BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 513|
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                                 THIRD READING


          Bill No:  AB 513
          Author:   De Leon (D), et al
          Amended:  9/1/09 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  6-3, 7/15/09
          AYES:  Alquist, Cedillo, DeSaulnier, Leno, Pavley, Wolk
          NOES:  Strickland, Aanestad, Cox
          NO VOTE RECORDED:  Maldonado, Negrete McLeod

           SENATE APPROPRIATIONS COMMITTEE  :  8-5, 8/27/09
          AYES:  Kehoe, Corbett, Hancock, Leno, Oropeza, Price, Wolk,  
            Yee
          NOES:  Cox, Denham, Runner, Walters, Wyland

           ASSEMBLY FLOOR  :  50-28, 6/2/09 - See last page for vote


           SUBJECT  :    Health care coverage: breast-feeding

           SOURCE  :     California WIC Association


           DIGEST  :    This bill requires health care service plan  
          contract and health insurance policy issued, renewed, or  
          amended on or after January 1, 2010, that provides  
          maternity coverage to provide coverage for lactation  
          consultation with a lactation consultant and for provisions  
          of a personal electric or personal manual breast pump or  
          coverage for the rental of a hospital grade electric breast  
          pump.

                                                           CONTINUED





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           ANALYSIS  :    Existing law, the Knox-Keene Health Care  
          Service Plan Act of 1975 (Knox-Keene Act), provides for the  
          licensure and regulation of health care service plans by  
          the Department of Managed Health Care and makes a willful  
          violation of that act a crime.  Existing law also provides  
          for the regulation of health insurers by the Department of  
          Insurance.  Under existing law, health care service plans  
          and health insurers are required to offer specified types  
          of coverage as part of their health care services plan  
          contracts or health insurance policies.  Existing law  
          imposes specified requirements upon a health care service  
          plan contract or health insurance policy that provides  
          maternity coverage.

          This bill requires specified health care service plans and  
          health insurers to include coverage for lactation  
          consultation (LC) and for the provision of a personal  
          electric or personal manual breast pump of coverage for the  
          rental of a hospital grade electric breast pump, as  
          defined, as part of their health care service plan  
          contracts or health insurance policies that provide  
          maternity coverage.

           Comments
           
          The author's office points out that breast-feeding has been  
          well established as a low-cost, low-tech preventive  
          intervention with far-reaching benefits for mothers and  
          babies and significant cost savings for health providers.   
          The author's office notes that exclusive breast-feeding for  
          three months has been shown to reduce health care costs for  
          infants in the first year of life alone by up to $475,  
          compared to non-breast-fed infants; and, LC provided by an  
          international board certified lactation consultant has been  
          shown to help women address the difficulties with initial  
          and continued breast-feeding.  The author's office asserts  
          that the coverage of LC and breast pump rentals required by  
          this bill will provide breast-feeding mothers with the  
          support and skilled assistance they need to ensure that  
          feeding gets off to a good start.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes








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          According to the Senate Appropriations Committee analysis:

                          Fiscal Impact (in thousands)

           Major Provisions                2009-10     2010-11     
           2011-12   Fund
           
          DMHC start-up            $50       $0        $0   Special*

          CalPERS benefits         $50       $100      $100  
          General/**
                                                            Special/
                                                            Private
          *Managed Care Fund
          ***Each state agency pays its employees premiums to CalPERS  
          out of its budget. Approximately 55 percent of employee  
          premiums are from the General Fund and 45 percent are from  
          other state funds.  These other funds are made up of  
          approximately 67 percent special funds and 33 percent  
          moneys from other sources such as federal funds.

