BILL NUMBER: AB 98	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member De La Torre
   (Coauthors: Assembly Members Brownley, Caballero, Carter, Chesbro,
Ma, Monning, Ruskin, Salas, Skinner, Torlakson, Torres, and Yamada)
   (Coauthors: Senators Hancock, Negrete McLeod, and Wolk)

                        JANUARY 6, 2009

   An act to add Section 10123.865 to the Insurance Code, relating to
health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 98, as introduced, De La Torre. Maternity services.
   Existing law provides for the regulation of health insurers by the
Department of Insurance. Under existing law, a health insurer that
provides maternity coverage may not restrict inpatient hospital
benefits, as specified, and is required to provide notice of the
maternity services coverage.
   This bill would require specified health insurance policies to
provide coverage for maternity services, as defined.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares the following:
   (a) In actual practice, health care service plans have been
required by the Knox-Keene Health Care Service Plan Act of 1975
(Chapter 2.2 (commencing with Section 1340) of Division 2 of the
Health and Safety Code) to provide maternity services as a basic
health care benefit.
   (b) At the same time, existing law does not require health
insurers to provide designated basic health care services and,
therefore, health insurers are not required to provide coverage for
maternity services.
   (c) Therefore, it is essential to clarify that all health coverage
made available to California consumers, whether issued by health
care service plans regulated by the Department of Managed Health Care
or by health insurers regulated by the Department of Insurance, must
include maternity services.
  SEC. 2.  Section 10123.865 is added to the Insurance Code, to read:

   10123.865.  (a) Every individual or group policy of health
insurance that covers hospital, medical, or surgical expenses and
that is issued, amended, renewed, or delivered on or after January 1,
2010, shall provide coverage for maternity services. For the
purposes of this section, "maternity services" include prenatal care,
ambulatory care maternity services, involuntary complications of
pregnancy, neonatal care, and inpatient hospital maternity care,
including labor and delivery and postpartum care.
   (b) This section shall not apply to Medicare supplement,
short-term limited duration health insurance, vision-only, or
CHAMPUS-supplement insurance, or to hospital indemnity,
hospital-only, accident-only, or specified disease insurance that
does not pay benefits on a fixed benefit, cash payment only basis.