
The Field Poll results online.
The Institute of Industrial Relations (IIR) is an "Organized Research
Unit" of the University of California at Berkeley, and it has
published two pieces on this topic.
The California Partnership, an organization focused on building an
anti-poverty movement in California, has issued a
fact
sheet about the impact of SB 2 on California's lowest-income workers.
Additional Resources
The California Managed Risk Medical Insurance Board has been tasked with
implementing SB 2. The public is welcome at the Board's monthly meetings.
Meeting agendas and information on SB 2 are
available
at the MRMIB site.
The Foundation for Taxpayer and Consumer Rights, a consumer advocacy
group, called on Governor Schwarzenegger to support the new statute.
Read their letter to the new governor.
Davis Wright Tremaine LLP, a health law firm, has summarized the relevant
requirements and operation of the new law
in an article online.
Coming Soon
Check back here as we will add more resources on SB 2, such as:
A history of legislative attempts to mandate employer-sponsored health
insurance; and
Scenarios of the projected costs that firms may incur due to SB 2.
See the "Caveats" below. I was once overwhelmed with my divorce and TONS of research are on these pages. I'm now back full time with my Insurance Practice and do not plan to keep these pages up. We are doing a fictional screen play though. I just couldn't stand to toss the countless hours of research it took to put these links together. I hope it helps you find what your looking for and that you can come to an amicable resolution of your problem with a lot less time, energy and aggravation than I had in mine.
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