BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
1104 (Cedillo)
Hearing Date: 5/27/2010 Amended: 4/27/2010
Consultant: Katie Johnson Policy Vote: Health 5-0
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BILL SUMMARY: SB 1104 would require health care service plan
contracts and health insurance policies that are issued,
amended, delivered, or renewed on or after January 1, 2011, and
that cover hospital, medical, or surgical expenses, to provide
coverage for the diagnosis and treatment of diabetes-related
complications.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
CalPERS premiums up to $1,009 ongoing costs
unknown General/*
increase up to $826 ongoing costs
unknownSpecial/
Other
*55 percent General Fund, 45 percent Special Funds and Other
Funds
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STAFF COMMENTS: SUSPENSE FILE.
This bill would require health care service plans and health
insurers, collectively carriers, to provide coverage for the
diagnosis and treatment of diabetes-related complications.
Fiscal impacts on both the Department of Managed Health Care
(DMHC) and the California Department of Insurance (CDI) to
review filings related to changes in products would be minor and
absorbable. Additionally, there would be no fiscal impact on
publicly-funded programs such as Medi-Cal, the Healthy Families
Program (HFP), the Access for Infants and Mothers (AIM) program,
and the Major Risk Medical Insurance Program (MRMIP) because
these services are already covered benefits.
The most recent amendments, which occurred after the California
Health Benefits Review Program (CHBRP) 2010 fiscal analysis was
completed, amended out the provision that would have required
plans and policies that do not include outpatient prescription
drug benefits to provide for the coverage for outpatient
prescriptions prescribed for the treatment of diabetes-related
complications. These amendments decrease CHBRP's estimated
impact on the premiums that employers pay on behalf of their
employees to the California Public Employees Retirement System
(CalPERS) by an unknown amount. In addition to other public
agencies, the state pays premiums on behalf of its employees to
CalPERS. Since this bill would continue to include the provision
of covering durable medical equipment and other treatments for
approximately 88,000 people who currently lack such coverage, it
is likely that increased costs to premiums paid by the state to
CalPERS would continue to be significant, meaning likely more
than $50,000, but less than CHBRP's original estimates of
$1,009,000 General Fund and $826,000 special and other funds
combined.
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SB 1104 (Cedillo)
Additionally, due to estimated premium increases in the
individual market, there would likely be up to 3,000 newly
uninsured people. Again, the recent amendments to this bill
regarding outpatient pharmaceuticals would decrease the impact
on individual market premiums. However, to the extent that
people become uninsured, there would be an unknown cost pressure
on county programs for the uninsured and federal fund allotments
that provide federal matching dollars for county moneys spent on
hospital indigent care.