BILL NUMBER: SB 728	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MAY 31, 2011
	AMENDED IN SENATE  MARCH 25, 2011

INTRODUCED BY   Senator Hernandez

                        FEBRUARY 18, 2011

   An act to add Section 100522 to the Government Code, relating to
health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 728, as amended, Hernandez. Health care coverage.
   Existing law, the federal Patient Protection and Affordable Care
Act, requires each state to, by January 1, 2014, establish an
American Health Benefit Exchange that makes available qualified
health plans to qualified individuals and employers. Existing state
law establishes the California Health Benefit Exchange within state
government, specifies the powers and duties of the board governing
the Exchange relative to determining eligibility for enrollment in
the Exchange and arranging for coverage under qualified health plans,
and requires the board to facilitate the purchase of qualified
health plans through the Exchange by qualified individuals and small
employers by January 1, 2014.
   The federal Patient Protection and Affordable Care Act also
requires that risk adjustments be made with regard to health insurers
and health plans providing coverage in the individual or small group
market within the state.
   Existing law establishes the Office of Statewide Health Planning
and Development and sets forth its powers and duties with respect to
health facility construction, health policy and planning, and health
professions development.
   This bill would require the board of the California Health Benefit
Exchange  , to the extent required by federal law,  to work
with the Office of Statewide Health Planning and Development, the
Department of Insurance, and the Department of Managed Health Care to
develop a risk adjustment system for products sold in the Exchange
and outside of the Exchange, as specified.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 100522 is added to the Government Code, to
read:
   100522.  (a)  Pursuant to the requirements imposed under
  To the extent required by federal law, and in
conformance with  Section 1343 of the federal act  ,
  and any rules or regulations issued under that
section,  the board shall collaborate with the Office of
Statewide Health Planning and Development, the Department of
Insurance, and the Department of Managed Health Care to develop a
risk adjustment system for products sold in the Exchange and outside
of the Exchange.
   (b) In developing the risk adjustment system, the board shall be
subject to the criteria and methods specified in Section 1343 of the
federal act. The board shall also consider  different
  various  data collection processes for purposes
of the risk adjustment system.
   (c) "Risk adjustment" shall have the same meaning as described in
Section 1343 of the federal act. 
   (d) No money from the General Fund shall be used for the purpose
of carrying out the provisions of this section.