Senate BillNo. 1005


Introduced by Senator Lara

(Coauthors: Senators Block, Calderon, De León, Mitchell, Padilla, and Torres)

(Coauthors: Assembly Members Bocanegra, Bonta, Dickinson, Fong, Gonzalez, Roger Hernández, Jones-Sawyer, Pan, Rendon, and Yamada)

February 13, 2014


An act to add Title 22.5 (commencing with Section 100530) to the Government Code, and to add Section 14102.1 to the Welfare and Institutions Code, relating to health care coverage, and making an appropriation therefor.

LEGISLATIVE COUNSEL’S DIGEST

SB 1005, as introduced, Lara. Health care coverage: immigration status.

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, and meets certain other requirements. PPACA specifies that an individual who is not a citizen or national of the United States or an alien lawfully present in the United States shall not be treated as a qualified individual and may not be covered under a qualified health plan offered through an Exchange. Existing law creates the California Health Benefit Exchange for the purpose of facilitating the enrollment of qualified individual and qualified small employers in qualified health plans as required under PPACA.

This bill would create the California Health Exchange Program For All Californians within state government and would require that the program be governed by the executive board that governs the California Health Benefit Exchange. The bill would specify the duties of the board relative to the program and would require the board to, by January 1, 2016, facilitate the enrollment into qualified health plans of individuals who are not eligible for full-scope Medi-Cal coverage and would have been eligible to purchase coverage through the Exchange but for their immigration status. The bill would require the board to provide premium subsidies and cost-sharing reductions to eligible individuals that are the same as the premium assistance and cost-sharing reductions the individuals would have received through the Exchange. The bill would create the California Health Trust Fund For All Californians as a continuously appropriated fund, thereby making an appropriation, would require the board to assess a charge on qualified health plans, and would make the implementation of the program’s provisions contingent on a determination by the board that sufficient financial resources exist or will exist in the fund. The bill would enact other related provisions.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. The federal Medicaid Program provisions prohibit payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law.

This bill would extend eligibility for full-scope Medi-Cal benefits to individuals who are otherwise eligible for those benefits but for their immigration status. The bill would require that benefits for those services be provided with state-only funds only if federal financial participation is not available. Because counties are required to make Medi-Cal eligibility determinations and this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program.

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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: yes. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

(a) It is the intent of the Legislature that all
2Californians, regardless of immigration status, have access to
3affordable health coverage and care.

4(b) It is the intent of the Legislature that all Californians who
5are eligible for Medi-Cal, a qualified health plan offered through
6the California Health Benefits Exchange, or affordable
7employer-based health coverage enroll in that coverage and obtain
8the care that they need.

9(c) It is further the intent of the Legislature, in enacting this
10measure, to ensure that all Californians be included in eligibility
11for coverage without regard to immigration status.

12

SEC. 2.  

Title 22.5 (commencing with Section 100530) is added
13to the Government Code, to read:

14 

15Title 22.5.  CALIFORNIA HEALTH EXCHANGE
16PROGRAM FOR ALL CALIFORNIANS

17

 

18

100530.  

(a) There is in state government the California Health
19Exchange Program for All Californians, an independent public
20entity not affiliated with an agency or department.

21(b) The program shall be governed by the executive board
22established pursuant to Section 100500. The board shall be subject
23to Section 100500.

24(c) It is the intent of the Legislature in enacting this program to
25provide affordable coverage for Californians who would be eligible
26for coverage and premium subsidies under the California Health
27Benefit Exchange established under Title 22 (commencing with
28Section 100500) but for their immigration status. It is further the
29intent of the Legislature that Californians eligible under this title
30be offered the same premiums and cost sharing that they would
31be offered through the California Health Benefit Exchange but for
32their immigration status.

33

100531.  

For purposes of this title, the following definitions
34shall apply:

35(a) “Board” means the board described in subdivision (b) of
36Section 100530.

37(b) “Carrier” means either a private health insurer holding a
38valid outstanding certificate of authority from the Insurance
P4    1Commissioner or a health care service plan, as defined under
2subdivision (f) of Section 1345 of the Health and Safety Code,
3licensed by the Department of Managed Health Care.

4(c) “Eligible individual” means an individual who would have
5been eligible to purchase coverage through the Exchange but for
6his or her immigration status and who is not eligible for full-scope
7Medi-Cal coverage under state law.

8(d) “Exchange” means the California Health Benefit Exchange
9established by Section 100500.

