2017 Renewal of Individual and Family Medical Plans

Insurance companies are mailing renewal information for individual and family policies, both benefit and premium changes. Some of the benefit changes are positive, some are not but most of these changes are dictated by The Affordable Care Act (ACA) commonly referred to as Obamacare. In most cases the premium increases are very substantial. I do not have complete rates for all the insurance companies as of yet.

Changes for 2017 cannot be made until November 1st for an effective date of January 1, 2017.

The individual health insurance market is shrinking. I will be setting phone appointments to begin on November to review plans. I strongly encourage that you to contact me. If you want to set a phone appointment with me, please respond to this e mail now and I will send you dates and times as options beginning in November.

Before your phone appointment, I will need to know the exact spelling of the names of doctors you want to continue to see, including their zip code. I will also need the exact spelling of any medications you need and the dosage.

If you believe you may be eligible for a subsidy through Covered California, I need to know your Estimated Modified Adjusted Gross Income for 2017. If you do not report a 2017 amount, I cannot complete a Covered California application as it will not be accepted into their system. I would encourage you to have a discussion with your tax professional. I need this information at the time of a phone appointment.

Some Grandfathered plans will be discontinued in 2017, we need to discuss replacement of those plans.

Blue Shield of California Individual and Family Plan 2017 Renewal

Blue Shield of California will be mailing your renewal information, both benefit and premium changes. Some of the benefit changes are positive, some are not but most of these changes are dictated by The Affordable Care Act (ACA) commonly referred to as Obamacare. In most cases the premium increases are very substantial. I do not have complete rates for all the insurance companies as of yet but I am told the rate increases will be much the same.

Here is what needs to be done:

Changes for 2017 cannot be made until November 1st for an effective date of January 1, 2017. You have to wait until November 1st.

The individual health insurance market is shrinking. I will be setting phone appointments to begin on November 1st to review your plan. I strongly encourage you to contact me. If you want to set a  phone appointment with me, please respond to this e mail and I will send you dates and times as options.

Before your phone appointment, I will need to know the exact spelling of the names of doctors you want to continue to see, including their zip code. I will also need the exact spelling of any medications you need and the dosage.

If you believe you may be eligible for a subsidy through Covered California, I need to know your Estimated Modified Adjusted Gross Income for 2017. The 2016 guide is attached for reference. The 2017 figures should be very close. If you do not report a 2017 amount, I cannot complete a Covered California application as it will not be accepted into their system. I would encourage you to have a discussion with your tax professional. I need this information at the time of a phone appointment.

Some Grandfathered plans will be discontinued in 2017, we need to discuss replacement of those plans.

 

2017 Individual and Family Medical Plans Require a Primary Care Physician

Beginning January 1, 2017 all individual and family health plans in California will require that members select a Primary Care Physician (PCP) or have one recommended by their health plan.

The terminology used in this case is confusing. A PCP has historically been a physician who is associated with an HMO which limits your choice. This is not the case in this instance.

You must choose a general physician who is in the network of your insurance company. If you do not choose a physician the insurance company will assign one to you. I know that at least one company will review your claims history in order to assign a physician that you have seen in the past.

YOU DO NOT EVER NEED TO SEE THE PHYSICIAN CHOSEN

YOU CAN CHANGE THE PHYSICIAN AT ANY TIME

The thought behind this is that if one is attached to a name of a physician, it is less likely that one will go to Urgent Care or the Emergency Room. An office visit or a phone call supposedly will lower health care spending.

In Summary, choose a physician or have one chosen for you.

2017 Open Enrollment for Covered California Individual and Family Plans

Although no official date has been sent as of yet, this is what is expected from Covered California:

You will receive information from Covered California asking you to update information that will include but not limited to:

 

change in modified adjusted gross income- this requires a discussion with your tax professional

change of address

change in marital status

change in the number of dependents in your house hold

please respond to all Covered California requests

Changes might require a new application.

