BILL NUMBER: SB 1005	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Lara
   (Coauthors: Senators Block, Calderon, De León, Mitchell, Padilla,
and Torres)
   (Coauthors: Assembly Members Bocanegra, Bonta, Dickinson, Fong,
Gonzalez, Roger Hernández, Jones-Sawyer, Pan, Rendon, and Yamada)

                        FEBRUARY 13, 2014

   An act to add Title 22.5 (commencing with Section 100530) to the
Government Code, and to add Section 14102.1 to the Welfare and
Institutions Code, relating to health care coverage, and making an
appropriation therefor.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1005, as introduced, Lara. Health care coverage: immigration
status.
   Existing law, the federal Patient Protection and Affordable Care
Act (PPACA), requires each state to, by January 1, 2014, establish an
American Health Benefit Exchange that facilitates the purchase of
qualified health plans by qualified individuals and qualified small
employers, and meets certain other requirements. PPACA specifies that
an individual who is not a citizen or national of the United States
or an alien lawfully present in the United States shall not be
treated as a qualified individual and may not be covered under a
qualified health plan offered through an Exchange. Existing law
creates the California Health Benefit Exchange for the purpose of
facilitating the enrollment of qualified individual and qualified
small employers in qualified health plans as required under PPACA.
   This bill would create the California Health Exchange Program For
All Californians within state government and would require that the
program be governed by the executive board that governs the
California Health Benefit Exchange. The bill would specify the duties
of the board relative to the program and would require the board to,
by January 1, 2016, facilitate the enrollment into qualified health
plans of individuals who are not eligible for full-scope Medi-Cal
coverage and would have been eligible to purchase coverage through
the Exchange but for their immigration status. The bill would require
the board to provide premium subsidies and cost-sharing reductions
to eligible individuals that are the same as the premium assistance
and cost-sharing reductions the individuals would have received
through the Exchange. The bill would create the California Health
Trust Fund For All Californians as a continuously appropriated fund,
thereby making an appropriation, would require the board to assess a
charge on qualified health plans, and would make the implementation
of the program's provisions contingent on a determination by the
board that sufficient financial resources exist or will exist in the
fund. The bill would enact other related provisions.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. The federal Medicaid Program provisions
prohibit payment to a state for medical assistance furnished to an
alien who is not lawfully admitted for permanent residence or
otherwise permanently residing in the United States under color of
law.
   This bill would extend eligibility for full-scope Medi-Cal
benefits to individuals who are otherwise eligible for those benefits
but for their immigration status. The bill would require that
benefits for those services be provided with state-only funds only if
federal financial participation is not available. Because counties
are required to make Medi-Cal eligibility determinations and this
bill would expand Medi-Cal eligibility, the bill would impose a
state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
   Vote: majority. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: yes.


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

  SECTION 1.  (a) It is the intent of the Legislature that all
Californians, regardless of immigration status, have access to
affordable health coverage and care.
   (b) It is the intent of the Legislature that all Californians who
are eligible for Medi-Cal, a qualified health plan offered through
the California Health Benefits Exchange, or affordable employer-based
health coverage enroll in that coverage and obtain the care that
they need.
   (c) It is further the intent of the Legislature, in enacting this
measure, to ensure that all Californians be included in eligibility
for coverage without regard to immigration status.
  SEC. 2.  Title 22.5 (commencing with Section 100530) is added to
the Government Code, to read:

      TITLE 22.5.  CALIFORNIA HEALTH EXCHANGE PROGRAM FOR ALL
CALIFORNIANS


   100530.  (a) There is in state government the California Health
Exchange Program for All Californians, an independent public entity
not affiliated with an agency or department.
   (b) The program shall be governed by the executive board
established pursuant to Section 100500. The board shall be subject to
Section 100500.
   (c) It is the intent of the Legislature in enacting this program
to provide affordable coverage for Californians who would be eligible
for coverage and premium subsidies under the California Health
Benefit Exchange established under Title 22 (commencing with Section
100500) but for their immigration status. It is further the intent of
the Legislature that Californians eligible under this title be
offered the same premiums and cost sharing that they would be offered
through the California Health Benefit Exchange but for their
immigration status.
