BILL NUMBER: AB 39 CHAPTERED
BILL TEXT
CHAPTER 532
FILED WITH SECRETARY OF STATE SEPTEMBER 28, 1999
APPROVED BY GOVERNOR SEPTEMBER 27, 1999
PASSED THE ASSEMBLY SEPTEMBER 9, 1999
PASSED THE SENATE SEPTEMBER 7, 1999
AMENDED IN SENATE SEPTEMBER 2, 1999
AMENDED IN SENATE JUNE 17, 1999
AMENDED IN ASSEMBLY MARCH 18, 1999
INTRODUCED BY Assembly Member Hertzberg
(Principal coauthor: Senator Speier)
(Coauthors: Assembly Members Alquist, Aroner, Calderon, Davis,
Firebaugh, Honda, Jackson, Keeley, Knox, Kuehl, Lempert, Longville,
Mazzoni, Shelley, Steinberg, Strom-Martin, Villaraigosa, Washington,
and Wildman)
(Coauthors: Senators Alpert, Bowen, Chesbro, Costa, Figueroa,
Hayden, Karnette, Murray, Ortiz, Perata, and Solis)
DECEMBER 7, 1998
An act to add Section 1367.25 to the Health and Safety Code,
relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 39, Hertzberg. Health care coverage: contraceptive drugs.
(1) Existing law provides for the licensure and regulation of
health care service plans administered by the Commissioner of
Corporations. Under existing law, a willful violation of any of
these provisions is punishable as either a felony or a misdemeanor.
Existing law requires that health care service plans provide
coverage for certain benefits and services.
This bill would require every group health care service plan
contract, and every individual health care service plan contract,
amended, renewed, or delivered on or after January 1, 2000, except
for a specialized health care service plan contract, to provide
coverage, under terms and conditions applicable to other benefits,
for a variety of federal Food and Drug Administration approved
prescription contraceptive methods. This bill would authorize
certain religious employers, as defined, to request a health care
service plan contract without coverage for those contraceptive
methods in certain circumstances.
By changing the definition of the crime applicable to health care
service plans, this bill would impose a state-mandated local program.
(2) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. This act shall be known and may be cited as the Women's
Contraception Equity Act.
SEC. 2. Section 1367.25 is added to the Health and Safety Code, to
read:
1367.25. (a) Every group health care service plan contract,
except for a specialized health care service plan contract, that is
issued, amended, renewed, or delivered on or after January 1, 2000,
and every individual health care service plan contract that is
amended, renewed, or delivered on or after January 1, 2000, except
for a specialized health care service plan contract, shall provide
coverage for the following, under general terms and conditions
applicable to all benefits:
(1) A health care service plan contract that provides coverage for
outpatient prescription drug benefits shall include coverage for a
variety of federal Food and Drug Administration approved prescription
contraceptive methods designated by the plan. In the event the
patient's participating provider, acting within his or her scope of
practice, determines that none of the methods designated by the plan
is medically appropriate for the patient's medical or personal
history, the plan shall also provide coverage for another federal
Food and Drug Administration approved, medically appropriate
prescription contraceptive method prescribed by the patient's
provider.
(2) Outpatient prescription benefits for an enrollee shall be the
same for an enrollee's covered spouse and covered nonspouse
dependents.
(b) Notwithstanding any other provision of this section, a
religious employer may request a health care service plan contract
without coverage for federal Food and Drug Administration approved
contraceptive methods that are contrary to the religious employer's
religious tenets. If so requested, a health care service plan
contract shall be provided without coverage for contraceptive
methods. This subdivision shall not be construed to deny an enrollee
coverage of, and timely access to, contraceptive methods.
(1) For purposes of this section, a "religious employer" is an
entity for which each of the following is true:
(A) The inculcation of religious values is the purpose of the
entity.
(B) The entity primarily employs persons who share the religious
tenets of the entity.
(C) The entity serves primarily persons who share the religious
tenets of the entity.
(D) The entity is a nonprofit organization as described in Section
6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as
amended.
(2) Every religious employer that invokes the exemption provided
under this section shall provide written notice to prospective
enrollees prior to enrollment with the plan, listing the
contraceptive health care services the employer refuses to cover for
religious reasons.
(c) Nothing in this section shall be construed to exclude coverage
for prescription contraceptive supplies ordered by a health care
provider with prescriptive authority for reasons other than
contraceptive purposes, such as decreasing the risk of ovarian cancer
or eliminating symptoms of menopause, or for prescription
contraception that is necessary to preserve the life or health of an
enrollee.
(d) Nothing in this section shall be construed to deny or restrict
in any way any existing right or benefit provided under law or by
contract.
(e) Nothing in this section shall be construed to require an
individual or group health care service plan to cover experimental or
investigational treatments.
SEC. 3. No reimbursement is required by this act pursuant to
Section 6 of Article XIIIB of the California Constitution because the
only costs that may be incurred by a local agency or school district
will be incurred because this act creates a new crime or infraction,
eliminates a crime or infraction, or changes the penalty for a crime
or infraction, within the meaning of Section 17556 of the Government
Code, or changes the definition of a crime within the meaning of
Section 6 of Article XIIIB of the California Constitution.