BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 2|
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CONFERENCE COMPLETED
Bill No: SB 2
Author: Burton (D) and Speier (D), et al
Amended: Conference Report No. 1
9/9/03
Vote: 21
SENATE INSURANCE COMMITTEE : 6-3, 4/30/03
AYES: Speier, Escutia, Figueroa, Perata, Scott, Soto
NOES: Johnson, Morrow, Oller
SENATE HEALTH & HUMAN SERV. COMMITTEE : 9-3, 5/7/03
AYES: Ortiz, Alarcon, Chesbro, Figueroa, Florez, Kuehl,
Romero, Vasconcellos, Vincent
NOES: Aanestad, Ashburn, Battin
NO VOTE RECORDED: Escutia
SENATE APPROPRIATIONS COMMITTEE : 8-5, 5/29/03
AYES: Alpert, Bowen, Burton, Escutia, Karnette, Machado,
Murray, Speier
NOES: Battin, Aanestad, Ashburn, Johnson, Poochigian
SENATE FLOOR : 25-14, 6/4/03
AYES: Alarcon, Alpert, Bowen, Burton, Cedillo, Chesbro,
Ducheny, Dunn, Escutia, Figueroa, Florez, Karnette,
Kuehl, Machado, Murray, Ortiz, Perata, Romero, Scott,
Sher, Soto, Speier, Torlakson, Vasconcellos, Vincent
NOES: Aanestad, Ackerman, Ashburn, Battin, Brulte, Denham,
Hollingsworth, Knight, Margett, McClintock, McPherson,
Morrow, Oller, Poochigian
NO VOTE RECORDED: Johnson
ASSEMBLY FLOOR : 45-30, 7/7/03 - See last page for vote
CONTINUED
SB 2
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2
CONFERENCE COMMITTEE : 4-2, 9/9/03
AYES: Alpert, Burton, Cohn, Frommer
NOES: Aanestad, Pacheco
SUBJECT : Health care coverage
SOURCE : California Medical Association
DIGEST : This bill enacts the Health Insurance Act of
2003 by creating the State Health Purchasing Program to be
administered by the Managed Risk Medical Insurance Board,
as specified.
Conference Amendments add implementation language to the
findings and declarations in the prior version of the bill.
ANALYSIS : Existing law does not provide a system of
health care coverage for all California residents and does
not require employers to provide health care coverage for
employees and dependents, other than coverage provided as
part of the workers' compensation system for work-related
employee injuries. Existing law provides for the creation
of various programs to provide health care services to
persons who have limited incomes and meet various
eligibility requirements. These programs include the
Healthy Families Program administered by the Managed Risk
Medical Insurance Board (MRMIB), and the Medi-Cal program
administered by the State Department of Health Services
(DHS). Existing law provides for the regulation of health
care service plans by the State Department of Managed
Health Care and health insurers by the State Department of
Insurance.
This bill creates the State Health Purchasing Program,
which would be administered by MRMIB. The bill requires
specified health benefits to be provided directly by
employers or through the program. The bill requires the
board to arrange health plan coverage for certain
employers, who would be required to pay a fee for employee
health coverage, except that employers who provide health
care coverage directly would receive a credit against the
fee. The bill requires employees and dependents of large
SB 2
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employers to be covered beginning January 1, 2006, while it
requires employees of medium employers to be covered
beginning January 1, 2007, subject to certain conditions.
Small employers are exempted from the requirement to
provide coverage and from the fee. The bill requires the
board to determine the fee to be paid by employers, and
provides that the associated employee contributions, which
employers would be required to collect from employees, may
not exceed 20 percent of the employer fee. The fees,
including the employee contributions, would be collected by
the State Employment Development Department and would be
deposited in the newly created State Health Purchasing
Fund. The moneys in the fund would be continuously
appropriated to the board for the purposes of the program.
The bill authorizes the board to coordinate coverage under
the program with coverage available under the Medi-Cal
program, the Healthy Families Program, and other public
programs, and imposes various requirements on the board and
DHS in that regard. The bill authorizes a loan from the
General Fund to the board for startup costs related to the
State Health Purchasing Program, subject to appropriation
by the Legislature. The bill enacts other related
provisions.
Existing law requires health care service plans and health
insurers to comply with various requirements relating to
health care coverage for small employers. A willful
violation of provisions governing health care service plans
is a crime.
This bill extends the application of these requirements to
health care coverage provided directly by employers under
the bill, and imposes various other requirements. Because
a willful violation of these provisions by health care
service plans would be a crime, the bill imposes a
state-mandated local program.