If there are no changes and your income listed on your Covered California application will remain the same for 2017, your policy will passively renew unless you decide to make a change, for example, enroll with a different insurance company.

 

This year there will be premium increases, changes in benefits which are influenced by Affordable Care Act rules and changes that have been made as a result of insurance company decisions.

Keep in mind that your 2016 subsidy has been based on the Modified Adjusted Gross Income that was listed on your Covered California application. Covered California will issue you an IRS form 1095 A to be filed with your 2016 tax return which will then be reconciled with your income. You may receive a tax credit or debit depending on your actual income.

Covered California has not determined when Open Enrollment will begin. In all likelihood it will be November 1st. As soon as I know the exact date I will send you an e mail. I will be setting up phone appointments to begin during Open Enrollment. If you would like to review your policy please let me know.

Remember, your 2016 subsidy is related to your 2016 Modified Adjusted Gross Income. Covered California will send you a 1095 A IRS form to be filed with your taxes. Your subsidy will be adjusted with your taxes depending on whether your income is more or less than what was reported on the enrollment application with Covered California.

Open Enrollment for 2017 Individual and Family Medical Plans

Open Enrollment begins on November 1, 2016 for an effective date of January 1, 2017.

Your insurance company may have sent you the renewal rate for your plan, however, rates in their entirety have not been published and are not available.

You cannot take any action until November 1st.

During the middle of October, send me an e mail to set up a phone appointment between November 1st and December 15th.

ID Theft protection now available for Blue Shield Medicare Supplement plan members

In 2015, the Blue Cross Blue Shield Association announced its commitment to making identity protection services available to its customers nationwide. We are pleased to share that we now offer credit monitoring and repair services at no cost to eligible Blue Shield Medicare Supplement plan members and their dependents effective May 2, 2016.

To administer our new identity protection offering, we’ve selected AllClear ID, a leader in customer security. Your Blue Shield Medicare Supplement plan customers can access AllClear Identity repair by calling (855) 904-5733, Monday through Saturday from 6 a.m. to 6 p.m., and a representative will help restore their identity. To do so, your customers will need to provide their name, Social Security number and date of birth.

This offering is available to Medicare Supplement plan members and their covered dependents for as long as they have a Blue Shield of California health policy in effect. Due to current laws and regulations, Blue Shield Federal Employee Programs (FEP) and Medicare Advantage HMO plan (MA-PD) and Medicare Prescription Drug Plan (PDP) members are not eligible to enroll in this new offering.

For added protection, Blue Shield Medicare Supplement plan members can opt in to receive AllClear ID Credit Monitoring at blueshieldca.allclearid.com. The service includes credit monitoring, a $1 million identity theft insurance policy and child protection for dependents under 18 years of age.

Rate Increases for 2017 Medical Insurance Plans

There will be a significant rate increase for 2017 plans. The reasons given are the end of funding that was available in the first three years to offset rates, the rise in specialty medication and claims from those who enroll during Special Enrollment Periods.

In regard to the specialty medication, sometimes pharmaceutical companies are raising prices of medications when the need for a medication increases. Newer specialty medications can approach $100,000 per course of treatment and/or per year.

Below is the press release from Covered California on July 19, 2016

SACRAMENTO, Calif. — Covered California unveiled its rates for 2017 on Tuesday and announced that some health insurance plans will be expanding into new areas throughout the state to compete for consumers in California.

The statewide weighted average change will be 13.2 percent, up from approximately four percent in each of the last two years. However, most consumers will see a much smaller increase — or pay less next year — if they switch to another plan.

“Shopping is going to be more important this year than ever before,” Covered California Executive Director Peter V. Lee said. “Almost 80 percent of our consumers will either be able to pay less than they are paying now, or see their rates go up by no more than 5 percent, if they shop and buy the lowest-cost plan at their same benefit level. That’s the power of shopping.”

