BILL ANALYSIS
AB 1825
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Date of Hearing: May 5, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1825 (De La Torre) - As Introduced: February 11, 2010
Policy Committee: Health Vote:12-6
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill requires policies in the individual and group health
insurance markets to provide coverage for maternity services.
This bill creates a mandate on insurers and not health plans, as
maternity benefits are already mandated for health plans. This
bill requires maternity services to include:
1)prenatal care
2)ambulatory care
3)care for pregnancy complications
4)neonatal care
5)inpatient hospital maternity care
6)postpartum care
FISCAL EFFECT
1)According to the California Health Benefits Review Program
(CHBRP), no direct state fiscal impact for publicly supported
health coverage provided through Medi-Cal, CalPERS, or Healthy
Families).
2) Increased premium costs in the
individual insurance market of $120 million. Increased premium
costs are largely offset by a reduction in out-of-pocket costs
for women who would otherwise pay for a variety of services
not covered by insurance in the absence of this mandate.
COMMENTS
1)Purpose . This bill is co-sponsored by the American Congress
of Obstetricians and Gynecologists (ACOG), California Chapter
and the California Commission on the Status of Women to
AB 1825
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address a coverage inequity with regard to maternity care.
Health plans regulated by DMHC are required by state law, and
most employers with group health products regulated by CDI,
are required under federal anti-discrimination laws to cover
maternity services. Health insurers in the individual market
do not have a parallel requirement. As a result, several
products in the individual market fail to provide a variety of
maternity-related coverage. This bill establishes a
requirement in this market. Providing equity with respect to
maternity coverage provides women and families in the
individual health market greater protection financially as
well as better health outcomes for new mothers and their
children.
2)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 98 (De La Torre) in 2009 and AB 1962 (De La Torre) in 2008
were similar to this bill. Each bill was vetoed due to
affordability concerns with regard to health coverage and the
premium pressures created by this and other health mandates.
3)Other Mandates in the Current Session . There are nine health
mandates that were introduced this year, including AB 1825.
Other mandates in the current session include:
a) AB 1600 (Beall): mental health parity
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 (Cedillo): diabetes related treatment
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081