Bill Text: CA AB513 | 2009-2010 | Regular Session | Amended

California Assembly Bill 513 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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-Amended.html

BILL NUMBER: AB 513	AMENDED
	BILL TEXT

	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   ) 

                        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, as amended, 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  a   specified 
health care service  plan   plans  and
 a  health  insurer   insurers
 to include coverage for lactation consultation and for the
rental of breast pumps 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.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


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 coverage for the rental of breast pumps.
  SEC. 2.  Section 1367.625 is added to the Health and Safety Code,
to read:
   1367.625.   (a)    Every health care service
plan contract, except a specialized 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 for the rental of
breast pumps. 
   (b) Nothing in this section shall be construed to mean that a
health care service plan is not required to provide breast-feeding
support benefits, including, but not limited to, lactation
consultation and breast pumps, to women and children enrolled in any
of the following:  
   (1) The Medi-Cal, Healthy Families, or Access to Infants and
Mothers programs when the health care service plan participates in,
or has a contract with, any of those programs.  
   (2) Private health care coverage where breast-feeding support
benefits are included as part of maternity or other benefits provided
by a health care service plan pursuant to a contract in effect
before January 1, 2010.  
   (c) This section shall not apply to specialized health care
service plans, Medicare supplement, short-term limited duration
health insurance, CHAMPUS-supplement insurance, TRI-CARE supplement,
or to 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 for the rental of
breast pumps. 
   (b) Nothing in this section shall be construed to mean that the
Medi-Cal fee-for-service program or a private insurer is not required
to provide breast-feeding support benefits, including, but not
limited to, lactation consultation and breast pumps, to women and
children enrolled in any of the following:  
   (1) Medi-Cal fee-for-service.  
   (2) Private health insurance where breast-feeding support benefits
are included as part of maternity or other benefits provided by the
insurer pursuant to a policy in effect before January 1, 2010. 

   (c) This section shall not apply to specialized health insurance,
Medicare supplement, short-term limited duration health insurance,
CHAMPUS-supplement insurance, TRI-CARE supplement, or to hospital
indemnity, accident-only, or specified disease insurance. 
  SEC. 4.  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.