BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 151
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 151 (Monning)
          As Amended June 29, 2011
          Majority vote
           
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          |ASSEMBLY:  |49-25|(May 26, 2011)  |SENATE: |23-15|(August 18,    |
          |           |     |                |        |     |2011)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Allows an individual to drop Medicare Advantage (MA) 
          coverage and enroll in Medicare supplement coverage of the same 
          issuer, or the issuer's parent company, if the MA issuer 
          increases premiums.  If Medicare supplement coverage is not 
          available from the same issuer, or parent company, allows an 
          individual under limited circumstances to enroll in Medicare 
          supplement coverage of an unaffiliated issuer.  Deletes obsolete 
          references in law and recognizes two new Medicare supplement 
          plans (M and N).

           The Senate amendments  : 

          1)Narrow the circumstances under which an individual is eligible 
            for Medicare supplement provided by a different issuer to when 
            the individual's MA plan:

             a)   Increases the premium by 15% or more;

             b)   Increases physician, hospital, or drug copayments by 15% 
               or more;

             c)   Reduces any benefits under the plan; or,

             d)   Discontinues, for other than good cause relating to 
               quality of care, its relationship or contract under the 
               plan with a provider who is currently furnishing services 
               to the individual.

          2)Limit enrollment in a Medicare supplement of an unaffiliated 
            issuer to the annual election period for a Medicare Advantage 
            plan, except where the Medicare Advantage plan has 
            discontinued its relationship with a provider currently 
            furnishing services to the individual.








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          3)State that this bill not be construed to authorize an 
            individual to enroll in a group Medicare supplement policy if 
            the individual does not meet the eligibility requirements for 
            the group.

           EXISTING LAW  allows an individual enrolled in a MA plan that 
          reduces any of its benefits, increases cost sharing, or 
          terminates certain relationships with providers, to enroll in 
          Medicare supplement coverage that is issued by the same issuer 
          of his or her MA plan or by a subsidiary of, or a network that 
          contracts with, the parent company of that issuer.

           AS PASSED BY THE ASSEMBLY , this bill allowed an individual 
          enrolled in a MA plan to drop MA coverage because of increases 
          in premium and to enroll in Medicare supplement coverage by the 
          same issuer of the MA plan, and if the MA plan issuer, did not 
          offer Medicare supplement coverage allowed the individual to 
          enroll in Medicare supplement coverage from any issuer under 
          specified circumstances.

           FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS  :  According to the author, the recent federal Patient 
          Protection and Affordable Care Act, among other things, will 
          begin to reduce the subsidy paid to Medicare Advantage plans in 
          2012 and use the savings to close the prescription drug coverage 
          gap, provide additional Medicare preventive services, and 
          implement other improvements.  MA plans have been paid about 13% 
          more than the amount paid for coverage in Original Medicare, a 
          subsidy that will be reduced under a complex formula.  This 
          subsidy has enabled Medicare Advantage plans in different 
          geographic areas to provide coverage or benefits that would not 
          have been possible without the subsidy.  The author states that 
          in some cases this has meant plans offer coverage in higher 
          costs areas that they would otherwise have shunned.  In other 
          cases, this has meant that plans offered additional benefits 
          that would not otherwise have been offered.  The new formula 
          will provide less total subsidy to these Medicare Advantage 
          plans, but will provide additional payments to high performing 
          plans.  The author states that this bill will ensure that all 
          Medicare recipients in a Medicare Advantage plan facing 
          increased costs or reduced benefits have the option to enroll in 
          Original Medicare and purchase a Medigap plan to help cover the 








                                                                  AB 151
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          costs of coinsurance, copayments, and deductibles.

          Proponents (American Association of Retired Persons, the sponsor 
          of this bill, California Health Advocates, American Federation 
          of State, County and Municipal Employees, Health Access 
          California, Congress of California Seniors and others) support 
          this bill because it ensures Medicare enrollees have the option 
          to switch to plans that are the most affordable and meet their 
          needs.  
           

          Analysis Prepared by  :    Teri Boughton / HEALTH / (916) 319-2097 



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