10(e) “Federal act” means the federal Patient Protection and
11Affordable Care Act (Public Law 111-148), as amended by the
12federal Health Care and Education Reconciliation Act of 2010
13(Public Law 111-152), and any amendments to, or regulations or
14guidance issued under, those acts.

15(f) “Fund” means the California Health Trust Fund for All
16Californians established by Section 100540.

17(g) “Health plan” and “qualified health plan” have the same
18meanings as those terms are defined in Section 1301 of the federal
19act.

20(h) “Medi-Cal coverage” means coverage under the Medi-Cal
21program pursuant to Chapter 7 (commencing with Section 14000)
22of Part 3 of Division 9 of the Welfare and Institutions Code.

23(i) “Program” means the California Health Exchange Program
24for All Californians.

25(j) “Supplemental coverage” means coverage through a
26specialized health care service plan contract, as defined in
27subdivision (o) of Section 1345 of the Health and Safety Code, or
28a specialized health insurance policy, as defined in Section 106 of
29the Insurance Code.

30

100532.  

The board shall, at a minimum, do all of the following:

31(a) Provide premium subsidies and cost-sharing reductions to
32eligible individuals. The premium assistance and cost-sharing
33reductions shall be the same as these individuals would have
34received if they had been eligible to receive premium assistance
35and cost-sharing reductions under the federal act by enrolling in
36coverage through the Exchange.

37(b) Enroll into coverage eligible individuals whose income
38exceeds the thresholds for premium subsidies.

39(c) Implement procedures for the certification, recertification,
40and decertification, of health plans as qualified health plans. The
P5    1board shall require health plans seeking certification as qualified
2health plans to do all of the following:

3(1) Submit a justification for any premium increase prior to
4implementation of the increase consistent with Article 6.2
5(commencing with Section 1385.01) of Chapter 2.2 of Division 2
6of the Health and Safety Code and Article 4.5 (commencing with
7Section 10181) of Chapter 1 of Part 2 of Division 2 of the Insurance
8Code.

9(2) (A) Make available to the public and submit to the board
10accurate and timely disclosure of the following information:

11(i) Claims payment policies and practices.

12(ii) Periodic financial disclosures.

13(iii) Data on enrollment.

14(iv) Data on disenrollment.

15(v) Data on the number of claims that are denied.

16(vi) Data on rating practices.

17(vii) Information on cost sharing and payments with respect to
18any out-of-network coverage.

19(viii) Information on enrollee and participant rights under state
20law.

21(B) The information required under subparagraph (A) shall be
22provided in plain language.

23(3) Permit individuals to learn, in a timely manner upon the
24request of the individual, the amount of cost sharing, including,
25but not limited to, deductibles, copayments, and coinsurance, under
26the individual’s plan or coverage that the individual would be
27responsible for paying with respect to the furnishing of a specific
28item or service by a participating provider. At a minimum, this
29information shall be made available to the individual through an
30Internet Web site and through other means for individuals without
31access to the Internet.

32(d) Provide for the operation of a toll-free telephone hotline to
33respond to requests for assistance.

34(e) Maintain an Internet Web site through which enrollees and
35prospective enrollees of qualified health plans may obtain
36standardized comparative information on those plans.

37(f) Assign a rating to each qualified health plan offered through
38the program in accordance with the criteria developed by board.

39(g) Utilize a standardized format for presenting health benefits
40plan options in the program.

P6    1(h) Inform individuals of eligibility requirements for the
2Medi-Cal program, the Exchange, or any applicable state or local
3public program and, if through screening of the application by the
4program, the program determines that an individual is eligible for
5the state or local program, enroll that individual in the program.

6(i) Establish and make available by electronic means a calculator
7to determine the actual cost of coverage after the application of
8any premium subsidy and any cost-sharing reduction pursuant to
9subdivision (a).

10(j) Establish a navigator program. Any entity chosen by the
11board as a navigator under this subdivision shall do all of the
12following:

13(1) Conduct public education activities to raise awareness of
14the availability of qualified health plans through the program.

15(2) Distribute fair and impartial information concerning
16enrollment in qualified health plans, and the availability of
17premium subsidies and cost-sharing reductions through the
18program.

19(3) Facilitate enrollment in qualified health plans.

20(4) Provide referrals to any applicable office of health insurance
21consumer assistance or health insurance ombudsman established
22under Section 2793 of the federal Public Health Service Act, or
23any other appropriate state agency or agencies, for any enrollee
24with a grievance, complaint, or question regarding his or her health
25plan, coverage, or a determination under that plan or coverage.

