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Appropriations Committee OKs Oral Chemo Bill

The Senate Committee on Appropriations yesterday approved AB 1000 by Henry Perea (D-Fresno), which requires insurers to cover oral chemotherapy medication.

“It’s a big day for cancer patients in California,” Assembly member Perea said. “We’ve been working on this since the beginning of last year, and it’s been a hard fight, the insurance companies have come out firing at it.”

Overall, it was a busy day for the Appropriations committee and the Legislature, which returned from summer recess yesterday. The current session only lasts for the next few weeks, before going on final recess — so the legislative docket will be full this month. The Legislature has until Aug. 31 to pass all bills for the year.

The oral chemotherapy bill, after being approved on a 4-1 vote in committee, now heads to the Senate floor for a vote.

The biggest question about AB 1000 has not come directly from insurance companies, but from the state’s Department of Finance, which has been concerned about the potential cost to California if oral chemotherapy is not included in the essential health benefits package, a concept that is a central underpinning of the health benefit exchange.

“We took care of that with one of the amendments to this bill,” Perea said. “This bill doesn’t require any benefits that exceed the essential health benefit plan. If it’s not covered, then the state’s not on the hook for it.”

That means the future of oral chemotherapy coverage in California rests in large part on two pieces of related legislation going through the Assembly and Senate now — two bills that establish what exactly will be counted as  essential health benefits.

Since those benefits include prescription coverage, it is possible that oral chemotherapy medication could be included as a required prescription medication, Perea said.

“We’re still doing the research on what’s in the two bills, and what they’re willing to cover,” Perea said. “That’s where a lot of discussion is going.”

A similar oral chemotherapy bill to AB 1000 has passed the Legislature twice before, and both times was vetoed by Republican Gov. Arnold Schwarzenegger. Perea hopes the third time is the charm.

“We’ve had bipartisan support in both chambers,” he said. “We’re excited about its possibilities.”

The two essential health benefit bills are AB 1453 (Bill Monning, D-Carmel) and SB 951 (Ed Hernandez, D-West Covina). They are both currently in Appropriations.

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