SB 10, as amended, Lara. Health care coverage: immigration status.
Existing law, the federal Patient Protection and Affordable Care Act (PPACA), requires each state to 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 (the Exchange) for the purpose of facilitating the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA.
This bill would require thebegin delete Secretary of California Health and
Human Servicesend deletebegin insert Exchangeend insert to apply to the United States Department of Health and Human Services for a waiver to allow individuals who are not eligible to obtain health coverage through the Exchange because of their immigration status to obtain coverage from the Exchange. The bill wouldbegin delete require,end deletebegin insert require the Exchange,end insert after that waiver has been granted,begin delete the Exchangeend delete tobegin delete offerend deletebegin insert require an issuer that offers a qualified health plan in the individual market through the
Exchange to concurrently offer aend insert California qualified health benefitbegin delete plans,end deletebegin insert plan,end insert
as specified, to these individuals.begin insert The requirement to offer California qualified health plans would become operative on January 1, 2018, for coverage effective for California qualified health plans beginning January 1, 2019, as specified.end insert The bill would require that individuals eligible to purchase California qualified health plans pay the cost of coverage without federalbegin delete assistance.end deletebegin insert assistance and meet other specified requirements. The bill would require that information provided by an applicant for coverage under the billend insertbegin insert be used only for the purposes of, and to the extent necessary for, ensuring the efficient operation
of the Exchange, including verifying the eligibility of an individual to enroll through the Exchange, and would prohibit that information from being disclosed to any other person except as provided by the bill.end insert
This bill would declare that it is to take effect immediately as an urgency statute.
Vote: 2⁄3. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 100522 is added to the Government Code,
2to read:
(a) begin insert(1)end insertbegin insert end insert Thebegin delete Secretary of California Health and Human begin insert Exchangeend insert shall apply to the United States Department of
4Servicesend delete
5Health and Human Services for a waiver authorized under Section
61332 of the federal act as defined in subdivision (e) of Section
7100501 in order to allow persons otherwise not able to obtain
8coverage by reason of immigration status
through the Exchange
9to obtain coverage from the Exchange by waiving the requirement
P3 1that the Exchange offer only qualified health plans solely for the
2purpose of offering coverage to persons otherwise not able to
3obtain coverage by reason of immigration status.
4
(2) The waiver of the requirement that the Exchange offer only
5qualified health plans as described in paragraph (1) shall be
6limited to requiring the Exchange to offer California qualified
7health plans consistent with this section only and shall not be
8construed to authorize the Exchange to offer any other nonqualified
9health plan.
10(b) The Exchange shallbegin delete offerend deletebegin insert
require an issuer that offers a
11qualified health plan in the individual market through the Exchange
12to concurrently offer aend insert California qualified healthbegin delete plans that shall begin insert
plan that meets all of the following criteria:end insert
13be subject to the requirements of this title, including all of those
14requirements applicable to qualified health plans. In addition,
15California qualified health plans shall be subject to the
16requirements of Section 1366.6 of the Health and Safety Code and
17Section 10112.3 of the Insurance Code in the same manner as
18qualified health plans.end delete
19
(1) Is subject to the requirements of this title, including all of
20those requirements applicable to qualified health plans.
21
(2) Is subject to the requirements of subdivisions (a), (b), and
22(d) of Section 1366.6 of the Health and Safety Code and
23subdivisions (a), (b), and (d) of Section 10112.3 of the Insurance
24Code in the same manner as qualified health plans.
25
(3) Is identical to the corresponding qualified health plan, except
26for the
eligibility requirements set forth in subdivision (c).
27(c) Persons eligible to purchase California qualified health plans
28shall pay the cost of coverage without federal advanced premium
29tax credit, federal cost-sharing reduction, or any other federal
30assistance.
31
(c) Persons eligible to purchase California qualified health
32plans shall pay the cost of coverage and shall not:
33
(1) Be eligible to
receive federal advanced premium tax credit,
34federal cost-sharing reduction, or any other federal assistance for
35the payment of premiums or cost sharing for a California qualified
36health plan.
37
(2) Otherwise be eligible for enrollment in a qualified health
38plan offered through the Exchange by reason of immigration status.
39
(d) An applicant for coverage under this section shall be
40required to provide only the information strictly necessary to
P4 1authenticate identity and determine eligibility under this section.
2Any person who receives information provided by an applicant
3under this section, whether directly or by another person at the
4request of the applicant, or receives information from any agency,
5shall use the information only for the purposes of, and to the extent
6necessary for, ensuring the efficient operation of the Exchange,
7including verifying the eligibility of an individual
to enroll through
8the Exchange. That information shall not be disclosed to any other
9person except as provided in this section.
10(d)
end delete
11begin insert(e)end insert Subdivisionsbegin delete (b) and (c)end deletebegin insert (b) to (d), inclusive,end insert shall become
12operativebegin insert on January 1, 2018, for coverage effective for California
13qualified health plans beginning January 1, 2019, contingentend insert upon
14federal approval
of the waiver pursuant to subdivision (a).
15(e) For purposes of this section, a “California qualified
health
16plan” means a product offered to persons not otherwise eligible to
17purchase coverage from the Exchange by reason of immigration
18status and that comply with each of the requirements of state law
19and the Exchange for a qualified health plan.
This act is an urgency statute necessary for the
21immediate preservation of the public peace, health, or safety within
22the meaning of Article IV of the Constitution and shall go into
23immediate effect. The facts constituting the necessity are:
24In order to request federal approval of the waiver to expand
25access to health care coverage in California as quickly as possible,
26it is necessary that this act go into immediate effect.
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