Bill Text: CA AB513 | 2009-2010 | Regular Session | Enrolled
Bill Title: Health care coverage: breast-feeding.
Spectrum: Partisan Bill (Democrat 15-0)
Status: (Vetoed) 2010-01-14 - Consideration of Governor's veto stricken from file. [AB513 Detail]
Download: California-2009-AB513-Enrolled.html
BILL NUMBER: AB 513 ENROLLED
BILL TEXT
PASSED THE SENATE SEPTEMBER 3, 2009
PASSED THE ASSEMBLY SEPTEMBER 9, 2009
AMENDED IN SENATE SEPTEMBER 1, 2009
AMENDED IN SENATE JULY 23, 2009
AMENDED IN ASSEMBLY MAY 5, 2009
INTRODUCED BY Assembly Member De Leon
(Coauthors: Assembly Members Brownley, Buchanan, Carter, Evans,
Fuentes, Furutani, Lieu, Bonnie Lowenthal, Ma, Salas, and Skinner)
(Coauthors: Senators Alquist, Leno, and Pavley)
FEBRUARY 24, 2009
An act to add Section 1367.625 to the Health and Safety Code, and
to add Section 10123.875 to the Insurance Code, relating to health
care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 513, De Leon. Health care coverage: breast-feeding.
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 that act a crime. Existing law also
provides for the regulation of health insurers by the Department of
Insurance. Under existing law, health care service plans and health
insurers are required to offer specified types of coverage as part of
their health care service plan contracts or health insurance
policies. Existing law imposes specified requirements upon a health
care service plan contract or health insurance policy that provides
maternity coverage.
This bill would require specified health care service plans and
health insurers to include coverage for lactation consultation and
the provision or rental of specified types of breast pumps, as
defined, as part of their health care service plan contracts or
health insurance policies that provide maternity coverage.
Because this bill would specify additional requirements under the
Knox-Keene Act, the willful violation of which would be a crime, it
would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares the following:
(a) Breast-feeding significantly reduces children's risk for
chronic diseases, such as diabetes, asthma, allergies, and infections
in the gastrointestinal, urinary, and respiratory tracts. Breast-fed
children have fewer visits to the doctor's office, fewer days of
hospitalization, and take fewer medications than children who were
formula-fed. Research provides strong evidence that breast-feeding
decreases the incidence or severity of diarrhea, lower respiratory
infection, otitis media, bacteremia, bacterial meningitis, botulism,
and necrotizing enterocolitis. There are a number of studies that
show a possible protective effect of exclusive breast-feeding against
sudden infant death syndrome (SIDS), insulin-dependent diabetes
mellitus, Crohn's disease, ulcerative colitis, lymphoma, allergic
diseases, and other chronic digestive diseases. Breast-feeding has
also been related to possible enhancement of cognitive development
and a decreased chance of obesity in childhood and adulthood. Studies
show that breast-feeding also reduces the mother's risk for type 2
diabetes and breast and ovarian cancers.
(b) All major health organizations recommend that babies get no
other food or drink besides breast milk for the first six months of
their life, with continued breast-feeding for at least the first one
to two years of life, as long as it is mutually desired. Exclusive
breast-feeding for three months has been shown to reduce health care
costs for infants in the first year of life alone by up to four
hundred seventy-five dollars ($475), compared to nonbreast-fed
infants.
(c) Lactation consultation provided by an international board
certified lactation consultant (IBCLC) has been shown to help women
address the difficulties with breast-feeding and can assist with the
initiation and continuance of breast-feeding.
(d) Therefore, it is essential to clarify that all health coverage
made available to California consumers that provides maternity
coverage, whether issued by health care service plans regulated by
the Department of Managed Health Care or by health insurers regulated
by the Department of Insurance, shall include coverage for lactation
consultation by an international board certified lactation
consultant (IBCLC) and the provision of a personal electric or
personal manual breast pump or coverage for the rental of a hospital
grade electric breast pump.
SEC. 2. Section 1367.625 is added to the Health and Safety Code,
to read:
1367.625. (a) Every health care service plan contract that
provides maternity coverage, and that is issued, amended, renewed, or
delivered on or after January 1, 2010, shall provide coverage for
lactation consultation with an international board certified
lactation consultant (IBCLC) and the provision of a personal electric
or personal manual breast pump or coverage for the rental of a
hospital grade electric breast pump.
(b) For the purposes of this section, "breast pump" means an
FDA-approved reusable breast pump that is considered to be durable
medical equipment, and meets state or federal quality standards for
durable medical equipment.
(c) This section shall not apply to any of the following:
(1) Specialized health care service plans.
(2) Medicare supplement plans.
(3) Short-term limited duration health insurance, except when
specifically for coverage during pregnancy or a postpartum period or
both.
(4) CHAMPUS-supplement plans.
(5) TRI-CARE supplement plans.
(6) Hospital indemnity, accident-only, or specified disease plans.
SEC. 3. Section 10123.875 is added to the Insurance Code, to read:
10123.875. (a) Every policy of health insurance that provides
maternity coverage, and that is issued, amended, renewed, or
delivered on or after January 1, 2010, shall provide coverage for
lactation consultation with an international board certified
lactation consultant (IBCLC) and the provision of a personal electric
or personal manual breast pump or coverage for the rental of a
hospital grade electric breast pump.
(b) For the purposes of this section, "breast pump" means an
FDA-approved reusable breast pump that is considered to be durable
medical equipment, and meets state or federal quality standards for
durable medical equipment.
(c) This section shall not apply to any of the following:
(1) Specialized health insurance.
(2) Medicare supplement insurance.
(3) Short-term limited duration health insurance, except when
specifically for coverage during pregnancy or a postpartum period or
both.
(4) CHAMPUS-supplement insurance.
(5) TRI-CARE supplement insurance.
(6) Hospital indemnity, accident-only, or specified disease
insurance.
SEC. 4. Section 1367.625 of the Health and Safety Code and Section
10123.875 of the Insurance Code, as added by this act, shall not be
construed to affect any other requirement to provide breast pumps or
lactation consultation in the Medi-Cal, Healthy Families, or Access
for Infants and Mothers programs.
SEC. 5. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
