BILL ANALYSIS �
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UNFINISHED BUSINESS
Bill No: SB 972
Author: Torres (D), et al.
Amended: 6/16/14
Vote: 21
SENATE HEALTH COMMITTEE : 6-1, 4/30/14
AYES: Hernandez, De Le�n, DeSaulnier, Evans, Monning, Wolk
NOES: Morrell
NO VOTE RECORDED: Beall, Nielsen
SENATE FLOOR : 33-0, 5/15/14
AYES: Anderson, Beall, Berryhill, Block, Cannella, Corbett,
Correa, De Le�n, DeSaulnier, Evans, Gaines, Galgiani, Hancock,
Hernandez, Hill, Hueso, Huff, Jackson, Knight, Lara, Leno,
Lieu, Liu, Mitchell, Monning, Morrell, Padilla, Pavley, Roth,
Torres, Vidak, Wolk, Wyland
NO VOTE RECORDED: Calderon, Fuller, Nielsen, Steinberg,
Walters, Wright, Yee
ASSEMBLY FLOOR : 73-3, 6/19/14 - See last page for vote
SUBJECT : California Health Benefit Exchange: board:
membership
SOURCE : Author
DIGEST : This bill expands the criteria for serving on the
California Health Benefit Exchange (Covered California) Board by
adding marketing of health insurance products, information
technology system management, management information systems,
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and enrollment counseling assistance with priority to cultural
and linguistic competency, to the list of areas of expertise
that are acceptable for appointment.
Assembly Amendments make technical changes and add coauthors.
ANALYSIS :
Existing law:
1. Establishes Covered California an independent public entity
not affiliated with an agency or department.
2. Requires Covered California to be governed by an executive
board, consisting of five members who are residents of
California. Of the members of the Board, two are appointed
by the Governor, one appointed by the Senate Rules Committee,
and one appointed by the Speaker of the Assembly. The
Secretary of the California Health and Human Services or
his/her designee serves as a voting, ex officio member.
3. Requires Covered California Board members, other than the ex
officio member, to be appointed for a term of four years,
except for the initial appointments of the Speaker and the
Senate Rules Committee which are two and five years,
respectively. Requires appointments made after January 2,
2011, by the Governor to be subject to confirmation by the
Senate.
4. Requires each person appointed to the Covered California
Board to have demonstrated and acknowledged expertise in at
least two of the following areas:
A. Individual health care coverage;
B. Small employer health care coverage;
C. Health benefits plan administration;
D. Health care finance;
E. Administering a public or private health care delivery
system; and
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F. Purchasing health plan coverage.
5. Requires appointing authorities to consider the expertise of
other members of the Covered California Board and attempt to
make appointments so that the Board's composition reflects a
diversity of expertise.
6. Requires appointing authorities to take into consideration
the cultural, ethnic, and geographical diversity of the state
so that the Covered California Board's composition reflects
the communities of California.
7. Prohibits Covered California Board members or staff from
being employed by, a consultant to, a member of the Board of
Directors of, affiliated with, or otherwise a representative
of, a carrier or other insurer, an agent or broker, a health
care provider, or a health care facility or health clinic
while serving on the Board or on the staff of Covered
California. Prohibits a member of the Board or of the staff
of Covered California from being a member, a Board member, or
an employee of a trade association of carriers, health
facilities, health clinics, or health care providers while
serving on the Board or on the staff of Covered California.
Prohibits a member of the Covered California Board or of the
staff of Covered California from being a health care provider
unless he/she receives no compensation for rendering services
as a health care provider and does not have an ownership
interest in a professional health care practice.
This bill adds four news areas of expertise to the list of
required demonstrated and acknowledged expertise for Board
members:
1. Marketing of health insurance products;
2. Information technology system management;
3. Management information systems; and
4. Enrollment counseling assistance, with priority to cultural
and linguistic competency.
Background
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California HealthCare Foundation (CHCF) report . An April 2014
report published by the CHCF on Consumers' and Enrollment
Counselors' Experiences with Covered California provides an
analysis of early consumer enrollment experiences associated
with the more than two million Californians who have signed up
for health insurance or applied for Medi-Cal through Covered
California. Researchers conducted interviews and focus groups
during a few weeks in February 2014 with a diverse group of
users, including participants applying online, by telephone, or
in person. The goal of the research is to identify areas for
improvement in the application process.
