BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 757 (Lieu)
          As Amended August 22, 2011
          Majority vote

           SENATE VOTE  :25-13  
           
           HEALTH              13-5        JUDICIARY           6-3         
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Feuer, Atkins, Dickinson, |
          |     |Bonilla, Eng, Gordon,     |     |Huber, Monning,           |
          |     |Hayashi,                  |     |Wieckowski                |
          |     |Roger Hern�ndez, Bonnie   |     |                          |
          |     |Lowenthal, Mitchell, Pan, |     |                          |
          |     |V. Manuel P�rez, Williams |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor,  |Nays:|Wagner, Beth Gaines,      |
          |     |Nestande, Silva           |     |Jones                     |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      12-5                                        
           
           -------------------------------- 
          |Ayes:|Fuentes, Blumenfield,     |
          |     |Bradford, Charles         |
          |     |Calderon, Campos, Davis,  |
          |     |Gatto, Hall, Hill, Lara,  |
          |     |Mitchell, Solorio         |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Harkey, Donnelly,         |
          |     |Nielsen, Norby, Wagner    |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Requires every group health care service plan (health 
          plan) contract and every policy or certificate of group health 
          insurance marketed, issued, or delivered to a resident of this 
          state, regardless of the situs of the contract to comply with 
          existing law that provides for equal coverage for registered 
          domestic partners.  Additionally, this bill prohibits such 
          contracts, policies, or certificates of an employee, subscriber, 
          insured, or policyholder from discriminating in coverage between 








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          different sex and same sex spouses and domestic partners and 
          states that the prohibitions and requirements imposed by this 
          bill are in addition to any other prohibitions and requirements 
          imposed by existing law.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee:

          1)Potential minor, absorbable costs to the Department of Managed 
            Health Care and California Department Insurance related to 
            ensuring carrier compliance with the provisions of this bill 
            that states that policies and plan contracts may not 
            discriminate on the basis of the sex of spouses or domestic 
            partners.  

          2)As it is unclear how the provisions of this bill that apply to 
            out-of-state carriers can be enforced by state regulators, 
            there is no anticipated direct state fiscal impact for 
            enforcement.  

           COMMENTS  :  According to the author, California has established 
          strong laws prohibiting discrimination in the issuance of 
          insurance policies in the state.  Existing law requires 
          California-based insurers to provide the same coverage to 
          domestic partners that they provide to spouses.  
          California-based insurers must comply with California's 
          antidiscrimination laws.  However, some out-of-state insurance 
          companies are attempting to evade complying with the California 
          law that prohibits the sale or issuance of discriminatory 
          insurance policies.  Some out-of-state insurance companies are 
          refusing to insure domestic partners of gay and lesbian 
          Californians, despite clear intent of the California Legislature 
          to prohibit the sale of any such discriminatory policy in 
          California.  Multi-state companies that do business in 
          California often contract with out-of-state insurance companies 
          to provide coverage for their employees.  Because some of these 
          out-of-state insurance companies believe there is a loophole in 
          the law, they are discriminating against employees who live in 
          California and who are in a domestic partnership by refusing to 
          provide equal coverage to domestic partners.  Because of this 
          practice, California-based insurance companies are at a 
          disadvantage in the marketplace because of the price savings 
          available to out-of-state companies that sell discriminatory 
          policies. 








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          This bill is sponsored by Equality California who writes the 
          goal of this bill is to ensure that out-of-state insurers 
          selling insurance in California abide by the same 
          nondiscrimination laws as California insurers.  According to the 
          California Association of Marriage and Family Therapists 
          (CAMFT), the California Insurance Equality Act (Act) was passed 
          in 2004 requiring group health care plans and insurers to 
          provide equal coverage to registered domestic partners.  CAMFT 
          provides a quote from then Insurance Commissioner John Garamendi 
          that the Act established a necessary and consistent standard of 
          non-discrimination in insurance in conformance with AB 205 
          (Goldberg), Chapter 421, Statutes of 2003, by ensuring that 
          insurance companies treat domestic partners in the same manner 
          as spouses in the purchase of insurance. While existing law 
          requires same coverage to registered domestic partners as that 
          of spouses, some out-of-state carriers do not comply and refuse 
          to insure the registered domestic partner of California 
          residents.

          AB 119 (Jones), Chapter 365, Statutes of 2009, prohibits health 
          plans and health insurers from charging a premium, price, or 
          charge differential for health care coverage because of the sex 
          of the prospective subscriber, enrollee, policyholder, or 
          insured.  AB 1586, (Koretz), Chapter 421, Statutes of 2005, 
          defines the term "sex," in existing law that prohibits health 
          plans and insurers from specified discriminatory acts, to have 
          the same meaning as "gender," as defined under the Penal Code, 
          as specified.  AB 2204 (Kehoe), Chapter 488, Statutes of 2004, 
          enacts the Act which requires group health plans, health 
          insurance, and all forms of insurance to provide equal coverage 
          to registered domestic partners.  AB 205 (Goldberg) seeks to 
          extend most of the rights and responsibilities available to 
          spouses solely available under state law to registered domestic 
          partners.


           Analysis Prepared by  :    Teri Boughton / HEALTH / (916) 319-2097 



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