As the country races toward a health care overhaul in the wake of President Barack Obama's re-election, his administration proposed rules today including one requiring insurers to cover everybody regardless of health condition.
California leaders are closely reading the federal rules to determine how they will deploy the Affordable Care Act in the nation's most populous state. State lawmakers and a new state marketplace for subsidized health coverage - Covered California - will use the rules to guide how they shape health care in the next year.
Besides the "guaranteed issue" requirement, the rules say that insurers can rate consumers based only on four factors: age, geography, family size and tobacco use. That excludes health condition, which previously has been a determinate factor in what consumers pay and whether they could get coverage.
This has been among the most popular pieces of the Affordable Care Act, and its costs are supposed to be mitigated by a spike in federal funds and healthy subscribers newly required to obtain care or pay a penalty. But critics fear that it will only attract the sickest patients to health care and drive up costs for other subscribers.
Gov. Jerry Brown and state lawmakers will convene a special legislative session on health care this winter to resolve some outstanding issues before the major pieces of the Affordable Care Act launch in 2014. Chief among their considerations will be a bill carrying out the newly proposed federal rules in California's individual market. Brown vetoed legislation in September that would have done that because he said it wasn't tethered enough to federal rules.