BILL ANALYSIS
AB 1586
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1586 (Koretz)
As Amended July 1, 2005
Majority vote
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|ASSEMBLY: |41-27|(May 16, 2005) |SENATE: |23-14|(September 6, |
| | | | | |2005) |
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Original Committee Reference: HEALTH
SUMMARY : Defines the term "sex," in existing law that prohibits
health care service plans (health plans) and insurers from
specified discriminatory acts, to have the same meaning as
"gender," as defined under the Penal Code, as specified.
The Senate amendments :
1)Permit premium, price, or charge differentials, unless
otherwise prohibited by law, because of the sex of any
individual when based on objective, valid, and up-to-date
statistical and actuarial data or sound underwriting
practices.
2)State that this bill is not intended to mandate that health
plans or insurers provide coverage for any particular benefit,
nor to prohibit sound underwriting practices or criteria based
on objective, valid, and up-to-date statistical and actuarial
data.
Specify that the purpose is to prohibit plans and insurers from
denying an individual a plan contract or policy, or coverage
for a benefit included in the contract or policy, based on the
person's sex, as defined.
EXISTING LAW :
1)Defines "gender" to mean sex, and includes a person's gender
identity and gender related appearance and behavior whether or
not stereotypically associated with the person's assigned sex
at birth.
2)Prohibits health plans from refusing to enter into any
contract or canceling or declining to renew or reinstate any
AB 1586
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contract because of the race, color, national origin,
ancestry, religion, sex, marital status, sexual orientation,
or age of any contracting party, prospective contracting
party, or person reasonably expected to benefit from that
contract as a subscriber, enrollee, member, or otherwise.
3)Prohibits the terms of any health plan contract from being
modified, and the benefits or coverage of any contract from
being subject to any limitations, exceptions, exclusions,
reductions, copayments, coinsurance, deductibles,
reservations, or premium, price, or charge differentials, or
other modifications because of the race, color, national
origin, ancestry, religion, sex, marital status, sexual
orientation, or age of any contracting party, potential
contracting party, or person reasonably expected to benefit
from that contract as a subscriber, enrollee, member, or
otherwise. Exempts premium, price, or charge differentials
because of the sex or age of any individual when it is based
on objective, valid, and up-to-date statistical and actuarial
data. Prohibits health plans from charging different premium
rates to individual enrollees within the same group solely on
the basis of the enrollee's sex.
4)Prohibits insurers from failing or refusing to accept an
application for, or issuing a policy to an applicant for,
health insurance (unless such insurance is to be issued to the
applicant by another insurer under the same management and
control), or canceling such insurance, under conditions less
favorable to the insured than in other comparable cases,
except for reasons applicable alike to persons of every
marital status, sex, race, color, religion, national origin,
or ancestry. Prohibits sex, race, color, religion, national
origin, or ancestry of itself from constituting a condition or
risk for which a higher rate, premium, or charge may be
required of the insured for such insurance.
AS PASSED BY THE ASSEMBLY , this bill defined the term "sex" to
include, but be not limited to, a person's gender, as specified,
under existing law that prohibits health care service plans
(health plans) and insurers from specified discriminatory acts.
FISCAL EFFECT : None
COMMENTS : According to the Gay and Lesbian Alliance Against
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Defamation (GLAAD) "transgender" is an umbrella term for people
whose gender identity and/or gender expression differs from the
sex they were assigned at birth. Transgender people can be
female-to-male (FTM) or male-to-female (MTF) and may or may not
choose to alter their bodies hormonally and/or surgically.
According to the Transgender Law Center, transition-related
health care and services can include blood work, hormones,
mental health therapy, and gender confirmation surgery. In
2002, the Transgender Law Center and the National Center for
Lesbian Rights released a report titled "Trans Realities: A
Legal Needs Assessment of San Francisco's Transgender
Communities," which stated that 93% of the transgender people
surveyed have utilized medical services as a part of their
transition. The study also found that transgender people in the
San Francisco Bay Area face significant barriers to accessing
transition-related health care and often experience
discrimination in accessing other forms of health care. Nearly
one in three respondents experienced some form of health
care-related gender identity discrimination, including routine
denial of coverage by health insurers for transition-related
procedures, and discriminatory or inappropriate behavior by
health care providers and staff.
In 1999, the Transgender Community Health Project, which is part
of the Center for HIV Information at the University of
California, San Francisco, published a report based on a survey
they administered to transgender persons in collaboration with a
number or entities, including public health clinics, the San
Francisco Department of Public Health, and HIV/AIDS groups. The
report indicated that transgender individuals face complex
social, physical and mental health, and substance use issues.
Drug use was common among interviewees, as was mental health
intervention (i.e., hospitalization and/or medication). The
researchers found that 52% of MTF and 57% of FTM subjects were
uninsured. Thirteen percent of MTF and 39% of FTM interviewees
reported being denied or having difficulties obtaining health
care.
Analysis Prepared by : Melanie Moreno / HEALTH / (916) 319-209
FN: 0013153