California Government Code

§ 100523

GOV § 100523 Effective Jan 1, 2025Title 22

Statute text

(a)Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose their employer-provided health care coverage as a result of a labor dispute.

(1)An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or labor dispute is a qualified individual for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the qualified individual above 138.1 percent of the federal poverty level for a family of the qualified individual’s size shall not be taken into account for the qualified individual and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.

(2)An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with household incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.

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Legislative history

Amended by Stats. 2024, Ch. 841, Sec. 1. (AB 2749) Effective January 1, 2025.