Lee said the opportunities to shop and save show that California has succeeded in building a competitive marketplace for health insurance, with rate increases that are still below trends in the individual market before the Affordable Care Act was passed.

“This is a new era of health care, where the consumer is in the driver’s seat with the power to look easily for a better deal, and where subsidies help absorb the impact of rate changes,” Lee said. “These options did not exist before the Affordable Care Act.”

Some consumers who choose to keep their plan will see a significant increase in their premium for 2017, while others will see a more modest increase, depending on where they live and what insurance plan they have. Consumers will begin receiving notices in October, when they will have an opportunity to review their new rates and change plans for their 2017 health coverage.

For many of those insured, the bulk of the premium increase will be absorbed by the subsidy paid by the government to help enrollees buy health insurance. Approximately 90 percent of Covered California enrollees get help to pay for their premiums. The average subsidy covers roughly 77 percent of the consumer’s monthly premium, and while premiums will rise, the subsidies will rise as well.

“Even though the average rate increase is larger this year than the last two years, the three-year average increase is 7 percent — substantially better than rate trends before the Affordable Care Act was enacted,” Lee said.

Lee said the average rate increase reflects the cost of medical care for consumers, not excessive profit.

“Under the new rules of the Affordable Care Act, insurers face strict limits on the amount of profit they can make selling health insurance,” Lee said. “So, while all plans are experiencing different cost pressures, we can be confident their rate increases are directly linked to health care costs, not administration or profit, which averaged 1.5 percent across our contracted plans.”

For consumers who get a tax credit to lower their costs — which is about 90 percent of those who sign up through Covered California — the amount they pay is impacted not only by the premium choice, but by changes in their tax credit. While the average rate increase is higher than past years, Covered California’s risk mix — the ratio of consumers who are healthy vs. sick — remains one of the best in the nation according to the Centers for Medicare and Medicaid Services (https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/index.html).

Other reasons for rate increases include:
A one-year adjustment due to the end of a funding mechanism in the Affordable Care Act known as reinsurance, which was designed to moderate rate increases during the first three years when exchanges were being established. The American Academy of Actuaries estimates this will add between 4 percent and 7 percent to premiums for 2017.
Special enrollment by some consumers who may be enrolling in health insurance only after they become sick or need care, which seems to have had a significant impact on rates for two insurance plans.
The rising cost of health care, especially specialty drugs.
Pent-up demand for health care now being accessed by those who were locked out of the health care system before the Affordable Care Act was enacted.
Lee said Covered California is working to address some of these issues on multiple fronts. The exchange is aggressively marketing to attract healthy consumers year-round, and it is working to ensure special enrollment is available only to those who meet qualifying circumstances. It is also sampling the special enrollment population to better understand how to make any further improvements needed.

“We work hard to build a robust exchange that drives competition by attracting as many consumers as possible,” Lee said. “Now, consistent with the vision of the Affordable Care Act, we will redouble our efforts to make sure our consumers and potential consumers understand the importance of signing up during open enrollment and remaining covered throughout the year.”

Lee said Covered California’s 11 health insurers are competing across the state for its 1.4 million members.

“The sheer number of enrollees and their overall health means consumers in the individual market are benefiting from competition,” Lee said.

Below is the complete list of the companies selected for the 2017 exchange:
Anthem Blue Cross of California
Blue Shield of California
Chinese Community Health Plan
Health Net
Kaiser Permanente
L.A. Care Health Plan
Molina Healthcare
Oscar Health Plan of California
Sharp Health Plan
Valley Health Plan
Western Health Advantage
Rate details by pricing regions can be found in “Covered California’s Health Insurance Companies and Plan Rates for 2017,” posted online at:http://coveredca.com/news/pdfs/CoveredCA-2017-rate-booklet.pdf

The preliminary rates are subject to a 60-day public comment period and regulatory review by the California Department of Managed Health Care. In addition, the California Department of Insurance will review Health Net’s EPO.