   100531.  For purposes of this title, the following definitions
shall apply:
   (a) "Board" means the board described in subdivision (b) of
Section 100530.
   (b) "Carrier" means either a private health insurer holding a
valid outstanding certificate of authority from the Insurance
Commissioner or a health care service plan, as defined under
subdivision (f) of Section 1345 of the Health and Safety Code,
licensed by the Department of Managed Health Care.
   (c) "Eligible individual" means an individual who would have been
eligible to purchase coverage through the Exchange but for his or her
immigration status and who is not eligible for full-scope Medi-Cal
coverage under state law.
   (d) "Exchange" means the California Health Benefit Exchange
established by Section 100500.
   (e) "Federal act" means the federal Patient Protection and
Affordable Care Act (Public Law 111-148), as amended by the federal
Health Care and Education Reconciliation Act of 2010 (Public Law
111-152), and any amendments to, or regulations or guidance issued
under, those acts.
   (f) "Fund" means the California Health Trust Fund for All
Californians established by Section 100540.
   (g) "Health plan" and "qualified health plan" have the same
meanings as those terms are defined in Section 1301 of the federal
act.
   (h) "Medi-Cal coverage" means coverage under the Medi-Cal program
pursuant to Chapter 7 (commencing with Section 14000) of Part 3 of
Division 9 of the Welfare and Institutions Code.
   (i) "Program" means the California Health Exchange Program for All
Californians.
   (j) "Supplemental coverage" means coverage through a specialized
health care service plan contract, as defined in subdivision (o) of
Section 1345 of the Health and Safety Code, or a specialized health
insurance policy, as defined in Section 106 of the Insurance Code.
   100532.  The board shall, at a minimum, do all of the following:
   (a) Provide premium subsidies and cost-sharing reductions to
eligible individuals. The premium assistance and cost-sharing
reductions shall be the same as these individuals would have received
if they had been eligible to receive premium assistance and
cost-sharing reductions under the federal act by enrolling in
coverage through the Exchange.
   (b) Enroll into coverage eligible individuals whose income exceeds
the thresholds for premium subsidies.
   (c) Implement procedures for the certification, recertification,
and decertification, of health plans as qualified health plans. The
board shall require health plans seeking certification as qualified
health plans to do all of the following:
   (1) Submit a justification for any premium increase prior to
implementation of the increase consistent with Article 6.2
(commencing with Section 1385.01) of Chapter 2.2 of Division 2 of the
Health and Safety Code and Article 4.5 (commencing with Section
10181) of Chapter 1 of Part 2 of Division 2 of the Insurance Code.
   (2) (A) Make available to the public and submit to the board
accurate and timely disclosure of the following information:
   (i) Claims payment policies and practices.
   (ii) Periodic financial disclosures.
   (iii) Data on enrollment.
   (iv) Data on disenrollment.
   (v) Data on the number of claims that are denied.
   (vi) Data on rating practices.
   (vii) Information on cost sharing and payments with respect to any
out-of-network coverage.
   (viii) Information on enrollee and participant rights under state
law.
   (B) The information required under subparagraph (A) shall be
provided in plain language.
   (3) Permit individuals to learn, in a timely manner upon the
request of the individual, the amount of cost sharing, including, but
not limited to, deductibles, copayments, and coinsurance, under the
individual's plan or coverage that the individual would be
responsible for paying with respect to the furnishing of a specific
item or service by a participating provider. At a minimum, this
information shall be made available to the individual through an
Internet Web site and through other means for individuals without
access to the Internet.
   (d) Provide for the operation of a toll-free telephone hotline to
respond to requests for assistance.
   (e) Maintain an Internet Web site through which enrollees and
prospective enrollees of qualified health plans may obtain
standardized comparative information on those plans.
   (f) Assign a rating to each qualified health plan offered through
the program in accordance with the criteria developed by board.
   (g) Utilize a standardized format for presenting health benefits
plan options in the program.
   (h) Inform individuals of eligibility requirements for the
Medi-Cal program, the Exchange, or any applicable state or local
public program and, if through screening of the application by the
program, the program determines that an individual is eligible for
the state or local program, enroll that individual in the program.
