BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          SB 1034 (Mitchell) - Health care coverage:  autism
          
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          |Version: April 26, 2016         |Policy Vote: HEALTH 6 - 0       |
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          |Urgency: No                     |Mandate: Yes                    |
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          |Hearing Date: May 27, 2016      |Consultant: Brendan McCarthy    |
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          Bill  
          Summary:  SB 1034 would delete the existing statutory sunset on  
          the mandate to provide health care coverage for behavioral  
          health treatment for autism and related disorders. The bill  
          would also revise the existing benefit mandate and apply the  
          benefit mandate to health care coverage provided by CalPERS.


          *********** ANALYSIS ADDENDUM - SUSPENSE FILE ***********
             The following information is revised to reflect amendments 
                      adopted by the committee on May 27, 2016




          Fiscal  
          Impact:  
           One-time costs of about $50,000 and ongoing costs of $15,000  
            per year to review health plan filings for compliance with the  
            requirements of the bill and to undertake any necessary  
            enforcement actions by the Department of Managed Health Care  
            (Managed Care Fund).








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           Likely costs of less than $100,000 per year for review of  
            health insurance plan filings and enforcement actions by the  
            Department of Insurance (Insurance Fund).
            
           No state costs are anticipated due to the elimination of the  
            existing sunset on the benefit mandate or the extension of the  
            existing benefit mandate to CalPERS coverage. While existing  
            law specifically mandates coverage for behavioral health  
            treatment, separate federal and state mental health parity  
            requirements and requirements for the provision of essential  
            health benefits implicitly require coverage for behavioral  
            health treatment for autism and related disorders. Therefore,  
            elimination of the statutory sunset and extension of the  
            mandate to CalPERS health coverage will not increase state  
            costs, because CalPERS plans would have to provide coverage  
            for these services even without a specific benefit mandate.  
            Nor will eliminating the sunset require the state to pay for  
            the costs to subsidize coverage for behavioral health  
            treatment coverage for subsidized Covered California plans.
            
           Ongoing costs of about $300,000 per year due to a minor  
            increase in health care premiums to CalPERS due to the  
            expansion of the existing benefit mandate to require coverage  
            to "keep" the functioning of eligible individuals (General  
            Fund, special funds, and local funds). About half of the above  
            costs would accrue to the state and half to local governments.  
             See below.

           Uncertain impact on CalPERS health care costs from other  
            changes to the existing benefit mandate in the bill (General  
            Fund, special funds, and local funds). According to the  
            California Health Benefits Review Program, there are several  
            changes to the existing benefit mandate that could increase  
            utilization of services, but that the Program was unable to  
            quantify. To the extent that those factors do increase  
            utilization, premium costs to CalPERS would increase. 

           No increased costs for the Medi-Cal program are anticipated  
            due to the bill. Current law exempts Medi-Cal managed care  
            plans from the existing benefit mandate. (However, federal  
            guidance requires coverage for behavioral health treatment for  
            Medi-Cal enrollees with autism or related disorders. The state  
            has just begun providing this benefit in Medi-Cal and is in  
            the process of transitioning Medi-Cal enrollee previously  








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            served by regional centers to having coverage provided by  
            Medi-Cal.)  This bill does not eliminate the existing Medi-Cal  
            exemption.


          Committee  
          Amendments:  specify that the bill would not require coverage  
          for services required under a student's Individualized  
          Educational Program.


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