BILL NUMBER: AB 12	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Beall

                        DECEMBER 4, 2006

   An act to add Division 113 (commencing with Section 131500) to the
Health and Safety Code, relating to health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 12, as introduced, Beall.  The Adult Health Coverage Expansion
Program.
   Existing law requires a health care service plan and a health
insurer to fairly and affirmatively offer, market, and sell its
contract or its policy, as specified, to small employers, as defined.
Existing law also provides for a local initiative, which is defined
as a prepaid health plan organized by a county government or by
stakeholders to provide comprehensive health care to eligible
Medi-Cal beneficiaries.
   This bill would create the Adult Health Coverage Expansion Program
that would be administered by a county or a local initiative
electing to participate in the program. The program would provide
health care coverage to eligible employees, as specified, of a small
business, as defined, that participates in the program. The bill
would fund the program through a combination of employer
contributions, employee premiums, and any state, local, or federal
funding made available for its purposes.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Division 113 (commencing with Section 131500) is added
to the Health and Safety Code, to read:

      DIVISION 113.  The Adult Health Coverage Expansion Program


      CHAPTER 1.  GENERAL PROVISIONS


   131500.  This division shall be known and may be cited as the
Adult Health Coverage Expansion Program.
   131501.  It is the intent of the Legislature that the Adult Health
Coverage Expansion Program provide health care coverage to eligible
adults employed in California who are without health care coverage.
   131502.  The following definitions apply for purposes of this
division:
   (a) "Local initiative" has the same meaning as set forth in
Section 12693.08 of the Insurance Code.
   (b) "Program" means the Adult Health Coverage Expansion Program.
   (c) "Small business" means an entity located in California that
employs 50 or fewer persons, with at least 35 percent of the
employees earning less than 300 percent of the federal poverty level,
and that has not offered health care coverage to its employees for,
at minimum, 12 consecutive months.
      CHAPTER 2.  ADMINISTRATION


   131510.  A county or a local initiative may establish a program
for small businesses located in its jurisdiction. The county or the
local initiative shall administer the program. The county or the
local initiative may enter into a memorandum of understanding with
another county or another local initiative for administration of the
program.
      CHAPTER 3.  ELIGIBILITY


   131520.  An adult age 19 to 64 years, inclusive, employed by a
small business is eligible to participate in the program if he or she
has a gross annual income that is less than 300 percent of the
federal poverty level, and his or her employer participates in the
program.
   131521.  A small business may apply to the county or the local
initiative that administers the program for the jurisdiction in which
the small business is located to obtain coverage for its employees
who meet the requirements of Section 131520.
      CHAPTER 4.  BENEFITS


   131530.  The county or the local initiative that establishes a
program shall offer health care coverage through the program, and all
health care services shall be provided to participants by a provider
operated by the county or by a provider with whom the county has
contracted to provide health care services.
   131531.  The health care services provided through the program
shall be comprehensive and shall include inpatient and outpatient
services, emergency care, and coverage for prescription medications.
Participants may be charged a copayment for the health care services.

      CHAPTER 5.  FUNDING


   131540.  The cost of the health care coverage provided through the
program shall be paid through a combination of contributions paid by
the small employer, premiums paid by participating employees, and
any state, county, and federal funding made available for this
purpose. The amount of the premium paid by a participating employee
shall be based on the amount of his or her hourly wage.