Store Research
AB 2244 of 2010: Health Care Coverage for Children with Pre-existing Conditions
December 10, 2010
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AB 2244 of 2010:
What: Amended and added Insurance Code statutes relating to health care coverage for children with preexisting conditions. This bill prohibits the exclusion or limitation of coverage for children due to any preexisting condition, except as specified. The bill requires plans and insurers offering coverage in the individual market to offer coverage for a child subject to specified requirements. The bill prescribes its limits on the rates that may be imposed for coverage of a child depending on, among other things, whether the child applies for coverage during an open enrollment period, as defined, or is a late enrollee as defined, and would, effective January 1, 2014, require plans and insurers to apply standard risk rates to the child coverage, except as specified. The bill prohibits a plan or carrier that does not or ceases to write new plan contracts or policies for children from offering new individual plan contracts or policies in this state for five years. The bill authorizes the Department of Managed Health Care and the Department of Insurance to issue guidance for purposes of implementing these provisions.
Who: Introduced on February 18, 2001 by Assembly member Mike Feuer on behalf of Health Access California (HAC). The bill was supported also by AARP, the American Federation of State, County and Municipal Employees, the California School Employees Association, the Congress of California Seniors, the Consumers Union, and the 100% Campaign. Those who opposed were Anthem Blue Cross, the Association of California Life & Health Insurance Companies, the California Association of Health Plans.
Why: According to the author, the newly enacted federal Patient Protection and Affordable Care Act prohibits use of pre-existing condition exclusions for children in the individual market. Assembly member Feuer maintains there was a dispute between insurers and the federal government about whether the new federal law requires guaranteed issue and this bill would clarify that for California. He stated that the new federal law also does not specifically address rating rules in the individual market prior to 2014 or prohibit insurers from refusing to sell to entire market segments. A/M Feuer maintains that this bill will align California law with the federal health care reform law and will ensure that children cannot be denied health insurance coverage or be charged more because of a pre-existing condition. The sponsor (HAC) argues that not all families with children who are eligible for Medi-Cal and Healthy Families can afford premiums for private insurance, but that a greater number could afford it if premiums for private insurance were no longer increased due to health conditions, and that this could produce state savings to the General Fund in the tens or hundreds of millions of dollars from reduced enrollment in Healthy Families and Medi-Cal.