Legislative Legerdemain: Part 1: Maternity
Usually when we think of last minute legislative action, we worry that some highly-paid industry lobbyists has managed to slip something in at the last minute that is bad for consumers. Still, every once in a while, our team manages to uses the rules to do some good things for consumers. This is one of those years.
As we reported earlier, both SB155 (Evans) and AB185 (R. Hernandez) had failed in the Assembly Appropriations committee: AB185 back in May when the suspense files were taken up in the first house and SB155 (Evans) only a few weeks ago when the second house suspense files were taken up. Both bills would have required maternity coverage as a basic benefit in health insurance, reversing the trend to the elimination of maternity coverage in individual health insurance. Today only 12% of individual policies cover maternity: five short years ago, it was over 80%.
SB155 and AB185 were stalled, but the effort to mandate maternity coverage lives on: on Friday, the Senate passed AB210 (R. Hernandez) on a 25-19 vote which would require maternity coverage in group health insurance where more and more very small businesses (under 15 employees) are also dropping maternity coverage. Also on Friday, the Assembly, with 49 votes, adopted amendments to SB222 (Evans/Alquist) to require maternity coverage in individual health insurance policies. We hope and expect both bills should pass to the Governor sometime this week: we will keep you updated.
How did this happen? It took a lot of hard work and a considerable willingness on the part of many legislators and their staff to put women and health care first and politics second—and then to use the rules of the legislative process to assure that maternity coverage happened this year. It was also helped by having the support not only of consumer groups but also medical groups and two major insurers, Kaiser Permanente and Blue Shield of California—and the fact that no insurer or trade association of insurers opposes this version. Even insurers that had previously opposed this mandate saw this would be part of the minimum essential benefits package in 2014 under federal health reform; what these bills do is get this benefit to Californians 18 months earlier, and allowing for a smoother transition to the federal rules, giving the industry time to adjust.
Now it is up to Governor Brown to protect women and their families from the lack of timely prenatal care. The Department of Managed Health Care already requires maternity coverage for all products, but it would level the playing field with those plans regulated under the Insurance Code, for the benefit of consumers, insurers, and regulators. Governor Brown can also send a clear signal that California will continue in the effort to implement and improve upon the federal health law.