CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 2749Introduced by Assembly Member WoodFebruary 15, 2024 An act to amend Section 100523 of the Government Code, relating to the California Health Benefit Exchange.LEGISLATIVE COUNSEL'S DIGESTAB 2749, as introduced, Wood. California Health Benefit Exchange: financial assistance.Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. PPACA authorizes a state to apply to the United States Department of Health and Human Services for a state innovation waiver of any or all PPACA requirements, if certain criteria are met, including that the state has enacted a law that provides for state actions under a waiver. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law requires the Exchange, upon appropriation by the Legislature, to administer a program of financial assistance beginning July 1, 2023, to help Californians obtain and maintain health benefits through the Exchange if they lose employer-provided health care coverage as a result of a labor dispute.This bill would make a technical, nonsubstantive change to this provision.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 100523 of the Government Code is amended to read:100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 2749Introduced by Assembly Member WoodFebruary 15, 2024 An act to amend Section 100523 of the Government Code, relating to the California Health Benefit Exchange.LEGISLATIVE COUNSEL'S DIGESTAB 2749, as introduced, Wood. California Health Benefit Exchange: financial assistance.Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. PPACA authorizes a state to apply to the United States Department of Health and Human Services for a state innovation waiver of any or all PPACA requirements, if certain criteria are met, including that the state has enacted a law that provides for state actions under a waiver. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law requires the Exchange, upon appropriation by the Legislature, to administer a program of financial assistance beginning July 1, 2023, to help Californians obtain and maintain health benefits through the Exchange if they lose employer-provided health care coverage as a result of a labor dispute.This bill would make a technical, nonsubstantive change to this provision.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 2749
Introduced by Assembly Member WoodFebruary 15, 2024
Introduced by Assembly Member Wood
February 15, 2024
An act to amend Section 100523 of the Government Code, relating to the California Health Benefit Exchange.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 2749, as introduced, Wood. California Health Benefit Exchange: financial assistance.
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. PPACA authorizes a state to apply to the United States Department of Health and Human Services for a state innovation waiver of any or all PPACA requirements, if certain criteria are met, including that the state has enacted a law that provides for state actions under a waiver. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law requires the Exchange, upon appropriation by the Legislature, to administer a program of financial assistance beginning July 1, 2023, to help Californians obtain and maintain health benefits through the Exchange if they lose employer-provided health care coverage as a result of a labor dispute.This bill would make a technical, nonsubstantive change to this provision.
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. PPACA authorizes a state to apply to the United States Department of Health and Human Services for a state innovation waiver of any or all PPACA requirements, if certain criteria are met, including that the state has enacted a law that provides for state actions under a waiver. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law requires the Exchange, upon appropriation by the Legislature, to administer a program of financial assistance beginning July 1, 2023, to help Californians obtain and maintain health benefits through the Exchange if they lose employer-provided health care coverage as a result of a labor dispute.
This bill would make a technical, nonsubstantive change to this provision.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 100523 of the Government Code is amended to read:100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 100523 of the Government Code is amended to read:100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.
SECTION 1. Section 100523 of the Government Code is amended to read:
### SECTION 1.
100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.
100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.
100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.
100523. (a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.
(1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollees size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.
(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.
(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.
(b) (1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.
(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.
(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollees employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.
(d) (1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.
(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.
(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.