Health care coverage: essential health benefits.
The proposed changes by AB 224 will revise Section 1367.005 of the Health and Safety Code, which governs the licensing and regulation of health care service plans. The review and establishment of a new benchmark plan for 2027 signal an adaptation to evolving healthcare requirements and aim to enhance the inclusivity of coverage options. Additionally, limiting the applicability of the current benefits plan to policy years before 2027 suggests that there may be a substantial shift in the types of essential health benefits that will be available moving forward.
Assembly Bill 224, introduced by Assembly Member Bonta, seeks to amend health care coverage regulations in California, specifically targeting essential health benefits as outlined under current law. The bill intends to review the existing benchmark plan in California and establish a new benchmark for the 2027 plan year. This legislative initiative aims to modernize health coverage standards to align with current health care needs and policies, thus impacting both individual and small group health insurance policies. The current legal framework mandates that health insurance policies must provide coverage for a comprehensive range of essential services as defined by the federal Affordable Care Act (ACA).
One significant point of contention may arise from differing opinions on the adequacy and scope of the proposed essential health benefits within AB 224. Stakeholders, including insurers and health advocates, could express concerns about potential cost implications or the sufficiency of coverage provided under the new benchmark. Moreover, the aspect of mental health services and their parity with other health benefits is likely to be closely scrutinized, as this remains a key area of focus in mental health reform and advocacy.