Amended in Assembly April 6, 2015

Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 1254

Introduced by Assembly Member Grove

February 27, 2015

An act to add Section 1367.255 to the Health and Safety Code, relating to health care service plans.

LEGISLATIVE COUNSEL’S DIGEST

AB 1254, as amended, Grove. Health care service plans: abortion coverage.

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires a health insurance issuer offering coverage in the individual or small group market to ensure that the coverage includes the essential health benefits package, as defined. PPACA does not require that a qualified health plan provide coverage for abortion, as specified.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the regulation of health care service plans by the Department of Managed Health Care. Under existing law, the Director of Managed Health Care may, after appropriate notice and opportunity for a hearing, by order suspend or revoke a license issued under the act, or assess administrative penalties if the director determines that the licensee has committed an act or omission constituting grounds for disciplinary action.

This bill would provide that a health care service plan is not required to include abortion as a covered benefit. The bill would prohibit the director from denying a license, or disciplining a licensee, on the basis that the plan excludes coverage for abortions.

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.  

Section 1367.255 is added to the begin delete end delete begin delete Welfare and end delete

begin delete Institutions end delete begin insert Health and Safety end insert Code, immediately following Section
1367.25, to read:

1367.255.  

(a) Notwithstanding any other law, a health care
service plan is not required to include abortion as a covered benefit.
The director shall not deny, suspend, or revoke the license of, or
otherwise sanction or discriminate against, a licensee on the basis
that the licensee excludes coverage for abortions pursuant to this
section.

(b) This section does not require a health care service plan to
exclude or restrict coverage for abortions.