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AB-767 Health care coverage: in vitro fertilization.(2019-2020)

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Date Published: 06/06/2019 09:00 PM
AB767:v95#DOCUMENT

Amended  IN  Senate  June 06, 2019
Amended  IN  Assembly  May 16, 2019
Amended  IN  Assembly  April 30, 2019
Amended  IN  Assembly  April 09, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 767


Introduced by Assembly Member Wicks
(Principal coauthors: Assembly Members Burke and Low)
(Principal coauthor: Senator Stern)

February 19, 2019


An act to add and repeal Section 100503.6 of the Government Code, relating to health care coverage.


LEGISLATIVE COUNSEL'S DIGEST


AB 767, as amended, Wicks. Health care coverage: essential health benefits: infertility. in vitro fertilization.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of its provisions a crime. Existing law provides for the regulation of health insurers by the Department of Insurance.

Existing federal law, the Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA.
Existing law requires certain group health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 1990, to offer coverage for the treatment of infertility, except in vitro fertilization, under those terms and conditions as may be agreed upon between the group subscriber or the group policyholder and the health care service plans or the health insurers. Existing law exempts any employer that is a religious organization or health care service plan or health insurer that is a subsidiary of an entity whose owner or corporate member is a religious organization from the requirement to offer coverage for forms of treatment of infertility in a manner inconsistent with the religious organization’s religious and ethical principles, as specified.

This bill would state the intent of the Legislature to consider the inclusion of infertility treatment in the definition of essential health benefits.

This bill would require the Exchange to develop options for the inclusion of in vitro fertilization coverage as part of, or as supplementary to, coverage currently offered through Covered California, in consultation with stakeholders and by considering specified options. The bill would further require the Exchange, on or before July 1, 2020, to report the options to the Legislature and make the report publicly available on its internet website. The bill would repeal these provisions on January 1, 2022.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 100503.6 is added to the Government Code, to read:

100503.6.
 (a) The Exchange, in consultation with stakeholders, shall develop options for the inclusion of in vitro fertilization coverage as part of, or as supplementary to, coverage currently offered through Covered California. The Exchange shall consider options that minimize both of the following:
(1) Impact on premiums.
(2) State fiscal impact.
(b) (1) On or before July 1, 2020, the Exchange shall report to the Legislature on the options developed pursuant to subdivision (a).
(2) The Exchange shall submit the report to the Legislature pursuant to Section 9795 and make the report publicly available on its internet website.
(c) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.

SECTION 1.

It is the intent of the Legislature to consider the inclusion of infertility treatment in the definition of essential health benefits.