26(5) Provide information in a manner that is culturally and
27linguistically appropriate to the needs of the population being
28served by the program.

29

100533.  

In addition to meeting the requirements of Section
30100532, the board shall do all of the following:

31(a) Determine the criteria and process for eligibility, enrollment,
32and disenrollment of enrollees and potential enrollees in the
33program and coordinate that process with the state and local
34government entities administering other health care coverage
35programs, including the Exchange, the State Department of Health
36Care Services, and California counties, in order to ensure consistent
37eligibility and enrollment processes and seamless transitions
38between coverage.

39(b) Develop processes to coordinate with the county entities
40that administer eligibility for the Medi-Cal program.

P7    1(c) Determine the minimum requirements a carrier must meet
2to be considered for participation in the program, and the standards
3and criteria for selecting qualified health plans to be offered
4through the program that are in the best interests of qualified
5individuals. The board shall consistently and uniformly apply these
6requirements, standards, and criteria to all carriers. In the course
7of selectively contracting for health care coverage offered to
8qualified individuals through the program, the board shall seek to
9contract with carriers so as to provide health care coverage choices
10that offer the optimal combination of choice, value, quality, and
11service.

12(d) Provide, in each region of the state, a choice of qualified
13health plans at each of the five levels of coverage contained in
14subsections (d) and (e) of Section 1302 of the federal act.

15(e) Require, as a condition of participation in the program,
16carriers to fairly and affirmatively offer, market, and sell in the
17program at least one product within each of the five levels of
18coverage contained in subsections (d) and (e) of Section 1302 of
19the federal act. The board may require carriers to offer additional
20products within each of those five levels of coverage. This
21subdivision shall not apply to a carrier that solely offers
22supplemental coverage in the program under paragraph (10) of
23subdivision (a) of Section 100534.

24(f) (1) Except as otherwise provided in this section, require, as
25a condition of participation in the program, carriers that sell any
26products outside the program to fairly and affirmatively offer,
27market, and sell all products made available to individuals in the
28program to individuals purchasing coverage outside the program.

29(2) For purposes of this subdivision, “product” does not include
30contracts entered into pursuant to Chapter 7 (commencing with
31Section 14000) of, or Chapter 8 (commencing with Section 14200)
32of, Part 3 of Division 9 of the Welfare and Institutions Code
33between the State Department of Health Care Services and carriers
34for enrolled Medi-Cal beneficiaries. “Product” also does not
35include a bridge plan product offered pursuant to Section 100504.5.

36(g) Determine when an enrollee’s coverage commences and the
37extent and scope of coverage.

38(h) Provide for the processing of applications and the enrollment
39and disenrollment of enrollees.

P8    1(i) Determine and approve cost-sharing provisions for qualified
2health plans.

3(j) Establish uniform billing and payment policies for qualified
4health plans offered in the program to ensure consistent enrollment
5and disenrollment activities for individuals enrolled in the program.

6(k) Undertake activities necessary to market and publicize the
7availability of health care coverage and subsidies through the
8program. The board shall also undertake outreach and enrollment
9activities that seek to assist enrollees and potential enrollees with
10enrolling and reenrolling in the program in the least burdensome
11manner, including populations that may experience barriers to
12enrollment, such as the disabled and those with limited English
13language proficiency.

14(l) Select and set performance standards and compensation for
15navigators selected under subdivision (h) of Section 100532.

16(m) Employ necessary staff. The board shall employ staff
17consistent with the applicable requirements imposed under
18subdivision (m) of Section 100503.

19(n) Assess a charge on the qualified health plans offered by
20carriers that is reasonable and necessary to support the
21development, operations, and prudent cash management of the
22program.

23(o) Authorize expenditures, as necessary, from the fund to pay
24program expenses to administer the program.

25(p) Keep an accurate accounting of all activities, receipts, and
26expenditures. Commencing January 1, 2017, the board shall
27conduct an annual audit.

