BILL ANALYSIS                                                                                                                                                                                                    �





                                                                  AB 1877

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          GOVERNOR'S VETO
          AB 1877 (Cooley)
          As Amended August 19, 2014
          2/3 vote
           
           
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          |ASSEMBLY:  |77-0 |(May 28, 2014)  |SENATE: |36-0 |(August 21,    |
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          |ASSEMBLY:  |78-0 |(August 25,     |        |     |               |
          |           |     |2014)           |        |     |               |
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           Original Committee Reference:   HEALTH  

           SUMMARY  :  Creates in state government the California Vision Care  
          Access Council (Council), governed by the Board of the  
          California Health Benefit Exchange (Exchange), to create a  
          Website to inform consumers about individual and employer-based  
          vision plans offered by participating carriers.  Contains an  
          urgency clause in order to become effective immediately upon  
          enactment.  Specifically,  this bill  :

          1)Gives the Council the following duties:

             a)   Construct, manage, and maintain a Web site, separate  
               from the Exchange's Web site, to allow consumers to obtain  
               standardized comparative information on participating  
               vision plans.  Establish an interagency agreement with the  
               Exchange allowing the Council to utilize certain resources  
               of the Exchange, including staff and information technology  
               infrastructure.  This bill prohibits the use of federal  
               Exchange funds from being used for purposes of this bill;
              
             b)   Determine minimum requirements for plans participating  
               in the Web site;











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             c)   Work cooperatively with the Exchange to establish a  
               direct link from the Exchange Web site to the Council Web  
               site.  Refer consumers to the Exchange and licensed agents  
               if they have questions about Medi-Cal or Exchange plan  
               enrollment and eligibility;

             d)   Provide information in a culturally and linguistically  
               appropriate manner using the services of licensed agents;  
               and,

             e)   Assess a charge on participating vision plans that is  
               reasonable and necessary to support the development,  
               operations, and prudent cash management of the Council.

          2)Gives the Council the authority to enter into contracts; adopt  
            an official seal; sue and be sued; adopt rules and  
            regulations; and receive and accept gifts, grants, or  
            donations from government agencies and from individuals,  
            associations, private foundations, or corporations, in  
            compliance with conflict of interest provisions adopted by the  
            Board at a public meeting.

          3)Prohibits the use of state General Fund moneys for the  
            purposes of this bill.  Creates the California Vision Care  
            Access Trust Fund (Fund) in the State Treasury, with funds  
            available upon appropriation by the Legislature, to fund the  
            activities of the Council, and requires any costs associated  
            with the implementation of this bill to be paid from the fund.  
             Makes this bill's implementation contingent on the existence  
            of sufficient moneys in the fund.
           The Senate amendments  make the Council subject to governance by  
          the Exchange Board, rather than a newly-created board, narrow  
          the duties of the Council to only create a Web site, rather than  
          a marketplace for vision coverage, eliminate continuous  
          appropriation of moneys from the Fund, and make numerous other  
          minor changes.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee:

          1)One-time administrative costs in the hundreds of thousands to  










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            low millions for administrative tasks such as developing  
            policies regarding the new marketplace, adopting regulations,  
            conducting stakeholder outreach, and overseeing the management  
            of funds donated to the new Vision Care Access Council for  
            development of the marketplace (special fund).

          2)One-time costs likely in the low millions to create a Web site  
            for comparing vision plans (special fund).

          3)Ongoing administrative costs likely in the millions of dollars  
            per year for the Council to manage the new system, review  
            filings by participating vision plans, and oversee financial  
            transactions conducted through the new marketplace (special  
            fund).

          4)One-time costs of about $160,000 over two years and ongoing  
            costs of about $100,000 for enforcement and consumer  
            assistance by the Department of Insurance (Insurance Fund).

           COMMENTS  :  In 2012, the Exchange Board adopted a policy to offer  
          supplemental dental and vision benefits through the Exchange, on  
          the basis that stand-alone vision plans may increase the  
          likelihood of utilization and provide greater emphasis on  
          preventive care, and that offering stand-alone vision plans  
          would bolster the consumer friendliness of the Exchange.   
          However, subsequent federal guidance indicated that stand-alone  
          vision plans cannot be offered in or through an exchange.

          VSP Global, the sponsor of this bill, notes that vision  
          coverage, particularly in California, is primarily provided  
          through stand-alone plans.  VSP Global further asserts that eye  
          doctors are able to detect previously undetected chronic  
          conditions like diabetes, hypertension, and high cholesterol.   
          Moreover, VSP Global asserts that enrollees in stand-alone  
          vision plans are more likely to utilize their benefits than  
          enrollees with vision benefits bundled with other health care  
          services.  This bill is intended to use federal guidance to  
          facilitate the purchase of affordable, quality vision care  
          coverage, thereby increasing access to vision care through  
          stand-alone vision plans.  
           










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          GOVERNOR'S VETO MESSAGE  :

               The bill would create the California Vision Care  
               Access Council as a new public entity charged with  
               operating a Web site that allows consumers to compare  
               information about vision plans that meet the Council's  
               requirements.  The bill would also require Covered  
               California's board to run the Council's operations,  
               and use the board's staff and resources to conduct the  
               activities of the Council, if permitted by federal  
               law.

               Creating a new state bureaucracy to inform consumers  
               about vision plans isn't necessary, nor is it  
               advisable to divert Covered California's focus with a  
               new scheme, the governance of which may be  
               impermissible under federal rules.
           

          Analysis Prepared by  :    Ben Russell / HEALTH / (916) 319-2097 
           
           
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