BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1600
                                                                  Page  1

          Date of Hearing:   April 21, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                 AB 1600 (Beall) - As Introduced:  January 10, 2010 

          Policy Committee:                              Health Vote:13-6

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill requires health plans and health insurers to provide  
          coverage for mental health and substance abuse treatment at  
          parity with other medical conditions. This bill exempts CalPERS  
          and Medi-Cal from requirements established by the bill. 

           FISCAL EFFECT  

          1)According to the California Health Benefits Review Program  
            (CHBRP), annual costs to the Healthy Families Program (HFP) of  
            $691,000 (33% GF).

          2)Annual increased premium costs in the private insurance market  
            of $54 million. These costs reflect increased premiums by  
            employers for group insurance and premiums paid in the  
            individual health insurance market. These increased costs are  
            partially offset by reduced out-of-pocket costs of $18 million  
            due to reduced co-payments and deductibles. 

          3)Federal health reform, the Patient Protection and Affordable  
            Care Act (PL-111-148), may impact the longer term fiscal  
            impacts of this bill by increasing health coverage generally  
            and mental health and substance abuse treatment parity  
            specifically. The federal law requires mental health and  
            substance abuse treatment to be covered as a basic benefit in  
            state-run health insurance exchanges that will provide health  
            coverage to millions of individuals. 

           COMMENTS  

           1)Rationale  . This bill is supported by a range of mental health  
            and substance abuse treatment stakeholders. This bill  








                                                                  AB 1600
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            increases mental health parity in California and increases  
            access to substance abuse services. Supporters indicate that,  
            although these benefits increase costs initially, substantial  
            savings are likely to accrue to the extent hospitalizations,  
            homelessness, and incarcerations are reduced. According to  
            CHBRP estimates, more than five million Californians will be  
            provided full parity with respect to mental health treatment  
            as a result of this bill and more than seven million  
            individuals will gain access to full parity for substance  
            abuse treatment services.

           2)Mental Health Parity  . Under current law, California has had  
            partial mental health parity for specified conditions since AB  
            88 (Thompson), Chapter 524, Statutes of 1999. AB 88 requires  
            treatment parity for "serious mental illness" (SMI) such as  
            schizophrenia, autism, and anorexia nervosa. Under current  
            law, less serious mental health issues are subject to  
            utilization controls such as annual caps on number of visits  
            and patient co-payments that exceed co-payments for other  
            medical treatment.  AB 1600 expands parity to other mental  
            illnesses specified in the Diagnostic and Statistical Manual  
            of Mental Disorders (DSM)-IV to include less serious mental  
            illness such as low-grade depression and anxiety. 

          Recent changes to federal law in this area have had impacts on  
            coverage in California. The Mental Health Parity and Addiction  
            Equity Act of 2008 went into effect on January 1, 2010 and  
            requires group health plans with more than 50 employees that  
            offer both medical and mental health benefits to ensure that  
            the mental health and substance abuse benefits are no more  
            restrictive than the medical and surgical benefits.
           
          3)Industry Cost Concerns  . Opponents of this bill contend  
            legislatively mandated health benefits increase costs and  
            limit insurer, employer, and individual choices with respect  
            to a variety of health benefits. Insurers indicate this bill  
            limits individual, employer, and employee choices with respect  
            to health care expenditures. When considered together,  
            mandates may also hinder the ability of insurers and employers  
            to offer a wide range of affordable products to consumers with  
            a variety of health care needs.  The specific opposition to  
            this bill may subside due to the federal mandate for parity  
            across a broad portion of the private health insurance market.  

           








                                                                 AB 1600
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          4)Related Legislation  . There are more than two dozen current law  
            health mandates, established over the last two decades, to  
            provide coverage for specified services such as cancer  
            screenings and treatment. There are another handful of  
            mandates to offer coverage for a number of other health  
            services. 

          AB 244 (Beall) in 2009, AB 1887 (Beall) in 2008, and AB 423  
            (Beall) in 2007 were similar to this bill. Each bill was  
            vetoed due to concerns about the costs of health mandates.  

          5)Other Health Mandates in the Current Session  . There are nine  
            health mandates under legislative consideration this year,  
            including AB 1600. Other proposed health mandates include: 

             a)   AB 1825 (De La Torre): maternity services 
             b)   AB 1826 (Huffman): pain prescriptions
             c)   AB 1904 (Villines): out-of-state carriers
             d)   AB 2587 (Berryhill): benefit mandates
             e)   SB 220 (Yee): tobacco cessation services
             f)   SB 890 (Alquist): basic health treatment services
             g)   SB 961 (Wright): cancer treatment
             h)   SB 1104: diabetes related treatment




           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081