28(q) (1) Notwithstanding Section 10231.5, annually prepare a
29written report on the implementation and performance of the
30program functions during the preceding fiscal year, including, at
31a minimum, the manner in which funds were expended and the
32progress toward, and the achievement of, the requirements of this
33title. The report shall also include data provided by health care
34service plans and health insurers offering bridge plan products
35regarding the extent of health care provider and health facility
36overlap in their Medi-Cal networks as compared to the health care
37provider and health facility networks contracting with the plan or
38insurer in their bridge plan contracts. This report shall be
39transmitted to the Legislature and the Governor and shall be made
40available to the public on the Internet Web site of the program. A
P9    1report made to the Legislature pursuant to this subdivision shall
2be submitted pursuant to Section 9795.

3(2) In addition to the report described in paragraph (1), the board
4shall be responsive to requests for additional information from the
5Legislature, including providing testimony and commenting on
6proposed state legislation or policy issues. The Legislature finds
7and declares that activities including, but not limited to, responding
8to legislative or executive inquiries, tracking and commenting on
9legislation and regulatory activities, and preparing reports on the
10implementation of this title and the performance of the program,
11are necessary state requirements and are distinct from the
12promotion of legislative or regulatory modifications referred to in
13subdivision (c) of Section 100540.

14(r) Maintain enrollment and expenditures to ensure that
15expenditures do not exceed the amount of revenue in the fund, and
16if sufficient revenue is not available to pay estimated expenditures,
17institute appropriate measures to ensure fiscal solvency.

18(s) Exercise all powers reasonably necessary to carry out and
19comply with the duties, responsibilities, and requirements of this
20title.

21(t) Consult with stakeholders relevant to carrying out the
22activities under this title, including, but not limited to, all of the
23following:

24(1) Health care consumers who are enrolled in health plans.

25(2) Individuals and entities with experience in facilitating
26enrollment in health plans.

27(3) The executive director of the Exchange.

28(4) The State Medi-Cal Director.

29(5) Advocates for enrolling hard-to-reach populations.

30(u) Facilitate the purchase of qualified health plans in the
31program by qualified individuals no later than January 1, 2016.

32(v) Require carriers participating in the program to immediately
33notify the program, under the terms and conditions established by
34the board when an individual is or will be enrolled in or disenrolled
35from any qualified health plan offered by the carrier.

36(w) Ensure that the program provides oral interpretation services
37in any language for individuals seeking coverage through the
38program and makes available a toll-free telephone number for the
39hearing and speech impaired. The board shall ensure that written
40information made available by the program is presented in a plainly
P10   1worded, easily understandable format and made available in
2prevalent languages.

3

100534.  

(a) The board may do the following:

4(1) Collect premiums and assist in the administration of
5subsidies.

6(2) Enter into contracts.

7(3) Sue and be sued.

8(4) Receive and accept gifts, grants, or donations of moneys
9from any agency of the United States, any agency of the state, any
10municipality, county, or other political subdivision of the state.

11(5) Receive and accept gifts, grants, or donations from
12individuals, associations, private foundations, or corporations, in
13compliance with the conflict of interest provisions to be adopted
14by the board at a public meeting.

15(6) Adopt rules and regulations, as necessary. Until January 1,
162018, any necessary rules and regulations may be adopted as
17emergency regulations in accordance with the Administrative
18Procedure Act (Chapter 3.5 (commencing with Section 11340) of
19Part 1 of Division 3 of Title 2). The adoption of these regulations
20shall be deemed to be an emergency and necessary for the
21immediate preservation of the public peace, health and safety, or
22general welfare.

23(7) Collaborate with the Exchange and the State Department of
24Health Care Services, to the extent possible, to allow an individual
25the option to remain enrolled with his or her carrier and provider
26network in the event the individual experiences a loss of eligibility
27for enrollment in a qualified health plan under this title and
28becomes eligible for the Exchange or the Medi-Cal program, or
29loses eligibility for the Medi-Cal program and becomes eligible
30for a qualified health plan through the program.

31(8) Share information with relevant state departments, consistent
32with the applicable laws governing confidentiality, necessary for
33the administration of the program.

34(9) Require carriers participating in the program to make
35available to the program and regularly update an electronic
36directory of contracting health care providers so that individuals
37seeking coverage through the program can search by health care
38provider name to determine which health plans in the program
39include that health care provider in their network. The board may
40also require a carrier to provide regularly updated information to
P11   1the program as to whether a health care provider is accepting new
2patients for a particular health plan. The program may provide an
3 integrated and uniform consumer directory of health care providers
4indicating which carriers the providers contract with and whether
5the providers are currently accepting new patients. The program
6may also establish methods by which health care providers may
7transmit relevant information directly to the program, rather than
8through a carrier.

