BILL ANALYSIS
AB 113
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Date of Hearing: January 21, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 113 (Portantino) - As Amended: January 4, 2010
Policy Committee: Health Vote:18-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill requires health plans and insurers to provide patients
with information regarding recommended timelines for the
screening for and diagnosis of breast cancer. This bill
authorizes information to be provided in a variety of formats
including letters, newsletters, coverage publications, or
electronic communication.
FISCAL EFFECT
No direct state fiscal impact. Because the provision of
information parameters in this bill are broad, health plans and
insurers indicate this bill codifies current notification
practices about mammography and other breast cancer screening
and diagnostic methods.
COMMENTS
1)Rationale . This bill establishes a requirement for health
plans and insurers to communicate with patients specifically
about breast cancer screening and diagnosis recommendations.
According to the author, increased communication about this
kind of screening will reduce morbidity and mortality by
identifying cancer earlier and more frequently than under
current law.
2)Breast Cancer in California . One in nine women in California
has a lifetime risk of being diagnosed with breast cancer. The
breast cancer death rate in California has dropped 20% over
the last two decades, but California women are more likely to
be diagnosed with breast cancer today. While the death rate
for breast cancer has dropped, the gains have not been shared
AB 113
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equally among all women. Women of color and low-income women
are less likely to be diagnosed at an early stage of cancer
and receive effective treatment. Therefore their survival
rates are lower than other groups of women. For example,
African-American women, although less likely to be diagnosed
with breast cancer, have one of the highest breast cancer
death rates.
3)Changes in Screening Guidelines . The United States Preventive
Services Task Force (USPSTF) is an independent federal panel
of experts in primary care and prevention that systematically
reviews the evidence of effectiveness and develops
recommendations for clinical preventive services. In November
2009 the USPSTF changed mammography screening recommendations
to biennial screening mammography for women aged 50 to 74
years. Many patients and providers have been concerned about
the recommendation due to the number of women diagnosed with
breast cancer prior to 50 years of age. In response, the
United States Senate approved an amendment to health reform
legislation that requires insurers to offer free mammograms
and other preventive services to women. This amendment and
legislation has not been finalized by Congress.
4)Related Legislation . AB 56 (Portantino) in 2008 was similar to
this bill and was vetoed due to concerns about premium
pressures created by health mandates. Because AB 113 codifies
current practice and emphasizes preventive health practices,
upward premium pressure is unlikely.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081