California 2015-2016 Regular Session Status: Enacted

SB 43 — Health care coverage: essential health benefits.

Last action — Chaptered by Secretary of State. Chapter 648, Statutes of 2015.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed Assembly
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced December 05, 2014. Enacted.

Prognosis

Likely to advance 72% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 2 sponsors

    1 primary, 1 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 8 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) , enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA requires a health insurance issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined. PPACA requires each state, by January 1, 2014, to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers. PPACA defines a qualified health plan as a plan that, among other requirements, provides an essential health benefits package. Existing state law creates the California Health Benefit Exchange (the Exchange) to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires an individual or small group health care service plan contract or individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2014, to cover essential health benefits, defined to include rehabilitative and habilitative services and the health benefits covered by particular benchmark plans, including a certain plan offered during the first quarter of 2012. Existing law requires habilitative services to be covered under the same terms and conditions applied to rehabilitative services under the plan contract or policy, and defines habilitative services to mean medically necessary health care services and health care devices that assist an individual in partially or fully acquiring or improving skills and functions and that are necessary to address a health condition. Existing law specifies that these provisions do not apply to specified plans, including grandfathered plans. Existing law authorizes the Department of Managed Health Care and the Department of Insurance to adopt emergency regulations implementing these provisions until March 1, 2016. This bill would, for an individual or small group health care service plan contract or an individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2017, prohibit limits on habilitative and rehabilitative services from being combined and would define essential health benefits to include the health benefits covered by particular benchmark plans as of the first quarter of 2014, as specified. The bill, for plan years commencing on or after January 1, 2016, would revise the definition of "habilitative services" to conform to federal regulations. The bill would authorize the Department of Managed Health Care and the Department of Insurance to adopt emergency regulations implementing amendments made to the above-described provisions during the 2015–16 Regular Session of the Legislature until July 1, 2018. Because a willful violation of the bill's requirements by a health care service plan would be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 648, Statutes of 2015.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 4:30 p.m.

  4. Assembly amendments concurred in. (Ayes 40. Noes 0. Page 2421.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 79. Noes 0. Page 2726.) Ordered to the Senate.

  7. Read second time. Ordered to third reading.

  8. From committee: Do pass. (Ayes 17. Noes 0.) (August 27).

  9. August 19 set for first hearing. Placed on APPR. suspense file.

  10. (Corrected August 17)

  11. From committee with author's amendments. Read second time and amended. Re-referred to Com. on APPR.

  12. Read second time and amended. Re-referred to Com. on APPR.

  13. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 17. Noes 1.) (July 14).

  14. July 7 hearing postponed by committee.

  15. Referred to Com. on HEALTH.

  16. In Assembly. Read first time. Held at Desk.

  17. Read third time. Passed. (Ayes 37. Noes 0. Page 1194.) Ordered to the Assembly.

  18. Read second time. Ordered to third reading.

  19. From committee: Do pass. (Ayes 7. Noes 0. Page 1146.) (May 28).

  20. Set for hearing May 28.

  21. May 11 hearing: Placed on APPR. suspense file.

  22. Set for hearing May 11.

  23. From committee: Do pass and re-refer to Com. on APPR. (Ayes 9. Noes 0. Page 859.) (April 29). Re-referred to Com. on APPR.

  24. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

  25. Set for hearing April 29.

  26. Referred to Com. on HEALTH.

  27. Read first time.

  28. From printer. May be acted upon on or after January 7.

  29. Introduced. To Com. on RLS. for assignment. To print.

Sponsors

  • Hernandez · Primary
  • Monning · Cosponsor

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 1 co-sponsors · 120 not signed on · 1 voted No

Sponsors (1)

  • Hernandez

Co-sponsors (1)

  • Monning

Not signed on (120)

120 members have not signed on to this bill.

Show all 120 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Unfinished Business SB43 Hernandez Concurrence

Passed 40 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 37000
Democratic 3000
Total 40000
% of votes cast 100%0%0%0%
How each member voted (40)
Member Party Vote
Anderson — Yea
Hernandez — Yea
Leyva — Yea
Liu — Yea
Moorlach — Yea
Morrell — Yea
Roth — Yea
Fuller — Yea
Cannella — Yea
Galgiani — Yea
Allen — Yea
Glazer — Yea
Mitchell — Yea
De León — Yea
Runner — Yea
Bates — Yea
Block — Yea
Hertzberg — Yea
Hill — Yea
Lara — Yea
Leno — Yea
Mendoza — Yea
Nielsen — Yea
Pan — Yea
Pavley — Yea
Wieckowski — Yea
Wolk — Yea
Hall — Yea
Beall — Yea
Hancock — Yea
Hueso — Yea
Huff — Yea
Monning — Yea
Vidak — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea

Official roll call →

SB 43 Hernandez Senate Third Reading By BONTA

Passed 79 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 70001
Republican 5000
Democratic 4000
Total 79001
% of votes cast 99%0%0%1%
How each member voted (80)
Member Party Vote
Achadjian — Yea
Baker — Yea
Brough — Yea
Brown — Yea
Holden — Yea
Levine — Yea
Maienschein — Yea
Mathis — Yea
Mayes — Yea
O'Donnell — Yea
Quirk — Yea
Rendon — Yea
Waldron — Yea
Eggman — Yea
Cooper — Yea
Frazier — Yea
Gatto — Yea
Gordon — Yea
Harper — Yea
Salas — Yea
Kim — Yea
Linder — Yea
Low — Yea
McCarty — Yea
Nazarian — Yea
Obernolte — Yea
Olsen — Yea
Burke — Yea
Chang — Yea
Chau — Yea
Chiu — Yea
Chu — Yea
Cooley — Yea
Perea — Yea
Ridley-Thomas — Yea
Rodriguez — Yea
Steinorth — Yea
Thurmond — Yea
Weber — Yea
Wilk — Yea
Williams — Yea
Gray — Yea
Atkins — Yea
Campos — Yea
Bonilla — Yea
Lopez — Yea
Hadley — