AB 543

This bill expands the definition of a health insurance mandate and requires the

Commissioner of Insurance (commissioner) to submit a report on the social or

financial impact of any bill or amendment containing a health insurance mandate,

or statement explaining the reason for not submitting such a report, before any

public hearing is held or vote is taken on the bill or amendment.

Current law defines a health insurance mandate as a statute that requires an

insurance policy to do any of four things: 1) permit a person to obtain treatment or

services from a particular type of health care provider; 2) provide coverage for the

treatment of a particular disease or condition; 3) provide coverage of a particular type

of health care treatment or service, including particular drugs, supplies, or

equipment; and 4) provide coverage for a particular type of person based on the

person's relationship to the insured. This bill provides that a statute is also a health

insurance mandate if it: 1) requires a particular benefit design under an insurance

policy for the treatment of a particular disease, condition, or other health care need,

for a particular type of health care treatment or service, or for the provision of

equipment, supplies, or drugs used in connection with a health care treatment or

service; or 2) imposes limits or conditions on a contract between an insurer and a

health care provider.

Current law requires that, if any bill contains a health insurance mandate

affecting an insurance policy, plan, or contract, the commissioner must submit to the

presiding officer of the house in which the bill is introduced a report on the social and

financial impact of the mandate. Current law provides that the presiding officer may

require that the report be printed and distributed as are amendments, but current

law does not specify a time by which the report must be submitted.

This bill requires that the commissioner submit a report if any amendment, as

well as any bill, contains a health insurance mandate. The commissioner may,

however, decide not to prepare a report and submit a written statement that explains

the reason for not preparing a report. In that case, the chairperson of a committee

to which the bill has been referred, the presiding officer of either house, or any other

member of the legislature may request that the commissioner submit a report

instead. The report or statement is printed as an appendix to the bill or amendment

and distributed to the members of the legislature, and made available to the public,

before any public hearing is held on the bill or amendment by a committee or before

any vote is taken on the bill or amendment by either house of the legislature.