BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1088
                                                                  Page  1

          Date of Hearing:   August 4, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                    SB 1088 (Price) - As Amended:  August 2, 2010 

          Policy Committee:                              Health Vote:13-6

          Urgency:                          State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill conforms state law to requirements of federal health  
          reform, the Patient Protection and Affordable Care Act  
          (PL-111-148).This bill prohibits the limiting age of dependent  
          health coverage from being less than 26 years of age, with  
          specified exceptions. The limiting age determines when children  
          are no longer considered dependents for the purposes of health  
          coverage. Under federal law the extension of dependent coverage  
          is effective for plan years on or after September 23, 2010.  
          Specifically, this bill: 

          1)Establishes parameters related to grandfathered health plans.  
            Grandfathered plans are exempt from some requirements of  
            federal health reform. 

          2)Establishes notice requirements for health plans and insurers  
            about the offer of dependent coverage. 

          3)Clarifies that nothing in this legislation requires a plan or  
            insurer to cover a dependent child. 

           FISCAL EFFECT  

          Annual increased costs of $85 million GF to CalPERS to provide  
          the employer share of health premium costs to 29,000 young  
          adults gaining access to health coverage through the increase in  
          the limiting age established by this bill. For CalPERS these  
          requirements become effective January 1, 2011. Cost impacts  
          associated with this bill would accrue in the absence of this  
          bill, as federal requirements would take effect without state  
          law changes. This bill provides clarification for implementation  
          for employers, health plans, and families. 








                                                                  SB 1088
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           COMMENTS  

           1)Rationale  . This bill conforms state law to federal health  
            reform requirements related to an increase in the age young  
            adults continue to qualify for health coverage via their  
            parents' employer-based health insurance. Under current state  
            law, young adults meeting specified eligibility criteria are  
            able to remain on their parents' health plan until their 23rd  
            birthday. According to national estimates, 2.4 million young  
            adults will access coverage through the mechanism established  
            by the expansion of dependent health coverage, 75% of whom  
            will have been previously uninsured. Recent amendments clarify  
            circumstances related to young adults that previously lost or  
            were denied dependent health coverage. 

           2)Dependent Health Coverage  . Most individual and group health  
            coverage policies set a limiting age for coverage of dependent  
            children. The limiting age determines when children are no  
            longer considered dependents for the purposes of health  
            coverage.  The age is often set at 19. However, contracts also  
            often allow a young person who is enrolled full-time in  
            college to remain on the policy as a dependent until age 23.   
            In addition, California statute establishes an exception to  
            the limiting age for those dependents who are incapable of  
            self-sustaining employment by reason of a physically or  
            mentally disabling injury, illness, or condition and who  
            remain chiefly dependent on the policyholder for support and  
            maintenance. This bill extends the limiting age for health  
            coverage until a dependent's 26th birthday without the  
            requirements such as disability or school enrollment. 

           3)California's Uninsured  . California has a large proportion of  
            uninsured residents. In 2009, 25% of the population lacked  
            health insurance for some or all of the year. The number of  
            the uninsured has increased significantly over the past few  
            years due to drops in employer-based coverage. Young adults  
            ages 19 to 29 generally account for between 20% and 30% of the  
            uninsured. In addition to being a significant share of  
            individuals lacking health insurance, young adults ages 21 to  
            24 have a likelihood of 40% of being uninsured. This bill  
            increases the number of young adults with access to health  
            coverage and will reduce the rate of the uninsured statewide.   










                                                                  SB 1088
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           4)Related Legislation  . AB 1602 (J. Perez), pending in the  
            Senate, enacts a series of changes related to health reform  
            including establishing the California Health Benefits Exchange  
            and allowing young adults to stay on their parents' health  
            coverage until age 26.

          AB 29 (Price), in 2009, prohibited the limiting age of dependent  
            health plan and insurance coverage from being less than 27  
            years of age. AB 29 was held on the Suspense File of this  
            committee.  

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