           SUPPORT  :   (Verified  9/1/09)

          California Women, Infant Children Association (source) 
          American Federation of State, County and Municipal  
          Employees
          American Red Cross
          Beach Cities Health District
          Breastfeeding Task Force of Greater Los Angeles
          California Breastfeeding Coalition
          California Center for Public Health Advocacy
          California Communities United Institute
          California Food Policy Advocates
          California Medical Association
          California Nurses Association
          Children's Hospital of Central California
          Consumer Action
          First 5 LA
          First 5, Fresno County
          First Five Santa Clara County
          Healthcare Professionals
          Inland Empire Breastfeeding Coalition
          LA Best Babies Network
          Planned Parenthood







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          Prevention Institute
          San Diego County Breastfeeding Coalition of 9 to 5 National  
          Assoc. of 
            Working Women
          State of California, Commission on the Status of Women
          The American College of Obstetricians and Gynecologists CA  
          Chapter
          Tulare County Breastfeeding Coalition
          United Nurses Association of California
          University of California, San Diego

           OPPOSITION  :    (Verified  9/1/09)

          Anthem Blue Cross
          Association of California Life & Health Insurance Companies
          Cal Chamber
          California Association of Health Plans
          Department of Finance
          Department of Health Care Services
          Dept of Managed Health Care
          Health Net

           ARGUMENTS IN SUPPORT  :    The sponsor of this bill, the  
          California Women, Infants and Children Association, notes  
          in support that 87 percent of California mothers initiate  
          breast-feeding in the hospital and this bill will ensure  
          that, in the early days and weeks after birth, mothers will  
          receive the help they need to solve normal and expected  
          problems so they can continue breast-feeding, exclusively,  
          without the need for formula.  Supporters, representing  
          health providers, public health groups, and breast-feeding  
          advocacy groups, assert that mothers should have access to  
          the support and tools they need to ensure that  
          breast-feeding is successful.  Supporters add that the  
          minimal costs associated with these services should be more  
          than offset by the reduction of medical conditions in  
          infants needing medical treatment. 

           ARGUMENTS IN OPPOSITION  :    Health plans, health insurers,  
          and business groups generally object to all benefit  
          mandates because, while they sympathize with the intent to  
          meet a need, mandates increase the already high cost of  
          care for everyone and hinder a carrier's ability to offer a  
          wider range of affordable products, which together may lead  







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          individuals and employers to drop coverage.  Health Net  
          contends that it already provides coverage for breast pumps  
          as part of durable medical equipment when there is a  
          demonstrated medical necessity and opposes this bill  
          because it requires coverage of pumps when they are not  
          needed for medical reasons but to assist the mother in  
          expressing milk on a schedule that is suitable for her.   
          Health Net also notes that most enrollees receive LC,  
          primarily from nurses, during delivery admission, and it is  
          not aware of any evidence that challenges the competence of  
          nurses to provide this assistance to new mothers. 

           ASSEMBLY FLOOR  : 
          AYES:  Ammiano, Arambula, Beall, Blumenfield, Brownley,  
            Buchanan, Caballero, Charles Calderon, Carter, Chesbro,  
            Coto, Davis, De La Torre, De Leon, Eng, Evans, Feuer,  
            Fong, Fuentes, Furutani, Galgiani, Hall, Hayashi,  
            Hernandez, Hill, Huber, Huffman, Jones, Krekorian, Lieu,  
            Bonnie Lowenthal, Ma, Mendoza, Monning, Nava, John A.  
            Perez, V. Manuel Perez, Portantino, Price, Ruskin, Salas,  
            Saldana, Skinner, Solorio, Swanson, Torlakson, Torres,  
            Torrico, Yamada, Bass
          NOES:  Adams, Anderson, Tom Berryhill, Blakeslee, Conway,  
            Cook, DeVore, Duvall, Emmerson, Fletcher, Fuller, Gaines,  
            Garrick, Gilmore, Hagman, Harkey, Jeffries, Knight,  
            Logue, Miller, Nestande, Niello, Nielsen, Silva, Smyth,  
            Audra Strickland, Tran, Villines
          NO VOTE RECORDED:  Bill Berryhill, Block


          JJA:do  9/1/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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