9(10) Make available supplemental coverage for enrollees of the
10program to the extent permitted by available funding. Any
11supplemental coverage offered in the program shall be subject to
12the charge imposed under subdivision (n) of Section 100533.

13(b) The program shall only collect information from individuals
14or designees of individuals necessary to administer the program.

15(c) The board shall have the authority to standardize products
16to be offered through the program.

17

100535.  

The board shall establish and use a competitive
18process to select participating carriers and any other contractors
19under this title. Any contract entered into pursuant to this title shall
20be exempt from Chapter 2 (commencing with Section 10100) of
21Division 2 of the Public Contract Code, and shall be exempt from
22the review or approval of any division of the Department of General
23Services.

24

100536.  

(a) The board shall establish an appeals process for
25prospective and current enrollees of the program.

26(b) The board shall not be required to provide an appeal if the
27subject of the appeal is within the jurisdiction of the Department
28of Managed Health Care pursuant to the Knox-Keene Health Care
29Service Plan Act of 1975 (Chapter 2.2 (commencing with Section
301340) of Division 2 of the Health and Safety Code) and its
31implementing regulations, or within the jurisdiction of the
32Department of Insurance pursuant to the Insurance Code and its
33implementing regulations.

34

100537.  

(a) Notwithstanding any other provision of law, the
35program shall not be subject to licensure or regulation by the
36Department of Insurance or the Department of Managed Health
37Care.

38(b) Carriers that contract with the program shall have a license
39or certificate of authority from, and shall be in good standing with,
40their respective regulatory agencies.

P12   1

100538.  

(a) Records of the program that reveal the deliberative
2processes, discussions, communications, or any other portion of
3the negotiations with entities contracting or seeking to contract
4with the program, entities with which the program is considering
5a contract, or entities with which the program is considering or
6enters into any other arrangement under which the program
7provides, receives, or arranges services or reimbursement shall be
8exempt from disclosure under the California Public Records Act
9(Chapter 3.5 (commencing with Section 6250) of Division 7 of
10Title 1).

11(b) The following records of the program shall be exempt from
12disclosure under the California Public Records Act (Chapter 3.5
13(commencing with Section 6250) of Division 7 of Title 1) as
14follows:

15(1) (A) Except for the portion of a contract that contains the
16rates of payments, contracts with participating carriers entered into
17pursuant to this title on or after the date the act that added this
18subparagraph becomes effective, shall be open to inspection one
19year after the effective dates of the contracts.

20(B) If contracts with participating carriers entered into pursuant
21to this title are amended, the amendments shall be open to
22inspection one year after the effective date of the amendments.

23(c) Three years after a contract or amendment is open to
24inspection pursuant to subdivision (b), the portion of the contract
25or amendment containing the rates of payment shall be open to
26inspection.

27(d) Notwithstanding any other law, entire contracts with
28participating carriers or amendments to contracts with participating
29carriers shall be open to inspection by the Joint Legislative Audit
30Committee. The committee shall maintain the confidentiality of
31the contracts and amendments until the contracts or amendments
32to a contract are open to inspection pursuant to subdivisions (b)
33and (c).

34

100539.  

(a) No individual or entity shall hold himself, herself,
35or itself out as representing, constituting, or otherwise providing
36services on behalf of the program unless that individual or entity
37has a valid agreement with the program to engage in those
38activities.

P13   1(b) Any individual or entity who aids or abets another individual
2or entity in violation of this section shall also be in violation of
3this section.

4

100540.  

(a) The California Health Trust Fund For All
5Californians is hereby created in the State Treasury for the purpose
6of this title. Notwithstanding Section 13340, all moneys in the
7fund shall be continuously appropriated without regard to fiscal
8year for the purposes of this title. Any moneys in the fund that are
9unexpended or unencumbered at the end of a fiscal year may be
10carried forward to the next succeeding fiscal year.

11(b) The board of the program shall establish and maintain a
12prudent reserve in the fund.

13(c) The board or staff of the program shall not utilize any funds
14intended for the administrative and operational expenses of the
15program for staff retreats, promotional giveaways, excessive
16executive compensation, or promotion of federal or state legislative
17or regulatory modifications.

18(d) Notwithstanding Section 16305.7, all interest earned on the
19moneys that have been deposited into the fund shall be retained
20in the fund and used for purposes consistent with the fund.

