BILL ANALYSIS Ó
AB 1795
Page 1
ASSEMBLY THIRD READING
AB
1795 (Atkins)
As Amended May 31, 2016
Majority vote
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |17-0 |Wood, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Campos, Dababneh, | |
| | |Cooley, Roger | |
| | |Hernández, Lackey, | |
| | |Nazarian, Olsen, | |
| | |Patterson, Rodriguez, | |
| | |Santiago, Steinorth, | |
| | |Thurmond, Waldron | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |15-4 |Gonzalez, Bloom, |Bigelow, Jones, |
| | |Bonilla, Bonta, |Obernolte, Wagner |
| | |Calderon, Chang, | |
| | |Daly, Eggman, Eduardo | |
| | |Garcia, Roger | |
| | |Hernández, Holden, | |
| | |Quirk, Santiago, | |
| | |Weber, Wood | |
| | | | |
AB 1795
Page 2
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SUMMARY: Changes provisions of the Every Woman Counts program
(EWC) and the Breast and Cervical Cancer Treatment program
(BCCTP) within the Department of Health Care Services (DHCS)
regarding eligibility for screenings, period of treatment, and
eligibility of coverage after reoccurrence of cancer.
Specifically, this bill:
1)Requires DHCS to provide breast cancer screening and
diagnostic services to individuals that meet existing
eligibility requirements and are either symptomatic, as
defined, or whose age is within the range for routine breast
cancer screening, as recommended by the United States
Preventative Services Task Force (USPSTF), subject to federal
action relating to breast cancer screening that overrides
those recommendations.
2)Deletes existing limits on the period of coverage for
treatment of breast cancer (18 months) and cervical cancer (24
months) and instead requires coverage for both cancers to
remain for the duration of treatment, as long as the
individual continues to meet all other eligibility
requirements.
3)Requires that a patient be eligible for coverage if diagnosed
with a reoccurrence of breast cancer or cervical cancer for
both new cancer sites or the same cancer site, as long as the
individual continues to meet all other eligibility
requirements.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
AB 1795
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1)DHCS has not provided a fiscal estimate for this bill. These
provisions of the bill will result in costs for cancer
treatment funded by state-only dollars:
a) Allowing an individual to remain on the program longer
by deleting the 18- and 24-month limits on the period of
coverage will result in additional months of eligibility.
b) Specifying an individual is eligible for cancer
treatment for additional cancers at the same cancer site.
This will allow beneficiaries to be eligible for additional
treatment services where they would otherwise be denied.
c) Allowing screening for symptomatic women under 40 would
allow more women to gain eligibility for breast cancer
treatment through the BCCTP.
Staff has estimated this bill could result in costs in the low
millions General Fund in the FFS program for cancer treatment
by allowing additional months and courses of treatment for
women who would otherwise not be eligible. For example, if an
additional 1,000 months of treatment are provided at an
average cost of $1,270 per month, costs would be $1.3 million.
Precise costs are difficult to predict based on limited
available data and unknown enrollment take-up.
2)Unclear, potential minor fiscal impact to EWC associated with
the provision requiring screening for symptomatic women under
40. If specifying in statute that screening symptomatic women
under 40 expands the number of women seeking care, staff
estimates additional cost pressure is approximately $100,000
(likely Proposition 99 or Breast Cancer Control funds).
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COMMENTS: According to the author, this bill is needed to
ensure that women have timely access to receive the necessary
services to detect and treat their cancers early. The author
asserts that changes are needed to allow low-income women in
California who are uninsured or underinsured to receive complete
treatment for breast and cervical cancer, provide that she is
not turned away if she is later diagnosed with the same cancer,
and allow women under age 40 who are symptomatic for breast
cancer to receive necessary screening services.
The mission of the EWC program is to save lives by preventing
and reducing the devastating effects of cancer through early
detection and diagnostic services. EWC provides free clinical
breast exams, mammograms, pelvic exams, and Pap tests to
California's low income uninsured and underserved women. These
screening services facilitate early detection that may prevent
untimely cancer deaths. Each year, EWC provides care for
approximately 300,000 individuals. EWC is funded, in part, by
$.01 of the tax on each pack of cigarettes sold in California.
The BCCTP provides cancer treatment and services for eligible
low-income California residents who are screened by the EWC or
Family Planning, Access, Care and Treatment program and found to
be in need of treatment for breast and/or cervical cancer.
BCCTP provides coverage for breast and cervical cancer treatment
and services related to cancer diagnosis. BCCTP provides
treatment coverage for approximately 9,000 individuals each
year, through both federal and state funding. Currently, the
state-funded BCCTP is not aligned with the federally-funded
BCCTP, causing gaps in service and treatment for women diagnosed
and treated through the state-funded program. Under the state
BCCTP, treatment coverage is limited to 18 months for breast
cancer and 24 months for cervical cancer, while federal funding
has no time limit and remains in effect for the duration of
treatment. State-funding for BCCTP does not allow coverage to a
woman who is re-diagnosed with the same cancer at the original
cancer site, while the federally funded program does.
AB 1795
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As of January 2016, the USPSTF recommends, with a B grade,
biennial screening mammography for women aged 50 to 74 years.
USPSTF also recommends, with a C grade, that the decision to
start screening mammography in women prior to age 50 years
should be an individual one. Women who place a higher value on
the potential benefit than the potential harms may choose to
begin biennial screening between the ages of 40 and 49 years.
According to Susan G. Komen California Affiliates, sponsor of
the bill, changes in the EWC and BCCTP specified in this bill
will ensure that women have timely access to necessary services
to detect and treat their cancers early. Health Access states
that despite expansion of Medi-Cal under the Patient Protection
and Affordable Care Act and subsidized health coverage through
Covered California, many low income Californians remain
uninsured and under-insured; limited benefit programs such as
BCCTP and EWC continue to be an important resource for them.
There is no known opposition to this bill.
Analysis Prepared by:
John Gilman / HEALTH / (916) 319-2097 FN:
0003276