Some insurance carriers will be increasing their coverage areas in 2017:
Oscar will be entering the market in San Francisco, Santa Clara and San Mateo counties.
Molina will expand into Orange County.
Kaiser will be available in Santa Cruz County.
With the expansion of its current carriers, almost all consumers (92.6 percent) will be able to choose from three or more carriers, and all will have at least two to select from.

In addition, more than 93 percent of hospitals in California will be available through at least one Covered California health insurance company in 2017, and 74 percent will be available in three or more plans.

Covered California also is improving its patient-centered benefit designs by increasing a consumer’s access to care by reducing the number of services that are subject to a consumer’s deductible.

Starting in 2017, consumers in Silver 70 plans will save as much as $55 on an urgent care visit and $10 on a primary care visit. In addition, consumers in Silver, Gold and Platinum plans will pay a flat copay for emergency room visits without having to satisfy a deductible, which could save them thousands of dollars.

These improvements build on features already in place that ensure most outpatient services in Silver, Gold and Platinum plans are not subject to a deductible, including primary care visits, specialist visits, lab tests, X-rays and imaging. In addition, some Enhanced Silver plans have little or no deductible and very low copays, such as $3 for an office visit. Even consumers in Covered California’s most affordable Bronze plans are allowed to see their doctor or a specialist three times before the visits are subject to the deductible.

In addition, the contract with health insurers for 2017 ensures consumers select or are provisionally assigned a primary care physician within 60 days of effectuation so they have an established source of care.

“Health care reform isn’t just about making insurance affordable, it’s about doing things to make it easier for consumers to get the right care at the right time,” Lee said.

In May, the Centers for Disease Control and Prevention announced that California’s uninsured rate had fallen to 8.1 percent at the end of 2015, down from 17 percent at the end of 2013, right before the Affordable Care Act began offering coverage.

“We can all be very proud of the extraordinary gains we have made in reducing California’s uninsured rate to a historic low,” Lee said.

About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

This article is from the Los Angeles Times date July 20, 2016

California Obamacare rates to jump

Premiums are set to go up an average of 13.2% next year. Rising medical costs are one reason, officials say.

BY MELODY PETERSEN AND NOAM N. LEVEY

Premiums for Californians’ Obamacare health coverage will rise an average of 13.2% next year — more than three times the increase of the last two years and a jump that is bound to stir debate in an election year.

The big increases come after two years in which California officials had boasted that the program helped insure hundreds of thousands people in the state while keeping costs moderately in check.

Premiums in the insurance program called Covered California rose just 4% in 2016 after rising 4.2% in 2015 — the first year that exchange officials negotiated with insurers. The program insures 1.4 million Californians.

On Tuesday, officials blamed next year’s premium hikes in the program on rising costs of medical care, including expensive specialty drugs and the end of a mechanism that held down rates for the first three years of Obamacare.

Two of the state’s biggest insurers — Blue Shield of California and Anthem Inc. — asked for the biggest hikes. Blue Shield’s premiums will jump an average of more than 19%, according to officials, and Anthem’s rates will rise more than 16%.

For consumers, the effect will depend on whether they get taxpayer-supported subsidies for their premiums and whether they are willing to switch to less-expensive plans that may come with higher co-pays and deductibles. Changing plans could also mean a new network of physicians, which could be disruptive to care for those with chronic conditions.

The rates vary significantly by region and insurer. Los Angeles and the rest of southwest Los Angeles County will see an average increase of almost 14%.

Blue Shield’s preferred provider organization rate in Los Angeles, chosen by 21% of those using the exchange, is increasing by an average of 19.5%. For a 40-year-old single person making $17,820 to $23,760, choosing a silver level plan, the monthly rate currently is $122, while the government pays Blue Shield $196. Next year that same person would pay $170, while the government would chip in $211 a month.

“We’re paying more for less,” said Jamie Court, president of Consumer Watchdog in Santa Monica. “Insurers are limiting access to doctors and hospitals while also demanding a higher price.”

Horacio Chavez, 34, of Boyle Heights said he made less than $25,000 last year as an education coordinator at a youth center. He currently pays a $100 premium for a Covered California plan that he uses for an annual checkup and a safety net in case of emergencies.

“I do want healthcare — I want the peace of mind that if anything happens to me that there’s some kind of coverage,” Chavez said. But “a 13% hike … that’s going to affect people.”

He said he’s already barely making ends meet trying to pay his rent, student loans from the University of Chicago, car payments and his health insurance premium.

“I’m already living check to check,” Chavez said.

Covered California officials defended the system Tuesday, saying that the competition among insurers offering coverage on the exchange was working to keep rates lower than they otherwise would be.

“California has a very competitive marketplace,” said Peter Lee, executive director of Covered California.

Obamacare has significantly reduced the number of uninsured Californians. Since the state’s health insurance exchange began offering coverage in 2014, the share of Californians without health insurance has fallen from 17% at the end of 2013 to 8.1% at the end of last year, according to officials.

Rates are expected to jump in other states too, although complete details won’t be available until later this year.

An analysis of 14 metro areas that have already announced their 2017 premiums found an average jump of 11%. The changes ranged from a decrease of 14% in Providence, R.I., to an increase of 26% in Portland, Ore., according to the analysis by the nonpartisan Kaiser Family Foundation.

The federal healthcare-  .gov   exchange provides insurance under the Affordable Care Act in 38 states. California and a few other states operate their own exchanges.

Around the country, several insurers, including giant UnitedHealth, have stopped selling health plans on the exchanges, and a number of new nonprofit health insurance co-ops have gone out of business.

Those decisions have fueled charges from the law’s critics that Obamacare isn’t working.

Former Secretary of State Hillary Clinton, the presumptive Democratic presidential nominee, is pushing a number of specific steps to ease price pressure on consumers, including allowing Americans ages 55 to 64 to buy into Medicare.

Republican presidential nominee Donald Trump has argued the health law should be repealed.

The health law’s next enrollment period begins a week before election day.

The state and federal health insurance exchanges provide coverage to about 12 million people nationally, representing just a fraction of the nation’s total insurance market. The vast majority of Americans — more than 250 million people — are in health plans purchased through an employer or provided by a government plan such as Medicare or Medicaid.

But the exchanges are a pillar of the Affordable Care Act’s program for guaranteeing Americans’ insurance coverage. And monthly premiums have become a closely watched barometer of how the law is performing.

Covered California’s Lee told the House Ways and Means Committee on July 12 that 2017 would be “a transitional year” for Obamacare, with rates seeing “significant adjustments” across the nation.

He said one reason for the increase was the end of a program designed to keep rates down during the insurance exchange’s first three years. The program had assessed a fee on all health insurers and then redistributed those funds among carriers whose members had the highest medical expenses, Lee said.

Lee added that some insurers had also not charged enough in the first two years because they didn’t have full data on the medical costs or health status of those signing up. Now they’re adjusting to account for those higher costs.

Mia Campitelli, a Blue Shield spokeswoman, said Tuesday that the insurer’s average 19.9% premium increase was “driven by our members using more healthcare services than we expected,” as well as the phaseout of the federal mechanism that had kept rates down in the law’s early years.

Anthem spokesman Darrel Ng said: “Factors such as increased use of medical services and added costs of drugs and medical therapies put upward pressure on rates and underscore the additional work that needs to be done to moderate the growth in healthcare costs.”

The financial pain for most Californians getting insurance through the exchange will be muted because 90% get taxpayer assistance to cover the premiums.

Americans making less than four times the federal poverty level — about $47,000 for a single adult or $97,000 for a family of four — qualify for the assistance.