21(e) Effective January 1, 2018, if at the end of any fiscal year,
22the fund has unencumbered funds in an amount that equals or is
23more than the board approved operating budget of the program
24for the next fiscal year, the board shall reduce the charges imposed
25under subdivision (n) of Section 100533 during the following fiscal
26year in an amount that will reduce any surplus funds of the program
27to an amount that is equal to the agency’s operating budget for the
28next fiscal year.

29

100541.  

(a) The board shall ensure that the establishment,
30operation, and administrative functions of the program do not
31exceed the combination of state funds, private donations, and other
32non-General Fund moneys available for this purpose.

33(b) The implementation of the provisions of this title, other than
34this section, Section 100530, and paragraphs (4) and (5) of
35subdivision (a) of Section 100534, shall be contingent on a
36determination by the board that sufficient financial resources exist
37or will exist in the fund. The determination shall be based on at
38least the following:

39(1) Financial projections identifying that sufficient resources
40exist or will exist in the fund to implement the program.

P14   1(2) A comparison of the projected resources available to support
2the program and the projected costs of activities required by this
3title.

4(3) The financial projections demonstrate the sufficiency of
5resources for at least the first two years of operation under this
6title.

7(c) The board shall provide notice to the Joint Legislative Budget
8Committee and the Director of Finance that sufficient financial
9resources exist in the fund to implement this title.

10(d) If the board determines that the level of resources in the fund
11cannot support the actions and responsibilities described in
12subdivision (a), it shall provide the Department of Finance and the
13Joint Legislative Budget Committee a detailed report on the
14changes to the functions, contracts, or staffing necessary to address
15the fiscal deficiency along with any contingency plan should it be
16impossible to operate the program without the use of General Fund
17moneys.

18(e) The board shall assess the impact of the program’s operations
19and policies on other publicly funded health programs administered
20by the state and the impact of publicly funded health programs
21administered by the state on the program’s operations and policies.
22This assessment shall include, at a minimum, an analysis of
23potential cost shifts or cost increases in other programs that may
24be due to program policies or operations. The assessment shall be
25completed on at least an annual basis and submitted to the Secretary
26of California Health and Human Services and the Director of
27Finance.

28

SEC. 3.  

Section 14102.1 is added to the Welfare and
29Institutions Code
, to read:

30

14102.1.  

(a) Notwithstanding any other law, individuals who
31meet all of the eligibility requirements for full-scope Medi-Cal
32benefits under this chapter, but for their immigration status, shall
33be eligible for full-scope Medi-Cal benefits.

34(b) This section shall not apply to individuals eligible for
35coverage pursuant to Section 14102.

36(c) Benefits for services under this section shall be provided
37with state-only funds only if federal financial participation is not
38available for those services. The department shall maximize federal
39financial participation in implementing this section to the extent
40allowable.

P15   1(d) Notwithstanding Chapter 3.5 (commencing with Section
211340) of Part 1 of Division 3 of Title 2 of the Government Code,
3the department, without taking any further regulatory action, shall
4implement, interpret, or make specific this section by means of
5all-county letters, plan letters, plan or provider bulletins, or similar
6instructions until the time regulations are adopted. The department
7shall adopt regulations by July 1, 2018, in accordance with the
8requirements of Chapter 3.5 (commencing with Section 11340) of
9Part 1 of Division 3 of Title 2 of the Government Code.
10Commencing July 1, 2015, and notwithstanding Section 10321.5
11of the Government Code, the department shall provide a status
12report to the Legislature on a semiannual basis, in compliance with
13Section 9795 of the Government Code, until regulations have been
14adopted.

15

SEC. 4.  

The Legislature finds and declares that Section 2 of
16this act, which adds Section 100538 to the Government Code,
17imposes a limitation on the public’s right of access to the meetings
18of public bodies or the writings of public officials and agencies
19within the meaning of Section 3 of Article I of the California
20Constitution. Pursuant to that constitutional provision, the
21Legislature makes the following findings to demonstrate the interest
22protected by this limitation and the need for protecting that interest:

23In order to ensure that the California Health Exchange Program
24for All Californians is not constrained in exercising its fiduciary
25powers and obligations to negotiate on behalf of the public, the
26limitations on the public’s right of access imposed by Section 2
27of this act are necessary.

28

SEC. 5.  

If the Commission on State Mandates determines that
29this act contains costs mandated by the state, reimbursement to
30local agencies and school districts for those costs shall be made
31pursuant to Part 7 (commencing with Section 17500) of Division
324 of Title 2 of the Government Code.



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