California Health Benefit Exchange: automatic health care coverage enrollment.

Plain English Breakdown

The bill summary and digest do not provide specific details on how disagreements with automatic enrollment will be handled.

Automatic Health Care Enrollment for California

This law allows Covered California to automatically enroll individuals in health care plans based on household enrollment or as the lowest cost plan available, starting July 1, 2027.

What This Bill Does

• Allows Covered California to enroll an individual in the same health plan as other members of their household if they are eligible.
• Requires Covered California to automatically enroll Indian individuals who qualify for reduced costs into the cheapest available plan.
• Makes it so that when someone applies for help with insurance through a state system, Covered California must sign them up right away or before their current coverage ends.

Who It Names or Affects

• People who apply for health insurance through the Statewide Automated Welfare System in California.
• Households with multiple people enrolled in different health care plans.

Terms To Know

California Health Benefit Exchange

Also known as Covered California, it is a system that helps Californians find and enroll in health insurance plans.

Limits and Unknowns

• The bill does not specify what happens if someone disagrees with the automatic enrollment.
• It is unclear how this will affect small employers who use Covered California for their employees.
• There are no details on how the state will fund these changes to the health care system.

Official Summary Text

AB 1907, as introduced, Addis.
California Health Benefit Exchange: automatic health care coverage enrollment.
Existing law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the federal Patient Protection and Affordable Care Act. Existing law requires the Exchange to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individual’s electronic account from an insurance affordability program. Existing law requires enrollment to occur before coverage through the insurance affordability program is terminated, and prohibits the premium due date from being sooner than the last day of the first month of enrollment.
This bill would, commencing July 1, 2027, additionally authorize the Exchange to enroll an individual in the plan in which other
members of the individual’s household are enrolled, as specified, or the lowest cost plan available to an Indian who is eligible for specified reduced cost sharing, as determined by the Exchange, and would require the Exchange to enroll an individual in any of the plans described above upon receipt of a complete application for an insurance affordability program submitted through the Statewide Automated Welfare System. The bill would require the Exchange to enroll the individual either before coverage through the insurance affordability program is terminated as described above or upon the receipt of a complete application for an insurance affordability program through the Statewide Automated Welfare System as described above.
Existing law requires the Exchange to provide an individual who is enrolled in a plan described above with a notice that includes specified information, including a statement that services received during the first month of enrollment will only
be covered by the plan if the premium is paid by the due date.
This bill would require the Exchange to provide the notice described above prior to the individual’s effective date of coverage, and to provide, instead of the statement described above, instructions on how to effectuate coverage in the selected plan, including by paying the premium on or before the due date, or, if there is no premium due, instructions on how to opt into the selected plan.

Current Bill Text

Download Bill PDF