States Fall Behind in Enacting Market Reforms

California has made a lot of progress in passing state laws to enact health reform. But the same cannot be said for many other states, according to a report by The Commonwealth Fund. The Affordable Care Act includes numerous consumer protections designed to improve the accessibility, adequacy, and affordability of private health insurance. But, without new legislation, some states face limitations in fully enforcing these reforms.

To date, only one state passed new legislation on all of these protections while an additional 10 states and the District of Columbia passed new legislation or issued a new regulation on at least one protection.

The following is California’s record of passing legislation to enact the reforms:

• Guaranteed issue & rating requirements – The state passed a new law on the 2014 market reform. State action only applies in the small group market. In 2012, California passed new legislation that prohibits health care service plans and commercial carriers in the small-group market from varying rates using any factors other than age, geographic area, and family composition.
• Essential health benefits, preexisting condition exclusions, waiting periods, & Actuarial value – The state passed a new law on the 2014 market reform.
• Out-of-pocket costs – No law has yet been passed.

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Last Updated 05/25/2022

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