BILL ANALYSIS
AB 39
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CONCURRENCE IN SENATE AMENDMENTS
AB 39 (Hertzberg)
As Amended September 2, 1999
Majority vote
ASSEMBLY: 52-26 (April 19, 1999)
SENATE: 23-12 (September 7, 1999)
Original Committee Reference: HEALTH
SUMMARY : Establishes the Women's Contraception Equity Act,
which requires health care service plan contracts to cover
prescription contraceptive methods. Specifically, this bill :
1)Requires specified group and individual health plan contracts
issued, amended, renewed, or delivered on or after January 1,
2000, that provide coverage for outpatient prescription drug
benefits to include coverage for a variety of federal Food and
Drug Administration (FDA) approved prescription contraceptive
methods.
2)Requires contraceptive benefits provided under the provisions
of this bill to be the same for an enrollee's covered spouse
and covered nonspouse dependents.
3)Exempts specialized health plan contracts from the
requirements of this bill.
4)Provides that a religious employer may request a health plan
contract without coverage for FDA-approved contraceptive
methods that are contrary to the religious employer's
religious tenets. Provides that this provision shall not be
construed to deny an enrollee coverage of, and timely access
to, contraceptive methods.
5)Defines "religious employer" as an entity for which:
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; and,
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d) The entity is a nonprofit organization pursuant to
Section 6022(a)(2)(A)I or iii, of the Internal Revenue
Code.
6)Requires any organization that invokes the religious exemption
in this bill to provide written notice to prospective
enrollees, listing the contraceptive services the employer
refuses to cover.
7)Provides that nothing in this bill is to be construed to
exclude coverage for prescription contraceptive supplies
ordered by a health care provider 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.
The Senate amendments insert the religious exemption and written
notice provisions of this bill.
EXISTING LAW :
1)Requires health plan contracts to cover a core package of
benefits plus certain other mandated benefits.
2)Permits health facilities and health professionals to refuse
to participate in certain clinical procedures on moral
grounds.
AS PASSED BY THE ASSEMBLY , this bill established the Women's
Contraception Equity Act, which requires health care service
plan contracts to cover prescription contraceptive methods.
FISCAL EFFECT : Negligible, according to the Assembly
Appropriations Committee analysis.
COMMENTS : This bill is intended to require health plans to
cover FDA-approved contraceptive methods. The author argues
that this bill addresses the inequity in prescription benefits
for women, since many plans do not provide routine coverage for
birth control. As a result, the author notes that women pay 63%
more in out-of-pocket costs (i.e., mostly attributed to
reproductive health expenses) than men. The author argues that
contraception should not be a luxury for women, that
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contraceptives have been shown to lower the risk of ovarian
cancer, and that reducing unintended pregnancies may lower
employer costs.
This bill is substantially similar to AB 160 and AB 1112, both
authored by Assemblymember Hertzberg and vetoed last session.
In his veto message for AB 160, Governor Wilson indicated a
willingness to ". . . sign legislation if it exempts religious
employers and organizations based on their religious beliefs .
. ." and highlighted his leadership in implementing the Family
Planning Access, Care and Treatment program (Family PACT).
Following this veto, Assemblymember Hertzberg introduced AB
1112, a substantially similar measure that exempted religious
organizations and permitted employees of such organizations who
earn up to 400% of the federal poverty level to secure
contraceptive coverage through the Family PACT program. The AB
1112 veto message stated that it is inappropriate for taxpayers
to pay for contraceptives for certain employees that earn up to
400% of the federal poverty level. This bill requires health
plans to provide contraceptive coverage, and SB 41 (Speier)
contains a companion requirement for disability insurers.
This bill exempts churches, synagogues, mosques, temples,
missions parochial schools, seminaries and convents from
providing contraceptive coverage. The Catholic Conference and
the California Association of Catholic Hospitals (CACH) argue
that this exemption does not go far enough, and desire to
include organizations such as hospitals, universities, private,
non-parochial schools, and social services agencies. The
sponsors, American College of Obstetricians and Gynecologists,
District IX, and Planned Parenthood Affiliates of California,
argue that an exemption for employers other than religious
organizations would allow an employer to make family planning
decisions for its employees. As employers and health care
providers, Catholic-affiliated hospitals provide health care
services, and they employ thousands of employees in managerial
and clinical positions that require no religious training,
experience or belief.
Analysis Prepared by : Ann Blackwood / HEALTH / (916) 319-2097
FN: 0003389