   (i) Establish and make available by electronic means a calculator
to determine the actual cost of coverage after the application of any
premium subsidy and any cost-sharing reduction pursuant to
subdivision (a).
   (j) Establish a navigator program. Any entity chosen by the board
as a navigator under this subdivision shall do all of the following:
   (1) Conduct public education activities to raise awareness of the
availability of qualified health plans through the program.
   (2) Distribute fair and impartial information concerning
enrollment in qualified health plans, and the availability of premium
subsidies and cost-sharing reductions through the program.
   (3) Facilitate enrollment in qualified health plans.
   (4) Provide referrals to any applicable office of health insurance
consumer assistance or health insurance ombudsman established under
Section 2793 of the federal Public Health Service Act, or any other
appropriate state agency or agencies, for any enrollee with a
grievance, complaint, or question regarding his or her health plan,
coverage, or a determination under that plan or coverage.
   (5) Provide information in a manner that is culturally and
linguistically appropriate to the needs of the population being
served by the program.
   100533.  In addition to meeting the requirements of Section
100532, the board shall do all of the following:
   (a) Determine the criteria and process for eligibility,
enrollment, and disenrollment of enrollees and potential enrollees in
the program and coordinate that process with the state and local
government entities administering other health care coverage
programs, including the Exchange, the State Department of Health Care
Services, and California counties, in order to ensure consistent
eligibility and enrollment processes and seamless transitions between
coverage.
   (b) Develop processes to coordinate with the county entities that
administer eligibility for the Medi-Cal program.
   (c) Determine the minimum requirements a carrier must meet to be
considered for participation in the program, and the standards and
criteria for selecting qualified health plans to be offered through
the program that are in the best interests of qualified individuals.
The board shall consistently and uniformly apply these requirements,
standards, and criteria to all carriers. In the course of selectively
contracting for health care coverage offered to qualified
individuals through the program, the board shall seek to contract
with carriers so as to provide health care coverage choices that
offer the optimal combination of choice, value, quality, and service.

   (d) Provide, in each region of the state, a choice of qualified
health plans at each of the five levels of coverage contained in
subsections (d) and (e) of Section 1302 of the federal act.
   (e) Require, as a condition of participation in the program,
carriers to fairly and affirmatively offer, market, and sell in the
program at least one product within each of the five levels of
coverage contained in subsections (d) and (e) of Section 1302 of the
federal act. The board may require carriers to offer additional
products within each of those five levels of coverage. This
subdivision shall not apply to a carrier that solely offers
supplemental coverage in the program under paragraph (10) of
subdivision (a) of Section 100534.
   (f) (1) Except as otherwise provided in this section, require, as
a condition of participation in the program, carriers that sell any
products outside the program to fairly and affirmatively offer,
market, and sell all products made available to individuals in the
program to individuals purchasing coverage outside the program.
   (2) For purposes of this subdivision, "product" does not include
contracts entered into pursuant to Chapter 7 (commencing with Section
14000) of, or Chapter 8 (commencing with Section 14200) of, Part 3
of Division 9 of the Welfare and Institutions Code between the State
Department of Health Care Services and carriers for enrolled Medi-Cal
beneficiaries. "Product" also does not include a bridge plan product
offered pursuant to Section 100504.5.
   (g) Determine when an enrollee's coverage commences and the extent
and scope of coverage.
   (h) Provide for the processing of applications and the enrollment
and disenrollment of enrollees.
   (i) Determine and approve cost-sharing provisions for qualified
health plans.
   (j) Establish uniform billing and payment policies for qualified
health plans offered in the program to ensure consistent enrollment
and disenrollment activities for individuals enrolled in the program.

   (k) Undertake activities necessary to market and publicize the
availability of health care coverage and subsidies through the
program. The board shall also undertake outreach and enrollment
activities that seek to assist enrollees and potential enrollees with
enrolling and reenrolling in the program in the least burdensome
manner, including populations that may experience barriers to
enrollment, such as the disabled and those with limited English
language proficiency.
   (l) Select and set performance standards and compensation for
navigators selected under subdivision (h) of Section 100532.
   (m) Employ necessary staff. The board shall employ staff
consistent with the applicable requirements imposed under subdivision
(m) of Section 100503.
