BILL ANALYSIS                                                                                                                                                                                                    






          SENATE PUBLIC EMPLOYMENT & RETIREMENT    BILL NO: SB 1262
          Lou Correa, Chair            Hearing date: April 12, 2010
          SB 1262 (Aanestad)    as introduced  2/19/10FISCAL:   YES

           CALPERS:  HIGH DEDUCTIBLE HEALTH PLANS AND HEALTH SAVINGS  
          ACCOUNTS
           

           HISTORY  :

              Sponsor:  author

              Prior legislation:  SB 353 (Dutton) 2009
                               Died in Senate Revenue and Taxation
                             AB 326 (Garrick) 2009
                         Died in Assembly Revenue and Taxation
                             AB 2609 (Richman) 2002
                         Died in Assembly Health

           
          SUMMARY  : 

          1)  Amends the Public Employees' Medical and Hospital Care  
          Act (PEMHCA), administered by the California Public  
          Employees' Retirement System (CalPERS) to:

          a)require that PEMHCA include a high deductible health plan  
            and corresponding Health Savings Accounts (HSA) as one of  
            the options that employees and annuitants who participate  
            in PEMHCA may choose,
            
            b)  require that the employer contribution rates in effect  
            for existing plans be paid for the high deductible plan and  
            corresponding HSAs, as specified, and
             
             c)  require that participating employees and annuitants who  
            opt for the high deductible plan pay their required  
            contributions and also contribute a minimum of $50 per  
            month to their HSA accounts.
             
           2)   This bill  also amends the Revenue and Taxation Code to  
          make various changes and clarifications to the Revenue and  
          Taxation Code, effective January 1, 2010, to allow taxable  
          Pamela Schneider
          Date:  4/6/10                                          Page 1  










          deductions, as specified, in connection with HSA accounts,  
          and create conformity between state and federal laws with  
          regard to HSA accounts.


           BACKGROUND AND ANALYSIS  :
          
           1)Existing state law  :

            a)  Creates PEMHCA, administered by CalPERS and  
            continuously appropriated for the exclusive benefit of  
            participating public employees and annuitants.  Local  
            contracting agencies and school districts may contract with  
            CalPERS to participate in PEMHCA.  In addition, PEMHCA  
            provides the state-sponsored health care plan for state  
            employees and annuitants.

            PEMHCA provides HMO and PPO health plans.  Participating  
            employees and annuitants may choose from among these plans.  
             PEMHCA does not currently offer a high deductible health  
            care plan with corresponding HSAs.

            b)  Requires participating public employers to pay a  
            percentage of the costs of the health care plans.  In  
            general, the State pays up to 85% of the weighted premium  
            cost for active employees and 80% for dependents, depending  
            on employee bargaining agreement.  The State pays 50% to  
            100% of the weighted premium for annuitants, depending on  
            length of service and date of hire.  Annuitants' dependents  
            receive 90% of the annuitant premium.  The formula for  
            annuitants and their dependents is sometimes referred to as  
            the 100/90 formula.

            Contracting local agencies and school districts may be  
            subject to the 100/90 formula for annuitants or a lesser  
            percentage contribution rate, depending on contract option  
            and the employee's length of service.

            c)  Requires that participating employees and annuitants  
            pay a percentage of health care costs, which may vary  
            depending on labor agreement, CalPERS contract, and length  
            of service.

          Pamela Schneider
          Date:  4/6/10                                          Page 2  










          2)   Existing federal laws  allow tax deductions for employer  
            and employee contributions to   HSA accounts that are used  
            for qualified medical expenses.  State tax laws do not  
            currently conform to federal laws in this regard.
           
