California is often on the forefront in innovation. Well it is now the first state to pass legislation to set up the health insurance exchange.
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With a Democratic legislature and a Republican governor, California becomes the first state to pass legislation to set up the health insurance exchange which is part of the health care reform bill.
Although the exchanges aren't not mandated to be up and running until 2014, California got its act together and started working on it.
California passed legislation creating a health-insurance marketplace, a move set to be echoed across the country as states take steps to implement federal law.
Millions of Americans around the U.S. are expected to eventually purchase their coverage through such exchanges, which will offer health plans to individuals and some small businesses.
The California legislature on Wednesday passed the second of two related bills to set up the exchange, putting the state at the forefront of efforts nationwide and create a blueprint that will likely influence other states. Under the national health-care overhaul law passed in March, states are supposed to set up exchanges, or their residents will be offered a federal version.
California Gov. Arnold Schwarzenegger, who has said he supported implementing the federal law, is expected to sign the bills.
Some of the stuff that California is doing:
The exchange is expected to offer insurance through a Web site that will provide standardized and detailed information about plans, so consumers can compare them.
The California exchange will have a toll-free number, and will set up a program of live helpers, or navigators, to help explain plans to consumers. It will also offer consumers a directory of medical providers, so they can figure out which plans include a particular doctor in their networks.
The exchanges aren't required to be fully up and running until January, 2014, when key national-overhaul provisions kick in, though some exchange operations may start earlier. Following federal requirements, the California exchange will sell insurance in five categories, ranging from rich "platinum"-level benefits to a catastrophic plan for young people.
It will also link eligible Californians to federal subsidies that would help pay for their coverage, or government programs such as Medicaid.
Like many things California often leads the way:
The California legislation will be "precedent-setting," said Jon Kingsdale, a consultant who headed the agency that runs the Massachusetts exchange.
It is also suppose to be the largest of any state:
California's exchange may be the largest one established by a single state, adding to its importance. Researchers at the University of California, Berkeley projected that 2.4 million people would be eligible for federal subsidies in the exchange, and another 2.2 million might purchase plans there without subsidies. They added that another 3.8 million people could be eligible to obtain coverage through the small-business part of the exchange. The federal law says businesses with as many as 100 employees can purchase coverage, and states can raise that cutoff in 2017.
There will also be vigorous oversight of the exchanges which the oversight will probably clash with insurance companies.
The California exchange would be created and governed by a new, independent board, with members appointed by the governor and legislative leaders, as well as a seat for the state's health secretary.
The exchange board will be given robust authority, including the power to selectively contract with insurers to offer plans within the exchange that meet its requirements. That provision drew opposition from some health insurers, in a likely preview of a lobbying battle set to play out in other statehouses.
Other tidbits:
The exchange's health plans will have to include benefits, cost-sharing and other design aspects laid out by federal law and regulation, though the California exchange may also layer on its own requirements. The federally-defined platinum plan would cover, on average, 90% of the cost of its benefits, while the thinner bronze version would cover at least 60%. All plans cap out-of-pocket costs for consumers.
In all, as more and more of the health care reform bill is implemented it will be much harder for Republicans to repeal it. People who benefit from it will REVOLT.