   (n) Assess a charge on the qualified health plans offered by
carriers that is reasonable and necessary to support the development,
operations, and prudent cash management of the program.
   (o) Authorize expenditures, as necessary, from the fund to pay
program expenses to administer the program.
   (p) Keep an accurate accounting of all activities, receipts, and
expenditures. Commencing January 1, 2017, the board shall conduct an
annual audit.
   (q) (1) Notwithstanding Section 10231.5, annually prepare a
written report on the implementation and performance of the program
functions during the preceding fiscal year, including, at a minimum,
the manner in which funds were expended and the progress toward, and
the achievement of, the requirements of this title. The report shall
also include data provided by health care service plans and health
insurers offering bridge plan products regarding the extent of health
care provider and health facility overlap in their Medi-Cal networks
as compared to the health care provider and health facility networks
contracting with the plan or insurer in their bridge plan contracts.
This report shall be transmitted to the Legislature and the Governor
and shall be made available to the public on the Internet Web site
of the program. A report made to the Legislature pursuant to this
subdivision shall be submitted pursuant to Section 9795.
   (2) In addition to the report described in paragraph (1), the
board shall be responsive to requests for additional information from
the Legislature, including providing testimony and commenting on
proposed state legislation or policy issues. The Legislature finds
and declares that activities including, but not limited to,
responding to legislative or executive inquiries, tracking and
commenting on legislation and regulatory activities, and preparing
reports on the implementation of this title and the performance of
the program, are necessary state requirements and are distinct from
the promotion of legislative or regulatory modifications referred to
in subdivision (c) of Section 100540.
   (r) Maintain enrollment and expenditures to ensure that
expenditures do not exceed the amount of revenue in the fund, and if
sufficient revenue is not available to pay estimated expenditures,
institute appropriate measures to ensure fiscal solvency.
   (s) Exercise all powers reasonably necessary to carry out and
comply with the duties, responsibilities, and requirements of this
title.
   (t) Consult with stakeholders relevant to carrying out the
activities under this title, including, but not limited to, all of
the following:
   (1) Health care consumers who are enrolled in health plans.
   (2) Individuals and entities with experience in facilitating
enrollment in health plans.
   (3) The executive director of the Exchange.
   (4) The State Medi-Cal Director.
   (5) Advocates for enrolling hard-to-reach populations.
   (u) Facilitate the purchase of qualified health plans in the
program by qualified individuals no later than January 1, 2016.
   (v) Require carriers participating in the program to immediately
notify the program, under the terms and conditions established by the
board when an individual is or will be enrolled in or disenrolled
from any qualified health plan offered by the carrier.
   (w) Ensure that the program provides oral interpretation services
in any language for individuals seeking coverage through the program
and makes available a toll-free telephone number for the hearing and
speech impaired. The board shall ensure that written information made
available by the program is presented in a plainly worded, easily
understandable format and made available in prevalent languages.
   100534.  (a) The board may do the following:
   (1) Collect premiums and assist in the administration of
subsidies.
   (2) Enter into contracts.
   (3) Sue and be sued.
   (4) Receive and accept gifts, grants, or donations of moneys from
any agency of the United States, any agency of the state, any
municipality, county, or other political subdivision of the state.
   (5) Receive and accept gifts, grants, or donations from
individuals, associations, private foundations, or corporations, in
compliance with the conflict of interest provisions to be adopted by
the board at a public meeting.
   (6) Adopt rules and regulations, as necessary. Until January 1,
2018, any necessary rules and regulations may be adopted as emergency
regulations in accordance with the Administrative Procedure Act
(Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2). The adoption of these regulations shall be deemed to be
an emergency and necessary for the immediate preservation of the
public peace, health and safety, or general welfare.
   (7) Collaborate with the Exchange and the State Department of
Health Care Services, to the extent possible, to allow an individual
the option to remain enrolled with his or her carrier and provider
network in the event the individual experiences a loss of eligibility
for enrollment in a qualified health plan under this title and
becomes eligible for the Exchange or the Medi-Cal program, or loses
eligibility for the Medi-Cal program and becomes eligible for a
qualified health plan through the program.