This bill provides that it shall not become operative
unless AB 1528 (Cohn) is also enacted and becomes
operative.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
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SUPPORT : (Verified 9/11/03)
California Medical Association (source)
AARP California
Amalgamated Transit Union Local 1574
American College of Cardiologists (California Chapter)
American College of Emergency Physicians (California
Chapter)
American Federation of State, County & Municipal Employees
American Nurses Association
Asian Pacific American Legal Center of Southern CA
Association of Flight Attendants Local 11
Bakery Wagon Drivers Local #484
Being Alive
Board of Supervisors County of Los Angeles
Brewery Soda & Mineral Water Bottlers of California Local
Union 896
Building & Construction Trades Council of San Mateo County
Building Material, Construction, Industrial, Profession &
Technical
Teamster Union Local #36
Bustamante, Cruz (Lieutenant Governor)
California Association of Health Underwriters (if amended)
California Association of Public Hospitals & Health Systems
California Commission on Aging
California Commission on the Status of Women
California Conference Board of the Amalgamated Transit
Union
California Conference of Machinists
California Faculty Association
California Federation of Teachers
California Independent Public Employees Legislative Council
California Labor Federation, AFL-CIO
California National Organization for Women
California Medical Association
California Optometric Association
California Organization of Police and Sheriffs
California Physical Therapy
California Professional Firefighters
California School Employees Association
California Teachers Association
California Women's Law Center
Central Labor Council of Alameda County
Central Labor Council of Contra Costa
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City and County of San Francisco
Coalition for Humane Immigrant Rights of L.A.
Communications Workers of America District 9
Communications Workers of America Local 9000
Communications Workers of America Local 9414
Communications Workers of America Local 9415
Communications Workers of America Local 9423
Communications Workers of America Local 9503
Congress of California Seniors
Consumer Federation of California
Consumers Union
East Bay Automotive Machinists Lodge #1546
Electrical Workers Local 595
E-LOAN
Engineers & Scientists of California, Local 20,
IFPTE,AFL-CIO
Faculty Association of California Community Colleges
Garamendi, John (Insurance Commissioner)
General Teamster, Local 386
General Teamsters, Warehousemen, Cannery Workers & Helpers
Union 94
General Truck Drivers Chauffeurs & Helpers Union Local 692
Glaziers Local 718
Greenlining
Harman International
Health Access California
Hotel Employees & Restaurant Employees International Union
Hotel Employees & Restaurant Employees Union Local 49
Hotel Employees and Restaurant Employees Union of San
Diego, Local 30
International Association of Bridge, Structural, Ornamental
& Reinforcing Iron Workers Local Union 377
International Association of Bridge, Structural, Ornamental
& Reinforcing Iron Workers Local Union 155
International Association of Machinists & Aerospace Workers
Local 1528
International Brotherhood of Electrical Workers Local Union
11
International Brotherhood of Electrical Workers Local Union
18
International Brotherhood of Electrical Workers Local 100
International Brotherhood of Electrical Workers Local 302
International Brotherhood of Electrical Workers Local 551
International Brotherhood of Electrical Workers Local 569
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International Brotherhood of Electrical Workers Local 1245
International Brotherhood of Teamsters Local 601
International Federation of Professional & Technical
Engineers Local 21
International Union of Operating Engineers Local 39
ITUP
Jericho
Joint Council of Interns & Residents
Korean Resource Center
Latino Issues Forum
League of Women Voters of California
League of Women Voters of Sonoma County
League of Women Voters of Whittier
Los Angeles County Board of Supervisors
Machinists Automotive Trades District Lodge #190 of
Northern California
Marine Firemen's Union
Mental Health Association of California
Mexican American Legal Defense & Educational Fund
National Association of Broadcast Employees & Technicians
National Association of Letter Carriers Branch 183
National Center for Lesbian Rights
National Immigration Law Center
Northern California District Council of the International
Longshore &
Warehouse Union
Older Women's League of California
Office & Professional Employees International Union Local 3
Painters & Allied Trades, District Council 36
Peninsula Automotive Machinists Union Local 1414
Pico California Project
Planned Parenthood Golden Gate
Planned Parenthood Affiliates of CA
Plumbers, Steamfitters & Refrigeration Fitters Local Union
467
Professional & Technical Engineers, Local 21, IFPTE,AFL-CIO
San Diego-Imperial Counties Labor Council
San Francisco Labor Council, AFL-CIO
San Mateo Central Labor Council
Secretary of State (Kevin Shelley)
Service Employees International Union Local 399
Service Employees International Union Local 1280
Services, Immigrant Rights & Education Network
Sheet Metal Workers' International Association Local 104
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Southern California District Council of Laborers
Southern California Pipe Trades District Council 16
Southern California Typographical & Mailer Union Local
14904
State Building & Construction Trades Council
Teamsters Joint Council 7
Teamsters Joint Council 42
The Breast Cancer Fund
Transport Workers Union of America
UAW Local 2865
Union of American Physicians and Dentists
United Food & Commercial Workers Region 8 States Council
United Food & Commercial Workers Union, Local 373
United Food & Commercial Workers Union, Local 839
United Food & Commercial Workers Union Local 870
United Food & Commercial Workers Union, Local 1179
United Farm Workers of America, AFL-CIO
United Nurses Associations of California/Union of Health
Care Professionals
United Steelworkers of America
UPTE/CWA Local 9119
Utility Workers Union of America Local 246
West Hollywood Democratic Club
Work and Family Coalition of Alameda County
OPPOSITION : (Verified 9/10/03)
Aesa Staffing
Alhambra Chamber of Commerce
American Electronics Association
Applebee's
Automotive Importing Manufacturing, Inc.
