BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1825
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 1825 (De La Torre)
          As Introduced February 11, 2010
          Majority vote 

           HEALTH              12-6        APPROPRIATIONS      12-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Carter, |Ayes:|Fuentes, Ammiano,         |
          |     |Caballero, Eng, Hayashi,  |     |Bradford, Charles         |
          |     |Hernandez, Jones, Bonnie  |     |Calderon, Coto, Davis,    |
          |     |Lowenthal, Nava,          |     |Monning, Ruskin, Skinner, |
          |     |V. Manuel Perez, Salas    |     |Solorio, Torlakson,       |
          |     |                          |     |Torrico                   |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Fletcher, Conway,         |Nays:|Conway, Harkey, Miller,   |
          |     |Emmerson, Gaines, Smyth,  |     |Nielsen, Norby            |
          |     |Audra Strickland          |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires every individual or group health insurance  
          policy, as specified, to cover maternity services, as defined.   
          Specifically,  this bill  :   

          1)Requires a health insurer with respect to a pending or  
            approved individual or group health insurance policy form on  
            file with the California Department of Insurance (CDI) as of  
            January 1, 2011, to submit to CDI, on or before March 1, 2011,  
            a revised policy form that provides coverage for maternity  
            services.

          2)Requires that the corresponding policy issued, amended, or  
            renewed on or after 30 days following CDI's approval of the  
            revised form to include coverage for maternity services.

          3)Defines "maternity services" to include prenatal care,  
            ambulatory care maternity services, involuntary complications  
            of pregnancy, neonatal care, and inpatient hospital maternity  
            care, including labor and delivery and postpartum care. 

          4)Exempts from the provisions of this bill specialized health  
            insurance, Medicare supplement insurance, short-term limited  
            duration health insurance, Civilian Health and Medical Program  








                                                                  AB 1825
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            of the Uniformed Services (CHAMPUS)-supplement insurance, or  
            TRI-CARE supplemental insurance, or hospital indemnity,  
            accident-only, or specified disease insurance. 

           EXISTING LAW  :

          1)Provides for the regulation of health plans by the Department  
            of Managed Health Care (DMHC) under the Knox-Keene Health Care  
            Service Plan Act of 1975 (Knox-Keene) and for the regulation  
            of health insurers by CDI under the Insurance Code. 

          2)Requires health plans under Knox-Keene to cover a number of  
            basic health care services and permits DMHC to define the  
            scope of the services and to exempt plans from the requirement  
            for good cause. 

          3)Provides, under Knox-Keene, that "basic health care services"  
            include:  a) physician services, including consultation and  
            referral; b) hospital inpatient services and ambulatory care  
            services; c) diagnostic laboratory and diagnostic and  
            therapeutic radiological services; d) home health services; e)  
            preventive health services; f) emergency health care services,  
            including ambulance and ambulance transport services and  
            out-of-area coverage; and, g) hospice care. 

          4)Provides, under Knox-Keene, that health plans must provide all  
            medically necessary basic health care services, including  
            maternity services necessary to prevent serious deterioration  
            of the health of the enrollee or the enrollee's fetus, and  
            preventive health care services, specifically including  
            prenatal care. 

          5)Prohibits health plans and health insurers from issuing  
            contracts and policies that contain a copayment or deductible  
            for inpatient hospital or ambulatory care maternity services  
            that exceed the most common amount charged for the same type  
            of care and services provided for other covered medical  
            conditions. 

          6)Prohibits health plans and health insurers providing maternity  
            benefits for a person covered continuously from conception  
            from attaching any exclusions, reductions, or limitations to  
            coverage for involuntary complications of pregnancy unless  
            those provisions apply to all of the benefits paid by the plan  








                                                                  AB 1825
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            or insurer. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee and the California Health Benefits Review Program,  
          this bill will have the following fiscal impact:

          1)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 :  The author asserts that one of the latest trends in  
          the individual market is for insurers to exclude maternity care  
          from their basic plan benefits to sell cheaper products to  
          target populations.  As more employers are dropping employee  
          health coverage, the author contends that insurance companies  
          are increasingly targeting the young, uninsured population of  
          the market with non-maternity products, even though 25% of these  
          individuals are women of childbearing age.  The author argues  
          that these types of non-maternity products delay and restrict  
          access to prenatal care, which can lead to serious health  
          complications for both the mother and the baby, and force more  
          women into state-funded programs, such as Medi-Cal or Access for  
          Infants and Mothers.  


           Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916)  
          319-2097 


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