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
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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
FN: 0003395