   (8) Share information with relevant state departments, consistent
with the applicable laws governing confidentiality, necessary for the
administration of the program.
   (9) Require carriers participating in the program to make
available to the program and regularly update an electronic directory
of contracting health care providers so that individuals seeking
coverage through the program can search by health care provider name
to determine which health plans in the program include that health
care provider in their network. The board may also require a carrier
to provide regularly updated information to the program as to whether
a health care provider is accepting new patients for a particular
health plan. The program may provide an integrated and uniform
consumer directory of health care providers indicating which carriers
the providers contract with and whether the providers are currently
accepting new patients. The program may also establish methods by
which health care providers may transmit relevant information
directly to the program, rather than through a carrier.
   (10) Make available supplemental coverage for enrollees of the
program to the extent permitted by available funding. Any
supplemental coverage offered in the program shall be subject to the
charge imposed under subdivision (n) of Section 100533.
   (b) The program shall only collect information from individuals or
designees of individuals necessary to administer the program.
   (c) The board shall have the authority to standardize products to
be offered through the program.
   100535.   The board shall establish and use a competitive process
to select participating carriers and any other contractors under this
title. Any contract entered into pursuant to this title shall be
exempt from Chapter 2 (commencing with Section 10100) of Division 2
of the Public Contract Code, and shall be exempt from the review or
approval of any division of the Department of General Services.
   100536.  (a) The board shall establish an appeals process for
prospective and current enrollees of the program.
   (b) The board shall not be required to provide an appeal if the
subject of the appeal is within the jurisdiction of the Department of
Managed Health Care pursuant to the Knox-Keene Health Care Service
Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of
Division 2 of the Health and Safety Code) and its implementing
regulations, or within the jurisdiction of the Department of
Insurance pursuant to the Insurance Code and its implementing
regulations.
   100537.  (a) Notwithstanding any other provision of law, the
program shall not be subject to licensure or regulation by the
Department of Insurance or the Department of Managed Health Care.
   (b) Carriers that contract with the program shall have a license
or certificate of authority from, and shall be in good standing with,
their respective regulatory agencies.
   100538.  (a) Records of the program that reveal the deliberative
processes, discussions, communications, or any other portion of the
negotiations with entities contracting or seeking to contract with
the program, entities with which the program is considering a
contract, or entities with which the program is considering or enters
into any other arrangement under which the program provides,
receives, or arranges services or reimbursement shall be exempt from
disclosure under the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1).
   (b) The following records of the program shall be exempt from
disclosure under the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1) as follows:
   (1) (A) Except for the portion of a contract that contains the
rates of payments, contracts with participating carriers entered into
pursuant to this title on or after the date the act that added this
subparagraph becomes effective, shall be open to inspection one year
after the effective dates of the contracts.
   (B) If contracts with participating carriers entered into pursuant
to this title are amended, the amendments shall be open to
inspection one year after the effective date of the amendments.
   (c) Three years after a contract or amendment is open to
inspection pursuant to subdivision (b), the portion of the contract
or amendment containing the rates of payment shall be open to
inspection.
   (d) Notwithstanding any other law, entire contracts with
participating carriers or amendments to contracts with participating
carriers shall be open to inspection by the Joint Legislative Audit
Committee. The committee shall maintain the confidentiality of the
contracts and amendments until the contracts or amendments to a
contract are open to inspection pursuant to subdivisions (b) and (c).

   100539.  (a) No individual or entity shall hold himself, herself,
or itself out as representing, constituting, or otherwise providing
services on behalf of the program unless that individual or entity
has a valid agreement with the program to engage in those activities.

   (b) Any individual or entity who aids or abets another individual
or entity in violation of this section shall also be in violation of
this section.
   100540.  (a) The California Health Trust Fund For All Californians
is hereby created in the State Treasury for the purpose of this
title. Notwithstanding Section 13340, all moneys in the fund shall be
continuously appropriated without regard to fiscal year for the
purposes of this title. Any moneys in the fund that are unexpended or
unencumbered at the end of a fiscal year may be carried forward to
the next succeeding fiscal year.
   (b) The board of the program shall establish and maintain a
prudent reserve in the fund.