           3)   This bill  :
          
            a)  requires the CalPERS board to offer a high deductible  
            health plan and corresponding HSA option, designed and  
            administered in compliance with federal IRS standards, to  
            all employees and annuitants who participate in PEMHCA,

            b)  requires an eligible employee or annuitant who elects  
            participation in a high deductible health plan and HSA to  
            contribute the cost of coverage less any portion paid by  
            the employer,

            c)  requires participating employees and annuitants to  
            designate at least $50 per month, deducted from salary or  
            retirement allowance, to be placed in the Public Employees'  
            Health Savings Fund, in an HSA in the employee's name, for  
            the payment of qualified medical expenses,

            d)  requires an employer of a participating employee or  
            annuitant who elects participation in an HSA to pay  
            employer contributions as currently required in PEMHCA,

            e)  requires the employer to also pay into the  
            participating employee's or annuitant's health savings  
            account an amount equal to the difference between the  
            employer cost for the high deductible plan and the cost of  
            the weighted average of the plan premiums the employer  
            would have paid if the employee had elected one of the  
            other health plans,

            f)  creates the Public Employees' Health Savings Fund in  
            the State Treasury under the exclusive control and  
            administration of CalPERS, for the exclusive benefit of  
            participants, and makes the fund continuously appropriated,  
            and

            g)  amends state tax laws, retroactively to January 1,  
            2010, to allow tax deductions for contributions to HSA  
          Pamela Schneider
          Date:  4/6/10                                          Page 3  










            accounts and otherwise conform to federal tax laws  
            governing HSAs and high deductible plans.
          

           FISCAL EFFECT  :  

           With regard to SB 353 (Dutton, 2009), the Senate Revenue and  
          Taxation Committee identified approximately $60 million  
          annually in lost revenue due to allowing qualified deductions  
          for contributions to HSAs.
           
           Regarding AB 2609 (Richman, 2002), which was substantially  
          the same as this bill with regard to requiring a high  
          deductible plan and HSAs for public employees, CalPERS noted  
          that negative selection (i.e., healthy employees migrating to  
          the high deductible plan and leaving the other plans with  
          higher percentages of sicker participants) could likely  
          increase the costs of the regular plans.  In addition,  
          CalPERS noted that administrative costs would increase due to  
          the burden of maintaining the HSA accounts, including  
          collections, account maintenance, and authorized  
          disbursements.  Specifically, CalPERS stated it would have to  
          design and maintain the technological systems necessary for  
          the program and devote up to 12 full-time positions to  
          maintain data, work with employers, and approve medical claim  
          disbursements.


           COMMENTS  :

           1)Arguments in support  :
            
                    According to the author, "SB 1262 lowers the cost  
              for CalPERS health care coverage, expands affordable  
              coverage options for recipients, and remedies the unfair  
              tax treatment of consumers who help fund their own care."

                     In addition, "The federal government and 46 other  
              states do not tax these accounts-neither should  
              California."

          2)   Arguments in opposition  :  
           
          Pamela Schneider
          Date:  4/6/10                                          Page 4  










              The California Labor Federation states that high  
              deductible plans "discourage sick workers and their  
              families from seeking care for routine illnesses,  
              potentially leading to subsequent health care costs that  
              are much higher than they would have been with early  
              treatments."  They note that those who benefit most from  
              high deductible health plans are the "wealthiest  
              employees who can stash money away at a very low cost to  
              cover expensive medical procedures."

              The California Professional Firefighters state that  
              creating these new tax deductions would "result in  
              revenue losses that could ultimately impact revenues that  
              are otherwise available for critical firefighting and  
              public safety services."

              Health Access California notes that it is not necessary  
              to require CalPERS to provide high deductible plans and  
              HSAs because CalPERS already has the authority to do so.


          3)   OPPOSITION  :

               American Federation of State, County and Municipal  
          Employees, AFL-CIO (AFSCME)
               California Labor Federation (CLF)
               California Professional Firefighters (CPF)
               California Retired Teachers Association (CalRTA)
               Health Access California
               Service Employees International Union, Local 1000 (SEIU)




                                      #####






          Pamela Schneider
          Date:  4/6/10                                          Page 5