Lawmakers to Consider Mandating Coverage for Acupuncture, Infertility, Among Other Services

The Senate insurance committee and the Assembly health committee today will consider several of the more than two dozen penidng bills that would require health insurers to cover additional services, the San Francisco Chronicle reports. Many of the bills are considered a "follow-up" to the state's 1999 patients' rights law, which established a "series of sweeping reforms" for consumers, including the right to sue managed care companies and the creation of the Department of Managed Health Care. The current collection of bills focuses on mandatory coverage, seeking to require insurers to cover "everything from wigs for cancer patients to acupuncture and infertility treatments," the Chronicle reports. AB 1826, for instance, sponsored by Assembly member Carole Migden (D-San Francisco), would require health plans to cover "all medically accepted forms" of infertility treatment or diagnosis, including in vitro fertilization. Another bill (AB 1996), written by Assembly member Helen Thomson (D-Davis), would require health plans to cover "all medically necessary drugs."

Critics of the proposals say they would drive up health costs and leave more Californians uninsured. The California Association of Health Plans estimates that 12 of the proposals could cost employers and consumers nearly $3 billion, a figure equal to a premium increase of $174 per insured person per year. Walter Zelman, the group's president, said, "We don't deny for a moment some of these mandates will have real value for some consumers, but we think we're facing a true crisis in affordability in California." The health plan association is urging legislators to consider a one-year moratorium on new health mandates. But Beth Capell, a lobbyist for Health Access of California, a coalition of community and labor groups, called the insurance industry's objections "scare tactics," saying, "The plans will claim these increases in costs will cost people health insurance coverage and cost people jobs. It's just not true." DMHC head Daniel Zingale said that the department is currently reviewing the proposals to determine whether they will support them. "It's wise to look at all of these proposals through the reality of today's rising health care costs," he said (Colliver, San Francisco Chronicle, 4/16).