BILL ANALYSIS                                                                                                                                                                                                    





                                                                  AB 244

                                                                  Page  1


          GOVERNOR'S VETO
          AB 244 (Beall)
          As Amended September 1, 2009
          2/3 vote

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          |ASSEMBLY:  |50-29|(June 1, 2009)  |SENATE: |24-11|(September 3,  |
          |           |     |                |        |     |2009)          |
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          |ASSEMBLY:  |49-26|(September 9,   |        |     |               |
          |           |     |2009)           |        |     |               |
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          Original Committee Reference:    HEALTH
           
           SUMMARY  :  Requires health plans and health insurers to cover the  
          diagnosis and medically necessary treatment of a mental illness,  
          as defined, of a person of any age, including a child, and not  
          limited to coverage for severe mental illness (SMI) as in  
          existing law.  

           The Senate amendments  make minor technical and clarifying  
          changes. 

           EXISTING LAW  :

          1)Establishes the Knox-Keene Health Care Service Plan Act of  
            1975 (Knox-Keene) to regulate and license health plans and  
            specialized health plans by the Department of Managed Health  
            Care (DMHC) and provides for the regulation of health insurers  
            by the California Department of Insurance (CDI).

          2)Requires every health plan contract or health insurance policy  
            issued, amended, or renewed on or after July 1, 2000, that  
            provides hospital, medical, or surgical coverage to provide  
            coverage for the diagnosis and medically necessary treatment  
            of SMIs of a person of any age, and of serious emotional  
            disturbances of a child, under the same terms and conditions  










                                                                  AB 244

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            applied to other medical conditions, as specified.

          3)Defines a specialized plan contract as a contract for health  
            care services in a single specialized area of health care,  
            including dental care, for subscribers or enrollees, or which  
            pays for or reimburses any part of the cost for those  
            services, in return for a prepaid or periodic charge, paid by  
            or on behalf of subscribers or enrollees.

          4)Defines specialized health insurance policy as a policy of  
            health insurance for covered benefits in a single specialized  
            area of health care, including dental-only, vision-only, and  
            behavioral health-only policies.  There is no requirement for  
            health insurers subject to regulation by CDI to cover  
            medically necessary basic services or any specific minimum  
            basic benefits.  

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

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, costs to DMHC and CDI to oversee these new filings  
          would be minor and absorbable.  A 2009 California Health  
          Benefits Review Program report on this bill identified $104,000  
          in costs to the Healthy Families Program.
           

          GOVERNOR'S VETO MESSAGE  :

               I have vetoed similar measures twice before.  The  
               addition of a new mandate, especially one of this  
               magnitude, will only serve to significantly increase  
               the overall cost of health care.  This, like other  
               mandates, also 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  










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               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:     Cassie Rafanan / HEALTH / (916)  
          319-2097 



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