Among the key findings were that many consumers were unaware
that in-person enrollment assistance was available, some
enrollees were surprised by how much documentation was needed
and found it to be difficult. The burden delayed successful
completion of the process for many people, especially Medi-Cal
applicants, and Covered California's online chat feature did not
work for anyone surveyed. Specific to the Latino population
were concerns about immigration problems and losing their home
to Medi-Cal. According to the report, the detailed questions
about family members, even those not applying for coverage,
unsettled some Latino consumers and made them worry they could
face problems with immigration. Also, some Latino consumers had
heard Medi-Cal could take their home if they enrolled in the
program. Many Vietnamese and Mandarin speaking consumers could
not enroll online in their primary language, which was
frustrating because some preferred to enroll online. They had
to rely on an English proficient family member or apply in
person with a Certified Enrollment Counselor (CEC) or agent who
could speak their primary language. Additionally, CECs did not
feel well trained and said they had limited ability to help
Medi-Cal applicants. A new dedicated call center line for CECs
was helping, but many felt on their own to figure out complex
enrollment problems. Many also had limited experience with
Medi-Cal and felt they could do little to help clients. Since
the research was conducted in February, Covered California hired
350 additional service center employees, increased bilingual
Spanish speaking staff, increased online chat resources,
including Spanish chat, and is expanding telephone line
capacity, posting qualified health plan applications in Spanish,
Chinese, Vietnamese, and Korean on the Web site, adding consumer
information including searchable Frequently Asked Questions,
requiring agents and CECs to complete annual recertification
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training, and creating a dedicated help line for Certified
Insurance Agents.
Board diversity . The author's office has submitted an article
written by California State Controller John Chiang published in
the Corporate Governance Advisor March/April of 2010 called
Strength in Diversity: The Changing Boardroom. In the article,
which focuses on corporate diversity for investment strategies,
the Controller writes that he asked the CalPERS Board to
commission a study on board diversity in an effort to find
empirical evidence that different combinations of talent can
lead to increased shareowner value. According to the article,
the report indicates that companies without ethnic minorities
and women on their boards eventually may be at a competitive
disadvantage and have under-performing share value.
Prior legislation
SB 900 (Alquist, Chapter 659, Statutes of 2010), and AB 1602
(Perez, Chapter 655, Statutes of 2010), established Covered
California.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local:
No
SUPPORT : (Verified 6/20/14)
California Association of Health Underwriters
California Primary Care Association
Latino Coalition for a Healthy California
SEIU Local 1000
Western Center on Law and Poverty
ARGUMENTS IN SUPPORT : The California Primary Care Association
(CPCA) states that early efforts to enroll the large uninsured
Latino population into Medi-Cal or Covered California were
largely ineffective because of shortcomings in marketing,
enrollment assistance, and numerous other oversights related to
cultural and linguistic competence. CPCA writes that Board
members with the added areas of expertise will help assure that
no eligible population will be overlooked or unserved.
The Western Center on Law and Poverty supports this bill and
believes that it will help Covered California have a Board with
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the expertise needed to reach Limited English Proficient
communities.
The California Association of Health Underwriters states that
having a Board appointee who understands the challenges of
servicing California's multi-cultural population will benefit
Covered California operations.
SEIU Local 1000 writes in support, stating that this bill will
broaden the factors that will be taken into consideration when
appointing members to the Board.
ASSEMBLY FLOOR : 73-3, 6/19/14
AYES: Achadjian, Alejo, Bigelow, Bloom, Bocanegra, Bonilla,
Bonta, Bradford, Brown, Buchanan, Ian Calderon, Campos, Chau,
Ch�vez, Chesbro, Conway, Cooley, Dababneh, Dahle, Daly,
Dickinson, Eggman, Fong, Fox, Frazier, Beth Gaines, Garcia,
Gatto, Gomez, Gonzalez, Gordon, Gorell, Gray, Hagman, Hall,
Harkey, Roger Hern�ndez, Holden, Jones, Jones-Sawyer, Levine,
Linder, Logue, Lowenthal, Maienschein, Medina, Melendez,
Mullin, Muratsuchi, Nazarian, Nestande, Olsen, Pan, Perea,
John A. P�rez, V. Manuel P�rez, Quirk, Quirk-Silva, Rendon,
Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner,
Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
NOES: Allen, Donnelly, Grove
NO VOTE RECORDED: Ammiano, Mansoor, Patterson, Vacancy
JL:dk 6/20/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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