Burbank Chamber of Commerce
California Assisted Living Association
California Bean Shippers Association
California Business Properties Assoc.
California Business Roundtable
California Chamber of Commerce
California Farm Bureau Federation
California Federation of Republican Women
California Grain & Feed Association
California Manufacturers & Technology Association
California Restaurant Association
California Seed Association
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California Small Business Association
California State Floral Association
California Taxpayers' Association
California Warehouse Association
California Women for Agriculture
Californians for Affordable Health Reform
Camarillo Recycling, Inc.
Capital Region Financial Group, LLC
Carr's Cleaners
Casey's Hallmark
Coalition of California Insurance Professionals
Computer-Terminal Services
Cordell Corporation
DBM
emPraxis
Enterprise Rent-A-Car of Sacramento
FAST Undercan
Frank Fats Inc.
Fresh Cut Florist & Gifts
Furniture at Work, Inc. dba Techline Studio
Health Insurance Association of America
KC Associates, Inc.
KCRA-TV
Kistner Insurance Services, LLC
KQCA-TV
LEED-Sacramento
Life Priority Network
Maher Accountancy
Metal Finishing Association of Southern California
Metropolitan Theatres Corporation
Motiva, Inc.
Mueller Homes, Inc.
National Association of Insurance and Financial
Advisors-California
National Federal of Independent Business
Newport Beach Chamber of Commerce
Novy, Linda (Gardeners' Guild)
Orange County Business Council
Pacific Egg & Poultry Association
Paper, Pulp & Film
Rancho Cordova Grocery Outlet
Redondo Beach Chamber
Re/Max Gold
Rose Colored Glass Company
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Rose Investigations
Sacramento Coca-Cola Bottling Co.
Sacramento Metropolitan Chamber of Commerce
Sacramento Philharmonic Orchestra
Sacramento River Cats Baseball Club
Sanford-Lussier, Inc.
SBC
Stanford Home for Children
Synergex International Corporation
The Movie Experience
The Small Business Resource Center
Visalia Chamber of Commerce (Board of Directors)
West Orange County Legislative Committee
Western Growers Association
Western Insurance Agents' Association
Wilcox Miller & Nelson
Women Volunteers in Politics
Yoder & Co.
ARGUMENTS IN SUPPORT : According to information provided
by the authors' office, working Californians and their
families should have health insurance coverage and that
most working Californians obtain their coverage through
their employment. In 2001, more than six million
Californians lacked coverage at some time, 3.6 million had
no coverage at any time, more than 80 percent of these were
working people or their families, and most of these working
Californians without coverage work for employers who do not
offer health benefits. People who have coverage have
better health outcomes than those who lack coverage, are
more likely to be in poor health, more likely to have
missed needed medications and treatment, and more likely to
have chronic conditions that are not properly managed.
Employers who do not provide coverage to their workers have
an unfair competitive advantage over those employers who
provide coverage, and that employers who provide coverage
to dependents often pay directly for the failure of other
employers to provide coverage for those dependents.
Employers who provide coverage also pay directly when a
previously uninsured person becomes an employee and the
accumulated health costs due to lack of insurance burden
the employer providing coverage.
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Controlling health care costs can be more readily achieved
if all working people and their families have coverage so
that cost shifting is minimized.
ASSEMBLY FLOOR :
AYES: Berg, Bermudez, Calderon, Canciamilla, Chan, Chavez,
Chu, Cohn, Corbett, Correa, Diaz, Dutra, Dymally,
Frommer, Goldberg, Hancock, Jerome Horton, Jackson,
Kehoe, Koretz, Laird, Leno, Levine, Lieber, Longville,
Lowenthal, Matthews, Montanez, Mullin, Nakano, Nation,
Negrete McLeod, Nunez, Oropeza, Parra, Pavley,
Ridley-Thomas, Salinas, Simitian, Steinberg, Vargas,
Wiggins, Wolk, Yee, Wesson
NOES: Aghazarian, Bates, Benoit, Bogh, Campbell, Cogdill,
Cox, Dutton, Garcia, Harman, Haynes, Shirley Horton,
Houston, Keene, La Malfa, La Suer, Leslie, Maldonado,
Maze, McCarthy, Mountjoy, Nakanishi, Pacheco, Plescia,
Richman, Runner, Samuelian, Spitzer, Strickland, Wyland
DLW:mel 9/11/03 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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