BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
2345 (De La Torre)
Hearing Date: 8/12/2010 Amended: 7/15/2010
Consultant: Katie Johnson Policy Vote: Health 6-2
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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.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Healthy Families unknown costs annually to the
extent General/*
increased premiums federal law were to no longer
requireFederal
these provisions
CalPERS increased premiums unknown costs annually to the
extent General/**
federal law were to no longer
requireSpecial
fhese provisions
*65 percent federal funds; 35 percent General Fund
**55 percent General Fund; 45 percent special and other funds
***See staff comments.
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STAFF COMMENTS: SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
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
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AB 2345 (De La Torre)
dependents, costs would be approximately $800,000 - $900,000
total funds for the Healthy Families Program, Major Risk Medical
Insurance Program (MRMIP), and the Access for Infants and
Mothers Program (AIM), and $778,934 total funds annually for
CalPERS.
While the provisions of this bill are required by the federal
ACA, by placing these requirements in state statute, there would
be costs in the annualized amounts above to these programs to
maintain these provisions if federal law were to be amended or
repealed.
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.
The author's proposed amendments would delete the contents of
the bill and would recast the provisions to specifically
reference 42 USC 300gg-13 of the Public Health Service Act, as
added by Section 1001 of the Patient Protection and Affordable
Care Act (Public Law 111-148).
These provisions of the ACA would require the provision of and
prohibit cost-sharing for specified preventive services.