Amended in Senate August 24, 2015

Amended in Senate July 7, 2015

Amended in Senate June 15, 2015

Amended in Assembly April 27, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 332

Introduced by Assembly Member Calderon

(Coauthor: Assembly Member Brown)

(Coauthor: Senator Liu)

February 13, 2015

An act to add and repeal Section 10234.75 of the Insurance Code, relating to insurance.

LEGISLATIVE COUNSEL’S DIGEST

AB 332, as amended, 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 establish the Long Term Care Insurance Task Force in the Department of Insurance, chaired by the Insurance Commissioner or his or her designee, and composed of specified stakeholders and representatives of government agencies to examine the components necessary to design and implement 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 July 1, 2017. begin insert The bill would require the department to produce, no later than July 1, 2018, an actuarial report of those recommendations, to be shared with and approved by the task force. If approved, the bill would require the report to be submitted to the Legislature, as specified. end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

The Legislature hereby finds and declares all of
the following:

(a) Recent public opinion research indicates that Californians,
regardless of political party or income level, are worried about the
costs of growing older. Two-thirds of respondents in the research
said that they are apprehensive about being able to afford long-term
care. Sixty-three percent of respondents worry as much about
paying for long-term care as they do for their future health care.

(b) A majority of respondents could not afford more than three
months of nursing home care at an average cost of six thousand
dollars ($6,000) per month in California. About four in 10
respondents could not afford a single month of care at that rate.
Among Latino voters, 88 percent said they do not have long-term
care insurance or are not sure whether they are covered for
supportive services like in-home care. Concerns about paying for
long-term care cut across all income levels and all partisan
affiliations.

(c) It is the intent of the Legislature to enact legislation
establishing a task force to explore the feasibility of developing
and implementing a culturally competent statewide insurance
program for long-term care services and supports.

SEC. 2.  

Section 10234.75 is added to the Insurance Code, to
read:

10234.75.  

(a) The Long Term Care Insurance Task Force (the
task force) is hereby created in the Department of Insurance. Under
the leadership of the commissioner, the task force shall examine
the components necessary to design and implement a statewide
long-term care insurance program.

(b) The task force shall consist of the following nine voting
members:

(1) The commissioner, or his or her designee, who shall serve
as the chair of the task force.

(2) The Director of Health Care Services, or his or her designee.

(3) The Director of the Department of Aging, or his or her
designee.

(4) Four persons appointed by the Governor, as follows:

(A) A certified actuary with expertise in long-term care
insurance.

(B) A nongovernment health policy expert.

(C) A representative of a long-term care provider association.

(D) A representative of a senior or consumer organization.

(5) One person, appointed by the Speaker of the Assembly, from
an employee representative organization that represents long-term
care workers.

(6) One person, appointed by the Senate Committee on Rules,
from the long-term care insurance industry.

(c) A task force member shall not receive a per diem or other
similar compensation for serving as a member of the task force.

(d) The Bagley-Keene Open Meeting Act (Article 9
(commencing with Section 11120) of Chapter 1 of Part 1 of
Division 3 of Title 2 of the Government Code) applies to meetings
of the task force.

(e) The task force shall do all of the following:

(1) Explore how a statewide long-term care insurance program
could be designed and implemented to expand the options for
people who are interested in insuring themselves against the risk
of costs associated with functional or cognitive disability, and
require long-term care, services, and supports.

(2) Explore options for the design of the program, including
eligibility, enrollment, benefits, financing, administration, and
interaction with the Medi-Cal program and other publicly funded
resources. In exploring these options, the task force shall consider
all of the following:

(A) Whether and how a long-term care insurance program could
be included as a benefit in the state disability insurance program
structure, possibly through a nominal increase in the payroll tax,
and whether the program could be structured in the same manner
as Paid Family Leave benefits.

(B) Allowing for enrollment in the program of working adults
who would make voluntary premium contributions either directly
or through payroll deductions through their employer.

(C) To the extent feasible, requiring a mandatory enrollment
with a voluntary opt-out option.

(D) Giving working adults the opportunity to plan for future
long-term care needs by providing a basic insurance benefit to
those who meet work requirements and have developed functional
or equivalent cognitive limitations.

(E) Helping individuals with functional or cognitive limitations
remain in their communities by purchasing nonmedical services
and supports such as home health care and adult day care.

(F) Helping offset the costs incurred by adults with chronic and
disabling conditions. The program need not be designed to cover
the entire cost associated with an individual’s long-term care needs.

(3) Evaluate how benefits under the program would be
coordinated with existing private health care coverage benefits.

begin delete

(4) Take into account the premiums necessary to provide an
adequate benefit within a solvent program.

end delete begin delete

(5)

end delete

begin insert (4) end insert  Evaluate the demands on the long-term care workforce as
the need for long-term care in California grows, and how the
long-term care workforce can be prepared to meet those demands.

begin delete

(6)

end delete

begin insert (5) end insert  Consider the establishment of a joint public and private
system to make long-term care accessible to as many individuals
within California as possible.

begin delete

(7)

end delete

begin insert (6) end insert  Make recommendations related to key regulatory provisions
necessary for the public to access existing long-term care insurance
programs and participate in future long-term care insurance
programs, whether those programs are recommended by the task
force or otherwise.

(f) The department shall operate within its existing budgetary
resources for purposes of implementing this section. Any
governmental agency that participates in the task force shall operate
within its existing budgetary resources for purposes of that
participation.

(g) The task force shall recommend options for establishing a
statewide long-term care insurance program and comment on the
respective degrees of feasibility of those options in a report
submitted to the commissioner, the Governor, and the Legislature
on or before July 1, 2017. The report submitted to the Legislature
shall be submitted in accordance with Section 9795 of the
Government Code.

begin insert

(h) To ensure an adequate benefit within a solvent program,
the department shall, no later than July 1, 2018, produce an
actuarial report of the recommendations made by the task force
pursuant to subdivision (g). The report shall be shared with and
approved by the members of the task force. If approved the report
shall be submitted to the Legislature in accordance with Section
9795 of the Government Code.

end insert begin delete

(h)

end delete

begin insert (i) end insert  The commissioner may seek private funds for purposes of
implementing this section.

begin delete

(i)

end delete

begin insert (j) end insert  This section shall remain in effect only until January 1, 2019,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2019, deletes or extends that date.