BILL ANALYSIS Ó AB 2115 Page 1 GOVERNOR'S VETO AB 2115 (Wood) As Enrolled September 2, 2016 2/3 vote -------------------------------------------------------------------- |ASSEMBLY: |71-0 |(May 23, 2016) |SENATE: |36-3 |(August 22, | | | | | | |2016) | | | | | | | | | | | | | | | -------------------------------------------------------------------- -------------------------------------------------------------------- |ASSEMBLY: |72-0 |(August 25, | | | | | | |2016) | | | | | | | | | | | | | | | | | | -------------------------------------------------------------------- Original Committee Reference: HEALTH SUMMARY: Requires health care service plans (health plans) and health insurers, when notifying enrollees who cease to be enrolled in health plans or insurance products about other health care coverage options, to also provide information on low- or no-cost programs for health care and prescription medicines on the Office of Patient Advocate (OPA) Web site. AB 2115 Page 2 The Senate amendments: 1)Delete language with respect to free or reduced cost prescription medicine through a manufacturer's patient assistance program (PAP) as part of the health plan and health insurer notice to enrollees who cease to be enrolled in health plans or insurance products. 2)Delete notice language specifying that the manufacturer PAP does not constitute coverage under the federal Patient Protection and Affordable Care Act (ACA). 3)Add notice language indicating that additional information on low- or no-cost programs for health care and prescription medicines may be found on the OPA Web site or the Internet Web site determined to be the most appropriate to contain this information, effective January 1, 2018. 4)Clarify language indicating no later than July 1, 2017, the Department of Managed Health Care, in consultation with the Office of the Patient Advocate, the Department of Insurance, and the California Health Benefit Exchange, to develop the statement to be included in the notice. 5)Delete language requiring the Department of Managed Health Care and California Department of Insurance to including notice information on locating free or reduced cost programs for health care and prescription medicines, such as through OPA's Web site. FISCAL EFFECT: According to the Senate Appropriations AB 2115 Page 3 Committee, pursuant to Senate Rule 28.8, negligible state costs. COMMENTS: According to the author, despite California's implementation of the ACA, which created or expanded coverage options for many Californians, gaps remain - with an estimated 3.8 million Californians under age 65 remaining without coverage. Compared to their insured counterparts, California's uninsured have reported having a significantly lower health status and a substantially higher rate of not seeking care due to cost concerns. Nationwide, an estimated 125,000 deaths per year and between 33 and 69% of medication-related hospital admissions are a result of patients not getting or taking a prescribed medicine in a timely manner. Washington State established a program using navigators and online resources to assist consumers in finding appropriate PAPs for their respective situations and medication needs, handling over 41 million prescriptions since 2009. A recent study of the Washington program found that patients receiving assistance in finding appropriate programs had nearly half the number of emergency department and hospital encounters as those not receiving such assistance. In helping to ensure Californians leaving coverage understand the programs available to them for free and reduced cost medicines, this bill will help to reduce the potential negative health impact that delays in access to prescribed medicines can cause. According to the National Conference of State Legislatures, PAPs has been a substantial and growing state interest for a number of years, generally in response to individuals who lack insurance coverage for medicines or who were not eligible for other government programs. In 1975, the first states began to authorize and fund direct subsidy programs. By 2009, a total of at least 42 states had established or authorized some type of program to provide pharmaceutical coverage or assistance; several of those are not currently operational. The subsidy programs, often termed "SPAPs," utilize state funds to pay for a AB 2115 Page 4 portion of the drug costs, usually for a defined population that meets enrollment criteria. In addition, an increasing number of states use discounts or bulk purchasing approaches that do not spend state funds for the drug purchases, identified as "Discount Programs." Since the passage of the ACA, state legislatures have been less active on SPAP issues. GOVERNOR'S VETO MESSAGE: I am returning Assembly Bill 2115 without my signature. Existing law requires health plans and insurers to notify individuals who will no longer be covered by that plan or insurer that they may be eligible for low or no-cost health coverage through Covered California or Medi-Cal. This bill adds to the notice a statement that information about low or no-cost health care and prescription medicines may be found on a website that is to be determined. I believe the current notification requirements are sufficient. Analysis Prepared by: Kristene Mapile / HEALTH / (916) 319-2097 FN: 0005098 AB 2115 Page 5