BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1543
                                                                  Page  1

          Date of Hearing:   May 28, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

             AB 1543 (Committee on Health) - As Amended:  May 21, 2009  

          Policy Committee:                              Health Vote:19-0

          Urgency:     Yes                  State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill conforms Medicare supplement contract and policy  
          requirements to recently enacted federal law, the Medicare  
          Improvements for Patients and Providers Act of 2008 (MIPPA).  
          Medicare supplement policies, also known as Medigap plans pay  
          for medical expenses not covered or only partially covered by  
          Medicare. Specifically, this bill:

          1)Establishes requirements for 11 standardized Medigap policies  
            and makes other changes to standards applied to Medigap  
            policies pursuant to MIPPA. 

          2)Establishes guaranteed issue (health coverage issued  
            regardless of health status) for specified dual eligibles who  
            are eligible for both Medicare and Medi-Cal and establishes  
            guaranteed issue under specified conditions related to  
            employer provided health coverage. 

          3)Requires Medigap issuers to adhere to genetic  
            non-discrimination requirements recently established in  
            federal law. 

          4)Clarifies specified Medicare Part C plans must be licensed by  
            the California Department of Managed Health Care (DMHC). 

           FISCAL EFFECT  

          No direct fiscal impact to DMHC or CDI to continue oversight of  
          Medigap insurance policies and enforce conformance with recent  
          changes to federal law. 

           COMMENTS  








                                                                  AB 1543
                                                                  Page  2


           1)Rationale  . This bill is sponsored by CDI to conform various  
            aspects of Medigap policies, oversight, and underwriting to  
            recently enacted federal law. MIPPA made changes to Medicare  
            Advantage plans, offered beneficiary improvements, increased  
            access for low-income beneficiaries, and modified prescription  
            drug benefits and physician services. This bill ensures that  
            California's health insurance regulators continue to have  
            authority over the Medigap market regulated by the state. 

           2)Recent Amendments  are generally technical and address health  
            insurer requests for health information and Medicare Advantage  
            licensure. 
           
          3)Medicare  is a 100% federally funded health insurance program  
            that provides coverage to eligible beneficiaries through  
            fee-for-service (FFS) and managed care arrangements. Most  
            individuals 65 and over are automatically entitled to Medicare  
            Part A if they or their spouse are eligible for Social  
            Security payments. People under 65 who receive Social Security  
            cash payments due to a disability are eligible for Medicare  
            after a two-year waiting period. Medicare beneficiaries pay  
            for their benefits through premiums, deductibles, coinsurance,  
            and co-payments. In California, of the more than 4 million  
            Medicare enrollees, 87% are elderly and 13% are disabled.
           


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081