On March 20, Governor Jerry Brown signed AB 369, mandating that plans allow Californians whose individual health plans were canceled by the Affordable Care Act to continue to receive coverage for their non-participating providers through treatment for pregnancy, cancer, and chronic conditions, among others. The bill passed unanimously and as an urgency measure, allowing it to take immediate effect. About 900,000 people in California had policies terminated because they didn’t meet the more stringent requirements of the ACA. Within that group, approximately 50,000 Californians lost plans because their insurance carriers withdrew from the state’s individual market.
Existing California law protects consumers in employer-based group policies when they are terminated, allowing people to receive continued care from their existing provider for up to a year in the event of pregnancy, surgery, an acute condition, or a terminal illness. AB 369 gives the same protections to individual policyholders whose plans were terminated due to the insurer’s or health care service plan’s market withdrawal or withdrawal of a specific health benefit plan between Dec. 1, 2013, and March 31, 2014.
Consumer groups and the California Association of Physician Groups supported AB 389, which expands existing member protections that were enacted before the ACA’s reforms. The ACA generally prevents insurers from refusing to cover someone based on health status and limits plans’ ability to charge higher premiums based on most health-related risk factors.