Support of California leaders
Senator Caroline MENJIVAR (D-SAN Fernando Valley), MSW, president of the Senate health committee: “Improve it towards the expansion of the essential advantages of California’s health marks a huge step forward for people with hearing loss, handicaps and those who fight against infertility. The new reference plan proposed means that children who are hard of hearing or deaf will have coverage for hearing aids that make a significant difference in their development and well-being. Sustainable medical equipment will have increased coverage for their independence.
Assembly of the MIA BONTA Assembly (D-OAKLAND), president of the Assembly Health Committee: “Expand the coverage with in vitro fertilization, annual hearing exams, hearing aids and sustainable medical equipment in the reference plan of our State shows that our State -of -scale commitment to prioritize significant access to care. Will be able to hear his teacher, and someone with mobility limitations that seek to remain independent, these changes will have impacts they feel every day.
The secretary of California Health & Human Services Agency Kim Johnson: “Updates of the California reference plan and essential health benefits will fill the coverage gaps for millions while improving access to fertility services, hearing aids and wheelchairs, which facilitates the burden of families looking for these vital health care services.”
Director of DMHC Mary Watanabe: “The selection of a new reference plan establishes a new standard for commercial health coverage in California. I want to extend my most sincere gratitude to state legislature, health plans, suppliers, defenders and public members who participated in the process and provided thoughtful comments and comments. This contribution was essential, and was considered in question, because we have examined new opportunities to improve and extend health coverage requirements as part of a new bench plan. ”.
How we got here
The Federal Patient Protection Act and Affordable Care (ACA) requires that individual and small group health plans offer a full set of services, called EHBS. EHBs must cover 10 main categories of services, including primary care, hospital services, prescription drugs and emergency emergency services. In these main categories, a state can decide which specific service plans must cover by selecting its reference plan, which defines the EHB coverage requirements.
The DMHC has worked in the past year with the Newsom administration and the legislature to update the California reference plan, in particular by organizing public meetings to share information on the enlargement of EHB and the process to update the state reference plan. These public meetings have enabled the public to comment on the advantages of the advantages that should be taken into account for inclusion in the new reference plan. In addition to public meetings, the DMHC has published public opinions on California’s work to update the reference plan and accepted public comments on the State Reference Plan Summary Project. If it is approved by CMS, the new requirements of the reference plan would take effect on January 1, 2027.