Nonetheless, Americans who make too much to qualify for subsidies are likely to feel the brunt of the higher premiums. That will probably increase pressure on the new president — Democrat or Republican — to review the exchanges in 2017 for ways to make health plans more affordable.

A year ago, Lee wrote an op-ed in The Times saying that Covered California’s power in negotiating with insurers was allowing Obamacare to work in the state.

“We now have the full picture in California, where we are proving that health insurance exchanges can keep prices in check,” he wrote.

Though the Affordable Care Act has improved care for millions of Americans — for example, insurance companies can no longer set lifetime limits on care or exclude anyone because of a preexisting condition — the 6-year-old law contains few controls on overall costs.

Spending on the country’s medical system averages more than $10,000 for every American, according to statistics released by the Obama administration this month, far higher than any other nation. melody.petersen

@ latimes.com   noam.levey@latimes.com   Times staff writer Soumya Karlamangla contributed to this report.

RICH PEDRONCELLI Associated Press

“CALIFORNIA has a very competitive marketplace,” said Peter Lee, executive director of Covered California. Above, Lee discusses the program last year.

Blue Shield Will Cancel All Grandfathered Plans On January 1, 2017

Your Blue Shield of California Grandfathered Individual and Family Medical Insurance Plan will no longer be available after December 31, 2016. You will be automatically enrolled in what Blue Shield considers to be an Affordable Care Act (aka Obamacare) plan that is similar to your current plan.

Starting January 1, 2017 you will qualify for a Special Enrollment Period which will allow you to switch to another company with an effective date of no later than March 1, 2017. Using the Special Enrollment Period may not necessarily be in your best interest, for example, if you use part of a Blue Shield deductible between January 1, 2017 and March 1, 2017, this amount may not carry over to another company. A similar situation may exist with the Maximum Out of Pocket limit.

We should discuss your plan change within Blue Shield or to another company during Open Enrollment which begins on November 1, 2016 for an effective date of January 1, 2017. I will be sending an e mail in the middle of October to set up phone appointments to discuss all your options.

Blue Shield will be notifying you beginning this month.

 

 

IRS Form 1095

The Affordable Care Act requires that everyone been enrolled in a qualified health plan or a penalty will be assessed at your tax filing. The method used to verify your enrollment is with a 1095 tax form. The form is to be mailed to all enrollees in a qualified health plan and submitted with your tax filing for IRS confirmation.

If you are receiving a subsidy through Covered California, the subsidized premium will be included on the 1095. The IRS will verify that the income reported on your Covered California application matches your actual income. If your income is less than what is listed on the application, you will receive an additional credit. If the income is more, you will be required to pay back a calculated amount.

Most insurance companies have sent out the 1095 to enrollees. If you have not received yours, it should arrive soon. Please review the form for its accuracy in terms of premium paid and subsidy allowed.

The above pertains to the 2015 tax year.

The companies that offered policies through my agency in 2015 were:
Anthem Blue Cross

Blue Shield of California

Cigna

Assurant Health

Aetna

United Health Care

Health Net

Kaiser

 

