SB 1255: Health insurance market: financial assistance.

Existing federal law, the Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers and that meets certain other requirements. Existing law creates the California Health Benefit Exchange, also known as Covered California, for the purpose of facilitating the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the PPACA. Existing law specifies the powers of the Covered California executive board, including the power to assist in the administration of subsidies for individuals with coverage made available through Covered California.

This bill would state the intent of the Legislature to enact legislation to ensure a stable health insurance market in California. require Covered California to administer financial assistance to help low- and middle-income Californians access affordable coverage, as specified, if the Legislature appropriates funds for that purpose. The bill would provide that priority for financial assistance shall be given to an individual whose premium payment is equal to or greater than 8% of his or her annual household income, as specified, or an individual whose annual household income is equal to or greater than 200% of the federal poverty level, as specified.