BILL ANALYSIS                                                                                                                                                                                                    





                                                                  AB 56

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          GOVERNOR'S VETO
          AB 56 (Portantino)
          As Amended September 1, 2009
          2/3 vote

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          |ASSEMBLY:  |50-26|(June 3, 2009)  |SENATE: |24-13|(September 2,  |
          |           |     |                |        |     |2009)          |
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          |ASSEMBLY:  |50-28|(September 8,   |        |     |               |
          |           |     |2009)           |        |     |               |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Requires health insurers to provide coverage for  
          mammography upon provider referral by July 1, 2010, and requires  
          health plans and health insurers to notify subscribers or  
          policyholders of recommended timelines for testing.

           The Senate amendments  :

          1)Add physician assistants to the list of providers eligible to  
            make a referral for a covered mammography beginning July 1,  
            2010, to the extent allowed by their scope of practice.

          2)Expand the method by which health plans and health insurers  
            may notify a subscriber or policyholder of recommended  
            timelines for an individual to undergo tests for the screening  
            or diagnosis of breast cancer. 

          3)Exclude self-insured employee welfare benefit plans from the  
            requirement to provide mammography beginning July 1, 2010.

          4)Make other technical and clarifying changes.

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar  
          to the version approved by the Senate.










                                                                  AB 56

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           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, to the extent that this bill increases the number of  
          mammograms annually, there would be costs to Medi-Cal, Access  
          for Infants and Mothers (AIM), and the Major Risk Medical  
          Insurance Program (MRMIP).  This could result in up to  
          approximately $375,000 in additional costs, using the 20,000  
          additional mammograms as the high end estimate of additional  
          mammograms resulting from this bill's provisions.  There would  
          also be minor and absorbable costs to the state-payer portion of  
          the California Public Employees Retirement System and no fiscal  
          impact on the Healthy Families Program.  
           
          GOVERNOR'S VETO MESSAGE  :

               The addition of a new mandate, no matter how small,  
               will only serve to increase the overall cost of health  
               care.  This, like other mandates, only increases cost  
               in an environment in which health coverage is  
               increasingly expensive.

               California has over 40 mandates on its health care  
               service plans and health insurance policies.  While  
               these mandates are well-intentioned, the costs  
               associated with the cumulative effect of these  
               mandates mean that these costs are passed through to  
               the purchaser and consumer.

               I continue to have serious concerns about the rising  
               costs of healthcare and must weigh the potential  
               benefits of a mandate with the comprehensive costs to  
               the entire delivery system and for that reason, I  
               cannot support this bill.



           Analysis Prepared by:     Marjorie Swartz / HEALTH / (916)  
          319-2097 













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