BILL ANALYSIS
AB 26
Page 1
Date of Hearing: April 13, 1999
ASSEMBLY COMMITTEE ON HEALTH
Martin Gallegos, Chair
AB 26 (Migden) - As Amended: April 8, 1999
SUBJECT : Domestic partners: health insurance.
SUMMARY : Provides for the definition, registration and
termination of "domestic partners" and requires health care
service plan group coverage (health plan) and disability
insurance group policies (health insurance) to include an offer
of domestic partner health care benefits as an elective coverage
option. Specifically, this bill :
1)Defines "domestic partners" and provides for the registration
and termination of domestic partnerships with the Secretary of
State, as specified.
2)Requires a health facility to allow a patient's domestic
partner to visit a patient, as specified.
3)Requires health plans and disability insurers, as specified,
to offer the option of domestic partner health care benefits
as an elective coverage option to contracting employers and
guaranteed associations, as specified.
4)Provides that health plans or disability insurers may require
a copy of a valid Declaration of Domestic Partnership and
notification of termination of the domestic partnership.
EXISTING LAW:
1)Provides for the licensure and regulation of health plans
administered by the Commissioner of Corporations.
2)Provides for the regulation of policies of disability
insurance administered by the Insurance Commissioner.
3)Requires that health plans and disability insurers provide
coverage for certain benefits and services.
4)Authorizes the Department of Health Services (DHS) to license
and regulate health facilities.
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5)Provides, by regulation, that a patient of a general acute
care hospital may designate visitors regardless of
relationship, as specified. Regulation also provides that a
patient of a general acute care hospital may designate
visitors in writing, should the patient later lack the
capacity to make such a designation known.
FISCAL EFFECT : Unknown
COMMENTS :
1) THE PURPOSE OF THIS LEGISLATION . According to information
provided by the author, over the past ten years several
studies have confirmed that, as a whole, the insurance
industry has been hostile to domestic partnership health
coverage. Although things are beginning to change, with some
companies now willing to offer coverage, the fact remains that
lack of availability and rate discrimination are still major
problems for many employers, particularly small companies.
According to the California Alliance for Pride and Equality
(CAPE), the sponsor of the bill, and the author, the Unruh
Civil Rights Act, the California Labor Code, and sections of
the California Code of Regulations prohibit discrimination on
the basis of sexual orientation and/or marital status. Yet
some health plans currently offer benefits to married spouses
that are not also offered for unmarried domestic partners.
This problem is particularly acute for same-sex couples whose
relationships are not currently recognized under existing law.
Elderly couples who form committed and exclusive
relationships share a similar problem. This bill helps
resolve the current inequity in law with respect to health
benefits. More than a decade of experience with domestic
partnership demonstrates that providing the option of such
benefits is both pro-civil rights and pro-business.
Nationally, more than 500 employers now provide some type of
benefits for domestic partners and most are self-insured.
Recently, several of California's largest insurers: Health
Net, Blue Cross, Blue Shield and PacifiCare, joined Kaiser
Permanente in voluntarily offering this elective coverage to
their clients.
2) SUPPORT . The California State Employees Association (CSEA)
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states that coverage of domestic partners is long overdue,
though such benefits have been in place in many private and
public sector workplaces for years. This is good public
policy, is a matter of fairness, and has not resulted in a
peak in premium costs. Domestic partner benefits have been
found, on the contrary, to improve employee morale,
attendance, and thus boost profitability and efficiency in the
workplace. Kaiser Permanente states that this bill reflects
their current policy, and that as a health benefits provider
they offer coverage of domestic partners to their purchaser
groups and as a benefit to their own employees. Kaiser
Permanente states that they offer this coverage as both a
matter of fairness and a way of better serving their
customers. While data are very limited, it has been their
experience that utilization rates for domestic partners do not
differ greatly, if at all, from general utilization rates.
3) OPPOSITION . The Committee on Moral Concern (CMC) states that
this bill would legalize pseudo marriages, called "domestic
partnerships." Gays and lesbians are not dependents and are
free and able to get their own jobs, write their own will, and
live with whom they please and as such, there is no need for
this bill. CMC states that heterosexual couples could use
this benefit as well and that if those couples are not willing
to commit to each other in a real marriage, the
taxpayer-supported state government should not commit to their
relationship either. The historical family arrangement works
best for society, struggling families do not need their tax
burden increased to recognize and support non-dependent adult
friendships, which is all domestic partnerships really are.
Finally, CMC states that domestic partnership devalues true
family commitments and lends an air of legitimacy to
homosexuality. By a unanimous vote, the Social Concerns
Advisory Council of the Fremont Evangelical Free Church
opposes this bill because it creates "domestic partnerships"
which, by degrading marriage, are socially destructive and
which, by advancing homosexuality, are contrary to the Bible.
4) PREVIOUS LEGISLATION . AB 1059 (Migden) of 1998, AB 54
(Murray) of 1997, and AB 627 (Katz) of 1995 were substantially
similar to this bill. In his veto message of AB 1059,
Governor Wilson stated: "Domestic partner health benefit
coverage is an issue that is more appropriately left to
negotiations between employers and employees. This coverage
is available for both large and small employers who wish to
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provide the benefit, as evidenced by the many employers who
choose to do so."
5) GROUP V. INDIVIDUAL COVERAGE . This bill only requires health
plans and disability insurers to offer domestic partner health
benefits in "group" policies; "individual" coverage is not
subject to the same mandate to offer. Should this bill move
forward, the author may wish to explore expanding the bill to
both group and individual coverage.
6) DOUBLE REFERRAL . Should this bill pass out of the Assembly
Health Committee, it will be referred to the Assembly
Judiciary Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
California Alliance for Pride and Equality (sponsor)
Academic Senate of the California State University
Association of Bay Area Governments
California Child, Youth and Family Coalition
California Federation of Teachers
California National Organization for Women
California Nurses Association
California Professional Firefighters
California School Employees Association
California State Employees Association
Congress of California Seniors
East Bay Municipal Utility District
Friends Committee on Legislation
Kaiser Permanente
Los Angeles Gay and Lesbian Center
Older Womens League of California
People for the American Way
Santa Barbara Stonewall Democratic Club
Service Employees International Union AFL-CIO, CLC
Numerous individuals
Opposition
Committee on Moral Concerns
Social Concerns Advisory Council, Fremont Evangelical Free
Church
Numerous individuals
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Analysis Prepared by : Ellen McCormick / HEALTH / (916)
319-2097