Lawmakers Pass Health Plan Tax

An article from the March 1, 2006 Los Angeles Times
The proposal would overhaul an existing levy on insurers and help fund Medi-Cal.
BY MELANIE MASON
SACRAMENTO — Culminating a prolonged, wonky debate that has consumed the Capitol for months, legislators on Monday approved a new tax on healthcare plans that would help finance the state’s public healthcare program for the poor.
The package of bills which await Gov. Jerry Brown’s signature — would overhaul an existing tax on managed care organizations, or MCOs, in an effort to secure more than $1 billion in federal money to help pay for Medi-Cal, which serves a third of the state’s population.
“I can’t emphasize enough the importance of the MCO financing proposal here before us today,” Assemblyman Rob Bonta (D-Alameda) said on the floor.
“We cannot risk losing this much-needed federal funding,” Bonta added. “We need to continue funding the expansion of healthcare coverage and protect programs from cuts during future budget deficits. Today’s proposal will allow us to do both.”
The new tax required bipartisan support to clear the two-thirds vote threshold. Some normally tax-averse Republicans said they backed the plan in part because it eliminated certain levies for health insurers, reducing the companies’ overall tax burdens. GOP lawmakers also were swayed by companion spending measures that increased money for services for the developmentally disabled and paid down state debts.
“Collectively, we came up with something that’s really good,” said Assemblyman Brian Maienschein (R-San Diego).
But not all Republicans were won over.
“What about the consumers?” asked state Sen. Jeff Stone (R-Temecula), questioning the assertion that there would be no costs passed along by the healthcare plans. “When we raise taxes, someone’s got to pay the bill.”
What is the tax plan?
Health insurers would be taxed according to an elaborately tiered system, based on the number of Medi-Cal and non-Medi-Cal patients each plan serves. Kaiser Permanente, a large nonprofit, has its own designated tax rate. Certain small local plans in Sacramento and San Diego counties are exempted entirely.
The new levy is offset by tax relief; corporate and gross premium taxes would be rolled back.
In all, the package would generate about $1.35 billion for the state. And with the eliminated taxes, the health plans as a whole would actually come out ahead by about $100 million.
Sound complicated? It is. Brown joked with reporters during his budget rollout that “very few people understand [the so-called MCO tax]. … I couldn’t explain it to you if I wanted to.”
Why is this necessary?
California currently imposes a tax only on the managed care organizations that serve Medi-Cal clients; the plans are then fully reimbursed with federal dollars. But the Obama administration has said such a tax structure doesn’t comply with federal rules. To draw down federal funds, the administration said, the state must tax all healthcare plans.
The state’s existing tax expires at the end of June. The Brown administration negotiated with health plans for more than a year to hammer out a replacement tax package in order to avoid losing more than $1 billion for Medi-Cal.
How do Republicans feel about the proposal?
It depends who you ask.
Republicans are typically loath to approve new taxes, and there are certainly GOP legislators who have rejected the proposal as a tax hike.
But others have been friendlier to the package, in part because of the traditional GOP allies on board. Most health insurers, including major players such as Blue Shield and Anthem as well as a trade group, the California Assn. of Health Plans, are in support and have said the new proposal will not affect consumers. The California Chamber of Commerce also backs the plan, and the Howard Jarvis Taxpayers Assn., an influential anti-tax group, is neutral.
Because the tax proposal required a two-thirds vote in the Legislature, some Republican support was crucial — the legislation needed at least one GOP vote in the Senate and at least three in the Assembly.
Ultimately, two Republicans in the Senate and 11 in the Assembly voted yes on the tax measure.
With that leverage, some Republicans pushed for policy priorities. The Assembly GOP laid out its wish list of spending it would like to see with the money made possible by a new tax.
Some conservative activists aren’t thrilled by the Assembly GOP’s bargaining. Grover Norquist, an anti-tax crusader, said such negotiating is bad policy and terrible politics.
Jon Fleischman, publisher of the influential conservative news site Flash Report, has been excoriating Republican members who signaled support.
What else was voted on?
Two other measures were approved Monday. One would put about $300 million into services for the developmentally disabled, including higher wages for staff at regional centers and increased money to support independent-living programs. Legislators in both parties have been agitating for more funding for such services for several years.
That bill also includes one of the items on the Assembly GOP priority list: about $120 million for certain nursing facilities to offset cuts that were passed five years ago.
The second bill deals with paying down the state’s debts. It would allocate $240 million toward paying off the state’s liabilities for retiree healthcare for public workers. It also would pay back a $173-million transportation loan. Debt repayment has been a priority for Republicans and for the governor.
What comes next?
The tax structure still needs to be approved by the Obama administration. State officials say they’re confident that the plan will pass muster. melanie.mason
@latimes.com

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