BILL ANALYSIS �
SB 1182
Page 1
SENATE THIRD READING
SB 1182 (Leno)
As Amended August 22, 2014
Majority vote
SENATE VOTE :21-12
HEALTH 13-6 APPROPRIATIONS 12-5
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|Ayes:|Pan, Ammiano, Bonilla, |Ayes:|Gatto, Bocanegra, |
| |Bonta, Chesbro, Gomez, | |Bradford, |
| |Gonzalez, | |Ian Calderon, Campos, |
| |Roger Hern�ndez, | |Eggman, Gomez, Holden, |
| |Lowenthal, Nazarian, | |Pan, Quirk, |
| |Ridley-Thomas, Rodriguez, | |Ridley-Thomas, Weber |
| |Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Maienschein, Ch�vez, |Nays:|Bigelow, Donnelly, Jones, |
| |Mansoor, Waldron, | |Linder, Wagner |
| |Patterson, Wagner | | |
| | | | |
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SUMMARY : Requires health plans and insurers to share specified
data with purchasers that have 1,000 or more enrollees or that
are multiemployer trusts. Specifically, this bill :
1)Requires a health plan or insurer annually to provide
deidentified claims data at no charge to a large group
purchaser upon request, if the purchaser is able to
demonstrate its ability to comply with state and federal
privacy laws and is either an employer with enrollment of
greater than 1,000 covered lives or a multiemployer trust.
2)Requires health plans and insurers to obtain a determination
by a qualified statistician that the claims data do not
provide a reasonable basis from which to identify an
individual. Provides that data that a statistician is unable
to determine has been deidentified shall not be shared under
this bill. Allows a health plan to provide the claims data in
an aggregated form as necessary to comply state and federal
privacy laws.
3)Makes the information shared not subject to public
SB 1182
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availability, as specified. Deems data shared under this bill
confidential information that shall not be shared by state
regulators and is exempt from disclosure under the California
Public Records Act.
4)As an alternative to providing claims data under 1) above,
requires a health plan or insurer to provide: deidentified
aggregated data sufficient for the purchaser to compare costs
of similar services from other health plans or insurers; and
deidentified aggregated patient level data that includes
demographics and encounter data, including data used to
experience rate the group, as specified. Requires the health
plan or insurer, for purposes of this requirement, to obtain a
formal determination, in writing, from a qualified
statistician that the shared data do not provide a reasonable
basis from which to identify an individual.
FISCAL EFFECT : Unknown. This bill, as amended, has not been
analyzed by a fiscal committee.
COMMENTS : The author writes the rising cost of health care is a
major concern for employers in California, and the lack of
transparency in pricing for the large group market has
contributed to uncontrolled cost increases for large employers
and union trusts. This bill is intended to bring transparency
to this market for purchasers in an effort to control costs.
According to the Medical Expenditure Panel Survey (MEPS), a
survey of employers conducted by the United States Census Bureau
that collects information on employer-sponsored health
insurance, premiums for employer-based coverage have increased
significantly over the past decade. MEPS data from 2012 show
the average annual premium for individual private sector
employer coverage in California is $5,422, an 85% increase since
2002. For family coverage, the average premium was $15,898, a
90% increase since 2002. For comparison, prices for goods and
services increased 27.6% during this period, according to the
Bureau of Labor Statistics' Consumer Price Index.
The California Labor Federation (Labor Fed), a co-sponsor of
this bill, writes that rising health care costs are taking a
toll on employers, workers, and union trust funds. The Labor
Fed argues every dollar that large purchasers have to put toward
health coverage is a dollar that comes out of workers' pockets,
with employers increasingly shifting costs to workers by
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increasing cost sharing and the use of high-deductible plans.
The Labor Fed argues that this bill's requirement for health
plans to disclose claims data to large purchasers will help
those purchasers understand health care cost drivers, institute
cost savings programs, and bargain effectively with health
plans. The California Teachers Association, in support, argues
the data provided under this bill will be an essential tool in
the bargaining process, one that has the potential to free up
funds for use in the classroom.
Kaiser Permanente, in opposition to a prior version of this
bill, argues that it currently provides very robust information
to its large group purchasers, and suggests this bill
inappropriately inserts the Legislature into private and
voluntary contractual discussions between plans and purchasers.
The California Association of Health Underwriters (CAHU), also
in opposition to a prior version, argues that health plans
currently go to great lengths to provide as much information as
possible to all size group purchasers to help them evaluate
coverage options for their workers in the highly competitive
group market. CAHU argues that this bill's data sharing
requirements are not necessary and that, by creating new
administrative costs, this bill has the potential to raise
premium costs.
Analysis Prepared by : Ben Russell / HEALTH / (916) 319-2097
FN: 0005298