BILL ANALYSIS Ó
AB 1954
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Date of Hearing: May 4, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
1954 (Burke) - As Amended April 25, 2016
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|Policy |Health |Vote:|14 - 4 |
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Urgency: No State Mandated Local Program: YesReimbursable:
No
SUMMARY:
This bill prohibits health plans and insurers from requiring an
enrollee to receive a referral prior to receiving coverage or
services for reproductive and sexual health care. It also:
1)Defines "reproductive and sexual health care" by reference to
existing Family Code and Health and Safety Code sections.
2)Exempts specialized health care plans and Medi-Cal managed
care plans.
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FISCAL EFFECT:
1)Costs in the range of $50,000 per year to the Department of
Managed Health Care (Managed Care Fund) and minor costs to
California Department of Insurance (Insurance Fund) for
ensuring and enforcing compliance.
2)Although this bill could slightly increase utilization of
reproductive and sexual health care in the private health care
market, to the extent it removes barriers to care, eliminating
referrals does not appear likely to result in a noticeable
premium impact. These services are often available without a
referral now and, although access to some of these services
without a referral varies by plan, the services are all
covered under current law.
COMMENTS:
1)Purpose. The purpose of this bill is to eliminate any
requirement for a referral before an enrollee can access
critical reproductive and sexual health care services.
2)Background. The inability to access comprehensive reproductive
health care in a timely manner can lead to negative health
outcomes including increased risk for unintended pregnancy,
increased spread of sexually transmitted diseases, and delayed
care for critical and time-sensitive reproductive health
services. A requirement for a referral may delay access to
needed care.
3)Support and Opposition. A prior version of this bill required
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plans and insurers to reimburse out-of-network providers for
reproductive and sexual health care services, which was
objectionable to plans. This bill has been amended to only
address referrals; thus current opposition is unknown. This
bill is co-sponsored by California Family Health Council,
California Latinas for Reproductive Justice, NARAL Pro-Choice
California, and Black Women for Wellness, and supported by
other groups.
4)Suggested amendment. The bill defines "reproductive and sexual
health care" as all reproductive and sexual health services
described in certain sections of code, including sections that
do not mention reproductive health care. The committee may
wish to consider removing references to sections not relevant
to reproductive and sexual health.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081