BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 2
                                                                  Page  1

          SENATE THIRD READING
          SB 2 (Burton and Speier)
          As Amended June 23, 2003
          Majority vote 

           SENATE VOTE  :25-14  
           
           HEALTH              16-8                                        
           
           -------------------------------- 
          |Ayes:|Frommer, Chan, Chavez,    |
          |     |Chu, Cohn, Goldberg,      |
          |     |Koretz, Lieber, Montanez, |
          |     |Nakano, Negrete McLeod,   |
          |     |Nunez, Ridley-Thomas,     |
          |     |Salinas, Wolk, Yee        |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Pacheco, Bates, Dutton,   |
          |     |Maze, McCarthy,           |
          |     |Nakanishi, Plescia,       |
          |     |Richman                   |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Enacts the Health Insurance Act of 2003 with the  
          intent of ensuring that all working Californians and their  
          families are provided health care coverage by their employer or  
          through a state program that purchases coverage using fees paid  
          by employers who do not provide coverage directly.  States  
          legislative intent to not reduce or eliminate funding for safety  
          net programs that provide access to care for those who remain  
          uninsured.

           EXISTING LAW  :

          1)Establishes the Medi-Cal program, administered by the  
            Department of Health Services (DHS), which provides  
            comprehensive health benefits to specified low-income  
            individuals.
           
          2)Establishes the Healthy Families Program (HFP), administered  
            by the Managed Risk Medical Insurance Board (MRMIB), to  
            provide low-cost, subsidized health, vision and dental  
            insurance to uninsured children, with family incomes up to  
            250% of the federal poverty level (FPL), who are not eligible  








                                                                  SB 2
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            for no-cost Medi-Cal, and parents with family incomes up to  
            200% FPL. 

          3)Imposes various requirements on health plans and health  
            insurers that sell coverage to small businesses, defined as  
            those with two to 50 employees.  These requirements include  
            guaranteed issuance of contracts and policies, guaranteed  
            renewal, limits on the use of preexisting condition  
            exclusions, and limitations on the extent to which rates can  
            vary from group to group based on health status or claims  
            experience.

           FISCAL EFFECT  :  None

           COMMENTS  :  This bill is intended to build upon our existing  
          employment-based health insurance system to ensure that working  
          families have health benefits.  According to the California  
          Federation of Labor, AFL-CIO, writing in support of this bill,  
          almost 20 million Californians receive health coverage through  
          employment yet California employers offer coverage at a rate  
          below the national average. 
          According to the UCLA Center for Health Policy Research, over  
          six million children and nonelderly adults in California were  
          uninsured for all or part of the year in 2001.  Although 79% of  
          Californians were insured all year, one in five (21%) lacked  
          coverage for some or all of the year.  Of the 6.3 million  
          Californians who lacked insurance, over 1.3 million were  
          children.  Over half the uninsured, 52.6%, or 3.3 million people  
          were uninsured for more than a year.  There are substantial  
          disparities in coverage stability across ethnic and racial  
          groups.  About 86% of whites and African Americans were insured  
          all year in 2001 compared with lower proportions for Asian  
          Americans and for American Indians and Alaska Natives.  Latinos  
          are the least likely to be insured all year (64.1%) and the most  
          likely to be uninsured all year (22.8%).  Coverage stability  
          varies even more by family income. Among nonelderly persons with  
          family incomes of at least 300% FPL, 89.9% were insured all year  
          compared with just 61.3% of those below poverty.  Just 3.7% of  
          those with incomes of 300% FPL or more were uninsured all year,  
          less than one-sixth the proportion (24.8%) of those below  
          poverty.  

          Having coverage during the year is largely a result of access to  
          employer-sponsored health benefits. According to UCLA, among  
          adult employees who were insured all year, 74% both worked for  








                                                                 SB 2
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          an employer who offered insurance, and accepted the health  
          benefits.  Another 12% were eligible but did not accept coverage  
          from their own employer, often because of coverage through  
          another family member.  In contrast, among adult employees who  
          were uninsured all year, 67.8% work for employers who offered no  
          health benefits; another 17.8% had employers who offered  
          coverage for which they were not eligible.  Only 14.4% were  
          eligible but did not take-up the offer.  The uninsured are  
          overwhelmingly low- and moderate-income working families and  
          individuals without access to affordable coverage through  
          employment.  Based on data from the Current Population Survey,  
          more than eight in ten uninsured adults and children are in  
          working families, including half who are in a family with at  
          least one adult employed full-time full-year.

          This bill is supported by a broad range of organizations  
          including consumer groups, advocates for seniors, provider  
          organizations, and labor unions.  Opponents, such as the  
          California Chamber of Commerce, are concerned that this bill  
          will be a burden to business leading to unemployment.  Opponents  
          believe the primary reason employers do not offer insurance is  
          the excessive cost of health care.

          This bill is one of several that have been introduced this year  
          to expand access to health coverage in the state.  It is  
          anticipated that legislation to increase health access will be  
          considered in a conference committee.  AB 1527  (Frommer),  
          pending in the Senate proposes a "pay or play" approach, similar  
          to this bill, but would apply the requirement only to employers  
          with more than 50 employees.  AB 1528 (Cohn), pending in the  
          Senate, adds an individual mandate to the requirement in AB 1527  
          and SB 2 that employers provide coverage.  Like SB 2, both AB  
          1527 and AB 1528 currently contain intent language only.  AB 30  
          (Richman), pending in the Senate, expands HFP to employed  
          uninsured childless adults whose family income does not exceed  
          200% of FPL, with premiums paid by the employee and employer  
          (25%), state (25%) and federal government (50%).  SB 921  
          (Kuehl), pending in the Assembly, proposes a single-payer  
          system. 


           Analysis Prepared by  :    Debra L. Roth / HEALTH / (916) 319-2097  

                                                                FN: 0002159