California Health Benefit Exchange.

Existing law provides various programs to provide health care coverage to persons with limited financial resources, including the Medi-Cal program and the Healthy Families Program. Existing law provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of its provisions a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law, the federal Patient Protection and Affordable Care Act (PPACA) , requires each state to, by January 1, 2014, establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers, as specified, and meets certain other requirements. This bill would enact the California Patient Protection and Affordable Care Act, and would, contingent on the enactment of SB 900, which would create the California Health Benefit Exchange (the Exchange) , specify the powers and duties of the board governing the Exchange relative to determining eligibility for enrollment in the Exchange and arranging for coverage under qualified health plans, and would require the board to facilitate the purchase of qualified health plans through the Exchange by qualified individuals and qualified small employers by January 1, 2014. The bill would create the California Health Trust Fund as a continuously appropriated fund and would make the implementation of these provisions contingent on a determination by the board that sufficient financial resources exist or will exist in the fund, as specified. The bill would enact other related provisions. The bill would impose various requirements on participating plans and insurers and, commencing January 1, 2014, on nonparticipating plans and insurers, as specified. Because a willful violation of these requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. Under existing law, the California Health Facilities Financing Authority Act, the California Health Facilities Authority is empowered to make loans under certain conditions from the continuously appropriated California Health Facilities Financing Authority Fund to nonprofit corporations or associations for financing or refinancing the acquisition, construction, or remodeling of health facilities. This bill would authorize the authority to provide a working capital loan of up to $5 million to assist in the establishment and operation of the California Health Benefit Exchange. The bill would require that loans awarded under the bill be made from the California Health Facilities Authority Fund and would require repayment of the loan by a specified date. Because the bill would expand the purposes for which a continuously appropriated fund may be used, it would make an appropriation. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.