BILL ANALYSIS
AB 26
Page 1
ASSEMBLY THIRD READING
AB 26 (Migden)
As Amended April 8, 1999
Majority vote
HEALTH 9-4 APPROPRIATIONS 14-7
-----------------------------------------------------------------
|Ayes:|Gallegos, Corbett, |Ayes:|Migden, Cedillo, Davis, |
| |Firebaugh, Kuehl, | |Hertzberg, Kuehl, Papan, |
| |Steinberg, Thomson, | |Romero, Shelley, |
| |Vincent, Wayne, Wildman | |Steinberg, Thomson, |
| | | |Wesson, Wiggins, Wright, |
| | | |Washington, |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Granlund, Aanestad, |Nays:|Brewer, Ashburn, |
| |Strickland, Thompson | |Campbell, Granlund, |
| | | |Maldonado, Runner, Zettel |
-----------------------------------------------------------------
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:
AB 26
Page 2
1)Provides for the licensure and regulation of health plans
administered by the Commissioner of Corporations and 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.
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 : According to the Assembly Appropriations
Committee analysis, one-time cost to the Secretary of State of
$118,000 in 1999-2000 to establish the registry required by this
bill, and costs of
$50,000 to $60,000 annually thereafter. These costs would be
fully offset by fees paid by registrants. In addition, this
bill requires county clerk offices to make registration forms
available to the public. County costs to do so would be
minimal, but would be state reimbursable in the event they
exceed $200 per county.
COMMENTS : According to the author, over the past 10 years
several studies have confirmed that, as a whole, the insurance
industry has been hostile to domestic partnership health
coverage. Although some companies are 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 sponsor,
California Alliance for Pride and Equality (CAPE), several
sections of California law and regulation 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.
AB 26
Page 3
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. 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.
The Committee on Moral Concern (CMC) states 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.
Similar legislation, AB 54 (Murray) of 1997 and AB 627 (Katz) of
1995 both died in the Assembly. AB 1059 (Migden) of 1998 was
vetoed and in his veto message, 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 provide the benefit, as evidenced by the
many employers who choose to do so."
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 this bill to both group and individual
coverage.
Analysis Prepared by : Ellen McCormick / HEALTH / (916)
AB 26
Page 4
319-2097
FN: 0000655