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Law Would Mandate Maternity Coverage

The Senate Health Committee approved AB 1825 by Assembly member Hector De La Torre (D-South Gate) on Wednesday, which would force health insurance groups and plans to cover maternity services for women in California.

“It is similar to AB 98, which was vetoed by the governor last year,” Senate member Gloria Negrete McLeod (D-Chino) said. “It is four years till the (national health care) health exchange will open. Already we’ve seen a drop in coverage since 2007 from 22% to 19% coverage … and four more years will push many more women out of coverage.”

Maternity coverage particularly needs to be covered, Negrete McLeod said, because in many cases women don’t plan to become pregnant, and then find themselves scrambling to change their coverage to accommodate their now-preexisting condition.

Sherrie Lowenstein, a lawyer for the state’s Department of Managed Care, spoke against the bill, saying that California needs to wait four years, until federal guidelines on health care reform come out, so that the state doesn’t end up on the hook in some way for its health care mandates.

“We can reconsider at that time,” Lowenstein said. “There are provisions in the bill that essentially require the state of California to pick up any additional cost in premiums beyond what the essential benefits are.” That could be a problem, she said, if the federal guidelines “don’t ultimately define what essential benefits are.”

Shannon Smith-Crowley of the American College of Obstetricians and Gynecologists disagreed. “We can’t afford to wait another four years,” she said. “While most women get coverage by the end of their pregnancy, it’s the beginning of the pregnancy that’s especially important.”

And support for the bill came from an unexpected source: Manolo Platine, a representative of Blue Shield of California.  “Blue Shield typically doesn’t support benefit mandates,” Platine said, “but we are supporting this one, because we believe maternity services are unique.”

It’s fundamental care, so it doesn’t make sense to allow some plans to decline maternity care on individual coverage, Platine said. “This practice undermines the basic concept of insurance,” he said, “which is to spread the risk for fundamental insurance needs across the largest population possible.”

 

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