BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          SB 126 (Steinberg) - Health care coverage: pervasive development  
          disorder or autism.
          
          Amended: As introduced          Policy Vote: Health 9-0
          Urgency: No                     Mandate: Yes
          Hearing Date: May 13, 2013      Consultant: Brendan McCarthy
          
          This bill does not meet the criteria for referral to the  
          Suspense File.
          
          
          Bill Summary: SB 126 would extend the sunset, until January 1,  
          2019, of the state's existing health benefit mandate requiring  
          health plans and health insurers to provide coverage for  
          behavioral health therapy for pervasive development disorder or  
          autism.

          Fiscal Impact: 
              Minor ongoing costs to the Department of Managed Health  
              Care (Managed Care Fund) and Department of Insurance  
              (Insurance Fund) for enforcement. See below.

              No additional cost to the state to provide subsidies for  
              health coverage costs in the California Health Benefit  
              Exchange . See below.

          Background: Current state law (SB 88, Thompson, Statutes of  
          1999) requires health plans and health insurers who provide  
          hospital, medical, or surgical coverage to provide coverage for  
          the diagnosis and treatment of severe mental illness (as  
          specified in statute). In addition, health plans and health  
          insurers are required to provide additional coverage for serious  
          emotional disturbances of a child. In both cases, coverage is  
          required to be provided under the same terms and conditions  
          applied to other medical conditions.

          Under current federal law, health plans and health insurers that  
          offer coverage for mental health or substance abuse disorders  
          are required to provide that coverage under the same terms and  
          conditions as other covered benefits.

          Collectively, these requirements are referred to as "mental  








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          health parity" requirements.

          In addition, current state law (SB 946, Steinberg, Statutes of  
          2011) specifically requires health plans and health insurers to  
          cover behavioral health therapy for pervasive development  
          disorder or autism. SB 946 has a statutory sunset of July 1,  
          2014

          Under the federal Patient Protection and Affordable Care Act,  
          health coverage provided in the small group or individual market  
          (including through health exchanges) must provide essential  
          health benefits. Under federal law, individuals purchasing  
          coverage through health benefit exchanges will be eligible for  
          subsidies, based on income, paid by the federal government.  
          However, if a state imposes a benefit mandate after January 1,  
          2012 that exceeds the benefits provided by the essential health  
          benefits benchmark plan, the state is responsible for providing  
          the subsidies for coverage of that mandated benefit.

          Proposed Law: SB 126 would extend the sunset, until January 1,  
          2019, on the state's existing health benefit mandate requiring  
          health plans and health insurers to provide coverage for  
          behavioral health therapy for pervasive development disorder or  
          autism.

          Related Legislation: SB 946 (Steinberg, Statutes of 2011)  
          requires health plans and health insurers to cover behavioral  
          health therapy for pervasive development disorder or autism.

          Staff Comments: According to an analysis of this bill by the  
          California Health Benefits Review Program, health plans and  
          health insurers are already required to provide coverage for  
          behavioral health therapy (provided it is medically necessary)  
          under state and federal mental health parity requirements. Thus,  
          this bill does not create a new coverage mandate.

          There is no expected additional enforcement cost to state  
          regulators, since they are already required to enforce existing  
          mental health parity requirements. Similarly, the state will not  
          be required to pay for the cost of subsidizing coverage in the  
          California Health Benefit Exchange, as this bill does not impose  
          a coverage mandate that goes beyond federal or state essential  
          health benefit requirements. 









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