BILL NUMBER: AB 1954 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 25, 2016
AMENDED IN ASSEMBLY APRIL 13, 2016
INTRODUCED BY Assembly Member Burke
FEBRUARY 12, 2016
An act to add Section 1367.31 to the Health and Safety Code, and
to add Section 10123.202 to the Insurance Code, relating to health
care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 1954, as amended, Burke. Health care coverage: reproductive
health care services.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the licensure and regulation of health care service
plans by the Department of Managed Health Care and makes a willful
violation of the act a crime. Existing law provides for the
regulation of health insurers by the Department of Insurance.
This bill would prohibit every health care service plan contract
or health insurance policy issued, amended, renewed, or delivered on
or after January 1, 2017, with exceptions, from requiring an enrollee
or insured to receive a referral in order to receive reproductive or
sexual health care services, as defined. Because a willful violation
of these provisions by a health care service plan would be a crime,
the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. This act shall be known and may be cited as the Direct
Access to Reproductive Health Care Act.
SEC. 2. (a) The Legislature hereby finds and declares all of the
following:
(1) For many women, reproductive health care is primary health
care.
(2) According to the Guttmacher Institute, one-half of all
pregnancies in the United States each year, more than three million
pregnancies, are unintended. By 45 years of age, more than one-half
of all women in the United States will have experienced an unintended
pregnancy, and three in 10 will have had an abortion.
(3) The inability to access comprehensive reproductive health care
in a timely manner can lead to negative health outcomes
outcomes, including increased risk for
unintended pregnancy, sexually transmitted diseases, and delayed care
for critical and time-sensitive reproductive health services.
(4) Providing timely access to comprehensive reproductive health
services is cost effective.
(5) California has a long history of, and commitment to, expanding
access to services that aim to reduce the risk of unintended
pregnancies, improve reproductive and sexual health outcomes, and
reduce costs.
(6) The Legislature has also passed measures to help health plan
enrollees and insureds access timely health care by setting standards
and policies regarding wait times for an appointment.
(b) It is hereby the intent of the Legislature in enacting this
act to build on current state and federal law to increase timely,
equal, and direct access to time-sensitive and comprehensive
reproductive and sexual health care services for enrollees in health
care service plans or insureds under health insurance policies by
prohibiting health care service plans or insurers from requiring an
enrollee or insured to secure a referral from a primary care provider
prior to receiving in-network reproductive and sexual health care
services.
SEC. 3. Section 1367.31 is added to the Health and Safety Code, to
read:
1367.31. (a) Every health care service plan contract issued,
amended, renewed, or delivered on or after January 1, 2017, shall be
prohibited from requiring an enrollee to receive a referral prior to
receiving coverage or services for reproductive and sexual health
care.
(b) (1) For the purposes of this section,
"reproductive and sexual health care services" are all reproductive
and sexual health services described in Sections 6924, 6925, 6926,
6927, 6928, and 6929 of the Family Code, or Sections 121020 and
124260 of the Health and Safety Code, obtained by a patient
at or above the minimum age specified in that section.
patient.
(2) This section applies whether or not the patient is a minor.
(c) This section shall not apply to specialized health care
service plan contracts or any health care service plan that is
governed by Section 14131 of the Welfare and Institutions Code.
SEC. 4. Section 10123.202 is added to the Insurance Code, to read:
10123.202. (a) Every health insurance policy issued, amended,
renewed, or delivered on or after January 1, 2017, excluding
specialized health insurance policies, shall be prohibited from
requiring an insured to receive a referral prior to receiving
coverage or services for reproductive and sexual health care.
(b) (1) For the purposes of this section,
"reproductive and sexual health care services" are all reproductive
and sexual health services described in Sections 6924, 6925, 6926,
6927, 6928, and 6929 of the Family Code, or Sections 121020 and
124260 of the Health and Safety Code, obtained by a patient
at or above the minimum age specified in that section.
patient.
(2) This section applies whether or not the patient is a minor.
SEC. 5. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.