BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          AB1846 (Gordon) - Consumer operated and oriented plans.
          
          Amended: June 28, 2012          Policy Vote: Health 5-3, 
          Insurance 5-3
          Urgency: No                     Mandate: Yes
          Hearing Date: August 6, 2012                           
          Consultant: Brendan McCarthy    
          
          This bill does not meet the criteria for referral to the 
          Suspense File.
          
          
          Bill Summary: AB 1846 would establish in law a licensing 
          framework for consumer operated and oriented plans (CO-OPs) to 
          provide health care coverage under the Department of Managed 
          Health Care and/or the Department of Insurance.

          Fiscal Impact: 
              One-time costs to the Department of Managed Care to develop 
              policies and adopt regulations of about $90,000 (Managed 
              Care Fund).

              One-time costs to the Department of Insurance to develop 
              policies and adopt regulations of about $80,000 (Insurance 
              Fund).

              Minor ongoing costs for enforcement (Managed Care Fund and 
              Insurance Fund) as the number of CO-OPs seeking licensure in 
              the state is likely to be small.

          Background: The federal Patient Protection and Affordable Care 
          Act (Affordable Care Act) authorizes the creation of consumer 
          operated and oriented plans (CO-OPs). Under the Affordable Care 
          Act, CO-OPs are defined as non-profit, member-run health 
          cooperatives. A CO-OP must be a new organization, cannot be 
          sponsored by a government agency, must meet conflict of interest 
          standards, must operate with a consumer focus, and must meet all 
          applicable state requirements. 

          The Affordable Care Act makes $6 billion in funding available 
          for startup loans to CO-OPs.









          AB 1846 (Gordon)
          Page 1


          Proposed Law: AB 1846 would establish in state law the licensing 
          framework for CO-OPs, in both Health and Safety Code (enforced 
          by the Department of Managed Health Care) and the Insurance Code 
          (enforced by the Department of Insurance). The provisions of the 
          bill incorporate federal requirements on CO-OPs into state law.

          Under the bill, CO-OPs seeking licensure would be required to 
          meet the same standards as other health plans or health 
          insurers, pay the same fees, and be subject to the same 
          regulatory requirements.

          The bill would place in law specific requirements on CO-OPs, 
          such governance rules, membership rules, and conflict of 
          interest provisions.

          The bill would authorize both the Department of Managed Health 
          Care and the Department of Insurance to adopt regulations to 
          implement the provisions of the bill.

          Related Legislation: 
              AB 1453 (Monning) would designate the Kaiser Small Group 
              HMO as the state's essential health benefit benchmark plan. 
              That bill will be heard in this committee.
              AB 1461 (Monning) would require health plans to comply with 
              federal requirements in the individual market. That bill 
              will be heard in this committee.
              SB 951 (Hernandez) would designate the Kaiser Small Group 
              HMO as the state's essential health benefit benchmark plan. 
              That bill is in the Assembly Appropriations Committee.
              SB 961 (Hernandez) would require health plans to comply 
              with federal requirements in the individual market. That 
              bill is in the Assembly Appropriations Committee.

          Staff Comments: Because the only costs that may be incurred by a 
          local government agency relate to crimes or infractions, the 
          bill does not create a reimbursable state mandate.