Health care bill would protect patients from high out-of-pocket costs

Sacramento Business Journal by Katthy Robertson

August 14, 2013:

California may go ahead of the feds on health care reform, again. The Assembly Health Committee passed legislation Tuesday to implement consumer protections in the Affordable Care Act against high out-of-pocket costs.

If Senate Bill 639 by Sen. Ed Hernandez is passed by the Legislature this year and signed by the governor, it will implement key protections despite a decision by the Obama administration to provide a one-year delay for some plans.

And many Californians would not get a delay in protection detailed Tuesday by the New York Times.

“With this bill, California can once again not just implement the federal law, but improve upon it so our patients get these benefits as soon as possible,” Anthony Wright, executive director of Health Access, said in a news release. “This bill ensures that no California consumer in individual or small group coverage has to wait to get these important consumer protections.”

SB 639 would limit annual out-of-pocket costs to $6,350 per individual.

The Times reported Tuesday that a little-noticed rule on the U.S. Department of Labor’s website since February would allow many group health plans to maintain separate out-of-pocket limits for medical and prescription drug coverage for 2014.

Health plans and employers sought a grace period to upgrade their computer systems to track all out-of-pocket costs, something they don’t currently do.

“California has been implementing other pieces of the legislation early and should be in a place to go ahead on this,” Wright said.

It’s possible the question is moot in California because benefits and out-of-pocket costs are already set by Covered California for 2014, he added.

Anne Gonzales, a spokeswoman with the new state health exchange, said Tuesday that staff was reviewing the impact of the federal delay on Covered California.

Source: John & Rusty Report via Choice Admin