AB 332, as introduced, Calderon. Long-term care insurance.
Existing law provides for the regulation of long-term care insurance by the Insurance Commissioner and prescribes various requirements and conditions governing the delivery of individual or group long-term care insurance in the state. Existing law establishes the California Partnership for Long-Term Care Program to link private long-term care insurance and health care service plan contracts that cover long-term care with the In-Home Supportive Services program and Medi-Cal and to provide Medi-Cal benefits to certain individuals who have income and resources above the eligibility levels for receipt of medical assistance, but who have purchased certified private long-term care insurance policies.
This bill would require the Insurance Commissioner to convene a task force composed of specified stakeholders and representatives of government agencies to examine the components necessary to design a statewide long-term care insurance program, as specified. The bill would require the task force to recommend options for establishing this program and to comment on their respective degrees of feasibility in a report submitted to the commissioner, the Governor, and the Legislature by January 1, 2017.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
The Legislature hereby finds and declares all of
2the following:
3(a) Recent public opinion research indicates that Californians,
4regardless of political party or income level, are worried about the
5costs of growing older. Two-thirds of respondents in the research
6said that they are apprehensive about being able to afford long-term
7care. Sixty-three percent of respondents worry as much about
8paying for long-term care as they do for their future health care.
9(b) A majority of respondents could not afford more than three
10months of nursing home care at an average cost of six thousand
11dollars ($6,000) per month in California. About 4 in 10 respondents
12could not afford a single
month of care at that rate. Among Latino
13voters, 88 percent said they do not have long-term care insurance
14 or are not sure whether they are covered for supportive services
15like in-home care. Concerns about paying for long-term care cut
16across all income levels and all partisan affiliations.
17(c) It is the intent of the Legislature to enact legislation
18establishing a task force to explore the feasibility of developing a
19statewide insurance program for long-term care services and
20supports.
Section 10234.75 is added to the Insurance Code, to
22read:
(a) The commissioner shall convene a task force to
24examine the components necessary to design a statewide long-term
25care insurance program. The task force shall do all of the following:
26(1) Explore how a statewide long-term care insurance program
27could be designed to expand the options for people who become
28functionally or cognitively disabled and require long-term care
29services and supports.
30(2) Explore options for the design of the program, including
31eligibility, enrollment, benefits, financing, administration, and
32interaction with the Medi-Cal program and other publicly funded
33resources. In exploring these options, the task force shall consider
34all of the following:
P3 1(A) Whether and how a long-term care insurance program could
2be included as a benefit in the state disability insurance program
3structure, possibly through a nominal increase in the payroll tax,
4and whether the program could be structured in the same manner
5as Paid Family Leave benefits.
6(B) Allowing for enrollment in the program of working adults
7who would make voluntary premium contributions either directly
8or through payroll deductions through their employer.
9(C) To the extent feasible, requiring a mandatory enrollment
10with a voluntary opt-out option.
11(D) Giving working adults the opportunity to plan for future
12long-term care needs by providing a basic insurance benefit to
13those who meet work requirements and have developed functional
14or equivalent
cognitive limitations.
15(E) Helping individuals with functional or cognitive limitations
16remain in their communities by purchasing nonmedical services
17and supports such as home health care and adult day care.
18(F) Helping offset the costs incurred by adults with chronic and
19disabling conditions. The program need not be designed to cover
20the entire costs associated with an individual’s long-term care
21needs.
22(3) Evaluate how benefits under the program would be
23coordinated with existing private health care coverage benefits.
24(4) Take into account the premiums necessary to provide an
25adequate benefit within a solvent program.
26(5) Evaluate the demands on the long-term care workforce as
27the need
for long-term care in California grows, and how the
28long-term care workforce can be prepared to meet those demands.
29(b) The task force shall be composed of key senior health policy
30and long-term care insurance stakeholders, at least one
31representative from the State Department of Health Care Services,
32at least one representative from the Employment Development
33Department, and at least one representative from a labor union
34representing long-term care workers. The task force may include
35representatives from other relevant federal, state, and local
36government agencies.
37(c) The department shall operate within its existing budgetary
38resources for purposes of implementing this section. Any
39governmental agency that participates in the task force shall operate
P4 1within its existing budgetary resources for purposes of that
2participation.
3(d) The task force shall recommend options for establishing a
4statewide long-term care insurance program and comment on the
5respective degrees of flexibility of those options in a report
6submitted to the commissioner, the Governor, and the Legislature
7on or before January 1, 2017. The report submitted to the
8Legislature shall be submitted in accordance with Section 9795 of
9the Government Code.
10(e) The commissioner may seek private funds for purposes of
11implementing this section.
12(f) This section shall remain in effect only until January 1, 2019,
13and as of that date is repealed, unless a later enacted statute, that
14is enacted before January 1, 2019, deletes or extends that date.
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