SB 406 by Dr. Richard Pan to Protect Key Provisions of the Affordable Care Act Signed into Law

September 30, 2020

SACRAMENTO, CA – As President Trump asks the Supreme Court to strike down the entire Affordable Care Act (ACA), and as it’s more in peril than ever following Trump’s Supreme Court nominee to replace the late Justice Ruth Bader Ginsburg, Senate Bill 406 by Dr. Richard Pan, which includes putting two Affordable Care Act (ACA) patient protections into state law, was signed by the Governor.

“If President Trump’s lawsuit before the Supreme Court to revoke the Affordable Care Act succeeds, millions of Americans will lose the ACA’s patient protections during the COVID-19 pandemic,” said Dr. Richard Pan, pediatrician and state senator. “California must take steps to keep two important patient protections in place in our state: banning lifetime coverage caps and removing patient cost sharing for evidence-based preventive services. I am grateful to the Governor for signing SB 406, ensuring Californians will remain protected.”

The ACA put in place a minimum requirement on insurers and health plans to provide coverage for preventive services and not impose any cost sharing requirements. In 2010, the legislature added this requirement to California law by referencing to the specific federal law section that imposed the requirement. This bill deletes the reference to federal law and puts those same specific federal requirements in California law. In order to ensure Americans have coverage for preventive services that can help detect serious conditions earlier or prevent them altogether, the ACA required private health plans, including individual, small group, large group, and self-insured plans to provide coverage for a range of preventive services. To ensure access without the burden of patient cost sharing, the ACA also prohibited cost sharing, such as copayments, coinsurance, and deductibles from being imposed on these services.

In 2011, the legislature added the annual and lifetime limit ban to California law by referencing the specific federal law section that imposed the prohibition. SB 406 deletes the reference to federal law and puts in California law those same federal requirements. This bill allows the annual and lifetime limit requirement to stand in California without reference to the ACA.

Before the ACA, many plans and insurers set a dollar limit on what they would spend for covered benefits during the entire time a person was enrolled in that plan. Once that lifetime limit was reached a person was required to pay the cost of all care exceeding those limits. In addition, prior to the ACA, many health plans set a dollar limit on yearly spending for a person’s covered benefits. Once that annual limit was reached a person was required to pay the cost of all care exceeding that limit.

“SB 406 will give the 1.4 million Californians who are enrolled in Covered California the peace of mind that their coverage will remain the same.”

 

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Dr. Richard Pan is a parent, small business owner, former UC Davis educator and pediatrician who represents Sacramento, West Sacramento, Elk Grove and unincorporated areas of Sacramento County in the state legislature and is the Chair of the Senate Health Committee. As a legislator, Dr. Pan continues to practice medicine at WellSpace Health Oak Park Community Clinic, pursuing his passion for working with families to build healthier communities.