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Senate OKs Oral Chemotherapy Mandate

Health insurers will need to cover oral chemotherapy medication if a bill passed Monday by the Senate is signed by the governor.

Today, the Assembly is expected to concur on AB 1000 by Henry Perea (D-Fresno), a decision that would send the bill to the governor’s desk for a signature.

The mandate on oral chemotherapy coverage would not necessarily apply to coverage within the Health benefits for the exchange, but said he has not yet had conversations with the Benefit Exchange. Bill author Perea said he’s talking with legislators about the possibility of including oral chemotherapy medication among the essential health exchange staff.

“No, primarily we’re working with legislators on the bill, and now with the governor,” Perea said. “It would still apply to private health insurers, and I believe it will ultimately be complemented by the health exchange board.”

A similar bill was passed twice before and vetoed both times by Republican Gov. Arnold Schwarzenegger. Perea is hoping for a different outcome with Gov. Jerry Brown, a Democrat.

Perea said Monday’s Senate vote was the culmination of two years of intensive lobbying and education work.

“It felt great knowing after two years of hard work we’re almost to the finish line,” Perea said. “This is important for these patients, not only for their access to treatment, but also for their ability to afford it.”

Senate member Roderick Wright (D-Inglewood), who introduced the bill to the Senate floor Monday, said he was very familiar with it since he’s the one who carried a similar bill twice before.

“In the world of cancer treatment, there are IV [intravenous] treatments and oral treatments, and many of the newer treatments are oral,” Wright said.

“Most insurance plans will pay for IV treatment, but they refuse to pay for the oral treatment.”

That can be costly and time-intensive, he said, because it requires people to be in the hospital setting. “But the cost of this [bill] is minimal,” he said, because it spreads the cost and risk out over a broad pool of people.

“The question is,” Wright said, “do we move our treatment into the 21st century? If this was experimental, it would not be included. But this is standard coverage.”

The bill passed the Senate on a 29-9-2 vote. The Senate and Assembly both approved the bill, but it still needs to go before the Assembly again today for concurrence before it can go to the governor’s office. The governor has until Sept. 30 to approve or veto all of this year’s legislation.

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