   (c) The board or staff of the program shall not utilize any funds
intended for the administrative and operational expenses of the
program for staff retreats, promotional giveaways, excessive
executive compensation, or promotion of federal or state legislative
or regulatory modifications.
   (d) Notwithstanding Section 16305.7, all interest earned on the
moneys that have been deposited into the fund shall be retained in
the fund and used for purposes consistent with the fund.
   (e) Effective January 1, 2018, if at the end of any fiscal year,
the fund has unencumbered funds in an amount that equals or is more
than the board approved operating budget of the program for the next
fiscal year, the board shall reduce the charges imposed under
subdivision (n) of Section 100533 during the following fiscal year in
an amount that will reduce any surplus funds of the program to an
amount that is equal to the agency's operating budget for the next
fiscal year.
   100541.  (a) The board shall ensure that the establishment,
operation, and administrative functions of the program do not exceed
the combination of state funds, private donations, and other
non-General Fund moneys available for this purpose.
   (b) The implementation of the provisions of this title, other than
this section, Section 100530, and paragraphs (4) and (5) of
subdivision (a) of Section 100534, shall be contingent on a
determination by the board that sufficient financial resources exist
or will exist in the fund. The determination shall be based on at
least the following:
   (1) Financial projections identifying that sufficient resources
exist or will exist in the fund to implement the program.
   (2) A comparison of the projected resources available to support
the program and the projected costs of activities required by this
title.
   (3) The financial projections demonstrate the sufficiency of
resources for at least the first two years of operation under this
title.
   (c) The board shall provide notice to the Joint Legislative Budget
Committee and the Director of Finance that sufficient financial
resources exist in the fund to implement this title.
   (d) If the board determines that the level of resources in the
fund cannot support the actions and responsibilities described in
subdivision (a), it shall provide the Department of Finance and the
Joint Legislative Budget Committee a detailed report on the changes
to the functions, contracts, or staffing necessary to address the
fiscal deficiency along with any contingency plan should it be
impossible to operate the program without the use of General Fund
moneys.
   (e) The board shall assess the impact of the program's operations
and policies on other publicly funded health programs administered by
the state and the impact of publicly funded health programs
administered by the state on the program's operations and policies.
This assessment shall include, at a minimum, an analysis of potential
cost shifts or cost increases in other programs that may be due to
program policies or operations. The assessment shall be completed on
at least an annual basis and submitted to the Secretary of California
Health and Human Services and the Director of Finance.
  SEC. 3.  Section 14102.1 is added to the Welfare and Institutions
Code, to read:
   14102.1.  (a) Notwithstanding any other law, individuals who meet
all of the eligibility requirements for full-scope Medi-Cal benefits
under this chapter, but for their immigration status, shall be
eligible for full-scope Medi-Cal benefits.
   (b) This section shall not apply to individuals eligible for
coverage pursuant to Section 14102.
   (c) Benefits for services under this section shall be provided
with state-only funds only if federal financial participation is not
                                             available for those
services. The department shall maximize federal financial
participation in implementing this section to the extent allowable.
   (d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department, without taking any further regulatory action, shall
implement, interpret, or make specific this section by means of
all-county letters, plan letters, plan or provider bulletins, or
similar instructions until the time regulations are adopted. The
department shall adopt regulations by July 1, 2018, in accordance
with the requirements of Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code. Commencing
July 1, 2015, and notwithstanding Section 10321.5 of the Government
Code, the department shall provide a status report to the Legislature
on a semiannual basis, in compliance with Section 9795 of the
Government Code, until regulations have been adopted.
  SEC. 4.  The Legislature finds and declares that Section 2 of this
act, which adds Section 100538 to the Government Code, imposes a
limitation on the public's right of access to the meetings of public
bodies or the writings of public officials and agencies within the
meaning of Section 3 of Article I of the California Constitution.
Pursuant to that constitutional provision, the Legislature makes the
following findings to demonstrate the interest protected by this
limitation and the need for protecting that interest:
   In order to ensure that the California Health Exchange Program for
All Californians is not constrained in exercising its fiduciary
powers and obligations to negotiate on behalf of the public, the
limitations on the public's right of access imposed by Section 2 of
this act are necessary.
  SEC. 5.  If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.