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CA Department of Insurance

Insurance Commissioner Dave Jones Reiterates Strong Support For Federal Healthcare Reform Law

News: 2011 Press Release

For Release: January 18, 2011
Media Calls Only: 916-492-3566
Insurance Commissioner Dave Jones Reiterates Strong Support For Federal Healthcare Reform Law
Cites critical need to move California forward

Insurance Commissioner Dave Jones today announced his continued support for the Federal Healthcare reform law passed in Congress and signed by President Obama last year. Jones voiced his support on the eve of the Congressional House vote to attempt to repeal the Federal Healthcare reform legislation.

"Passage of the federal health care reform law is one of the most significant legislative accomplishments of the last fifty years," said Commissioner Jones. "Attempting to repeal health care reform or working to defund implementation or enforcement of the law will only serve to prevent tens of millions of Americans from having the health insurance coverage they desperately need. I believe it is critically important to move forward here in California even if a new Republican majority in the House of Representatives wants to turn back the clock and deny Americans healthcare."

On the night he was inaugurated, Commissioner Jones announced that implementation of health care reform and the Affordable Care Act were his first priorities. To that end, he immediately signed emergency regulations to give the Insurance Commissioner the authority to enforce the new 80% Medical Loss Ratio for health insurance in the individual market. Some 3 million or so Californians purchase insurance in the individual health insurance market.

Effective January 1st, under the federal Affordable Care Act, health insurers in the individual market are required to have a "medical loss ratio" of 80%. In effect, this means that 80% of the health insurance premium dollar should go into actual health care, not insurer profits, marketing and overhead. Prior to the passage of the federal Affordable Care Act, the Medical Loss Ratio requirement in California in the individual health insurance market was 70%.

Immediate Benefits of Patient Protection and Affordable Care Act

  • Insurers cannot deny coverage to children with pre-existing conditions. The open enrollment period for children in California began on January 1st and runs through March 1, 2011.
  • The creation of a new state-run Pre-Existing Condition Insurance Plan, or temporary high risk pool, so that those who have pre-existing conditions can get coverage right away. We have already set this up in California. Californians who could not get insurance before due to pre-existing conditions can now get basic insurance coverage.
  • Giving consumers better information so they can compare health insurance plans in a meaningful way. There is now an internet portal where consumers can go to compare health insurance products and their prices offered in your area. You can look up the information at www.healthcare.gov.
  • Parents can now keep their dependents on their health insurance to age 26. 
  • Preventative care must now be available without co-payments or deductibles, so that no one avoids going to the doctor in order to stay well or get a screening because they cannot afford to pay for the visit. 
  • Seniors get a $250 check to help cover the cost of prescription drugs if they fall into the "donut hole" where they are required to otherwise pick up thousands of dollars in drug costs. Over time the donut hole will be closed.
  • The new federal law prohibits rescissions of health insurance. The rescission issue has gotten a good deal of attention and the new law puts an end to an abhorrent practice. 
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The California Department of Insurance, established in 1868, is the largest consumer protection agency in California, regulating the $123 billion insurance marketplace. In 2013 the California Department of Insurance received more than 170,000 calls from consumers and helped recover over $63 million in claims and premiums. Please visit the Department of Insurance web site at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800.927.HELP or 213.897.8921. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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