BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 972| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: SB 972 Author: Torres (D) Amended: 5/6/14 Vote: 21 SENATE HEALTH COMMITTEE : 6-1, 4/30/14 AYES: Hernandez, De León, DeSaulnier, Evans, Monning, Wolk NOES: Morrell NO VOTE RECORDED: Beall, Nielsen SUBJECT : California Health Benefit Exchange: board: membership SOURCE : Author DIGEST : This bill expands the criteria for serving on the California Health Benefit Exchange (Covered California) Board by adding marketing of health insurance products, information technology system management, management information systems, and enrollment counseling assistance with priority to cultural and linguistic competency, to the list of areas of expertise that are acceptable for appointment. ANALYSIS : Existing law: 1. Establishes Covered California an independent public entity not affiliated with an agency or department. CONTINUED SB 972 Page 2 2. Requires Covered California to be governed by an executive board, consisting of five members who are residents of California. Of the members of the Board, two are appointed by the Governor, one appointed by the Senate Committee on Rules, and one appointed by the Speaker of the Assembly. The Secretary of the California Health and Human Services or his/her designee serves as a voting, ex officio member. 3. Requires Covered California Board members, other than the ex officio member, to be appointed for a term of four years, except for the initial appointments of the Speaker and Rules Committee which are two and five years, respectively. Requires appointments made after January 2, 2011, by the Governor to be subject to confirmation by the Senate. 4. Requires each person appointed to the Covered California Board to have demonstrated and acknowledged expertise in at least two of the following areas: A. Individual health care coverage; B. Small employer health care coverage; C. Health benefits plan administration; D. Health care finance; E. Administering a public or private health care delivery system; and F. Purchasing health plan coverage. 5. Requires appointing authorities to consider the expertise of other members of the Covered California Board and attempt to make appointments so that the Board's composition reflects a diversity of expertise. 6. Requires appointing authorities to take into consideration the cultural, ethnic, and geographical diversity of the state so that the Covered California Board's composition reflects the communities of California. 7. Prohibits Covered California Board members or staff from being employed by, a consultant to, a member of the Board of CONTINUED SB 972 Page 3 Directors of, affiliated with, or otherwise a representative of, a carrier or other insurer, an agent or broker, a health care provider, or a health care facility or health clinic while serving on the Board or on the staff of Covered California. Prohibits a member of the Board or of the staff of Covered California from being a member, a Board member, or an employee of a trade association of carriers, health facilities, health clinics, or health care providers while serving on the Board or on the staff of Covered California. Prohibits a member of the Covered California Board or of the staff of Covered California from being a health care provider unless he/she receives no compensation for rendering services as a health care provider and does not have an ownership interest in a professional health care practice. This bill adds four news areas of expertise to the list of required demonstrated and acknowledged expertise for Board members: 1. Marketing of health insurance products; 2. Information technology system management; 3. Management information systems; and 4. Enrollment counseling assistance, with priority to cultural and linguistic competency. Background CHCF Report . An April 2014 report published by the California HealthCare Foundation on Consumers' and Enrollment Counselors' Experiences with Covered California provides an analysis of early consumer enrollment experiences associated with the more than two million Californians who have signed up for health insurance or applied for Medi-Cal through Covered California. Researchers conducted interviews and focus groups during a few weeks in February 2014 with a diverse group of users, including participants applying online, by telephone, or in person. The goal of the research is to identify areas for improvement in the application process. Among the key findings were that many consumers were unaware that in-person enrollment assistance was available, some CONTINUED SB 972 Page 4 enrollees were surprised by how much documentation was needed and found it to be difficult. The burden delayed successful completion of the process for many people, especially Medi-Cal applicants, and Covered California's online chat feature did not work for anyone surveyed. Specific to the Latino population were concerns about immigration problems and losing their home to Medi-Cal. According to the report, the detailed questions about family members, even those not applying for coverage, unsettled some Latino consumers and made them worry they could face problems with immigration. Also, some Latino consumers had heard Medi-Cal could take their home if they enrolled in the program. Many Vietnamese and Mandarin speaking consumers could not enroll online in their primary language, which was frustrating because some preferred to enroll online. They had to rely on an English proficient family member or apply in person with a Certified Enrollment Counselor (CECs) or agent who could speak their primary language. Additionally, CECs did not feel well trained and said they had limited ability to help Medi-Cal applicants. A new dedicated call center line for CECs was helping, but many felt on their own to figure out complex enrollment problems. Many also had limited experience with Medi-Cal and felt they could do little to help clients. Since the research was conducted in February, Covered California hired 350 additional service center employees, increased bilingual Spanish speaking staff, increased online chat resources, including Spanish chat, and is expanding telephone line capacity, posting qualified health plan applications in Spanish, Chinese, Vietnamese, and Korean on the Web site, adding consumer information including searchable Frequently Asked Questions, requiring agents and CECs to complete annual recertification training, and creating a dedicated help line for Certified Insurance Agents. Board diversity . The author's office has submitted an article written by California State Controller John Chiang published in the Corporate Governance Advisor March/April of 2010 called Strength in Diversity: The Changing Boardroom. In the article, which focuses on corporate diversity for investment strategies, the Controller writes that he asked the CalPERS Board to commission a study on board diversity in an effort to find empirical evidence that different combinations of talent can lead to increased shareowner value. According to the article, the report indicates that companies without ethnic minorities and women on their boards eventually may be at a competitive CONTINUED SB 972 Page 5 disadvantage and have under-performing share value. Prior legislation SB 900 (Alquist, Chapter 659, Statutes of 2010), and AB 1602 (Perez, Chapter 655, Statutes of 2010), established Covered California. FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local: No SUPPORT : (Verified 5/9/14) California Primary Care Association Latino Coalition for a Healthy California ARGUMENTS IN SUPPORT : The California Primary Care Association writes in support that California implemented perhaps the most successful Affordable Care Act outreach and enrollment program in the nation, however, Covered California's activities were not without fault. Early efforts to enroll the large uninsured Latino population into Medi-Cal or Covered California were largely ineffective because of shortcomings in marketing, enrollment assistance, and numerous other oversights related to cultural and linguistic competence. The Latino Coalition for a Healthy California writes that this bill is a step in the right direction and will help improve the customer service and enrollment experience. JL:d 5/12/14 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED