BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           2345 (De La Torre)
          
          Hearing Date:  8/2/2010         Amended: 7/15/2010
          Consultant: Katie Johnson       Policy Vote: Health 6-2
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  AB 2345 would prohibit health care service plans  
          and health insurers from imposing cost-sharing requirements,  
          such as copayments and coinsurance, on specified preventive  
          services as stated in the Patient Protection and Affordable Care  
          Act (ACA) for group and individual contracts and policies  
          issued, amended, renewed, or delivered on or after September 23,  
          2010.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          Healthy Families                $425              $850  
          $850General/*
          increased premiums                                Federal

          CalPERS increased premiums      $390              $780  
          $780General/**
                                                                 Special

          *65 percent federal funds; 35 percent General Fund
          **55 percent General Fund; 45 percent special and other funds
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          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.
          
          Subject to the minimum interval established by the federal  
          Department of Health and Human Services (HHS), this bill would  
          prohibit health care service plans and health insurers from  
          imposing cost-sharing requirements, such as copayments and  
          coinsurance, on specified preventive services as stated in the  
          ACA for group and individual contracts and policies issued,  
          amended, renewed, or delivered on or after September 23, 2010.











          Those preventive services include, at a minimum, immunizations,  
          preventive care and screenings, and breast cancer screening,  
          mammography, and prevention.

          To the extent that health plans and insurers that contract with  
          the Managed Risk Medical Insurance Board (MRMIB) and the  
          California Public Employees Retirement System (CalPERS) do not  
          currently fully comply with these requirements, there could be  
          cost pressure to increase rates.

          If MRMIB and CalPERS had to pay $1 annually more in premiums for  
          each of their respective 800,000 to 900,000 subscribers and  
          778,934 state employees and their dependents, costs would be  
          approximately $800,000 - $900,000 total funds for the Healthy  
          Families Program, Major Risk Medical Insurance Program (MRMIP),  
          and the 

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          AB 2345 (De La Torre)

          Access for Infants and Mothers Program (AIM), and $778,934 total  
          funds annually for CalPERS.

          Healthy Families costs are shared approximately 65 percent  
          federal funds and 35 percent General Fund as well as subscriber  
          premiums; MRMIP's costs are about 40 percent state tobacco tax  
          revenue and 60 percent subscriber premiums; AIM costs are shared  
          approximately 65 percent federal funds and 35 percent state  
          tobacco tax revenue. CalPERS costs are shared approximately 55  
          percent General Fund and 45 percent special and other funds as  
          well as some subscriber premiums.

          While the provisions of this bill are required by the federal  
          ACA, by placing these requirements in state statute, there would  
          be costs to these programs to maintain these provisions if  
          federal law were to be amended or repealed.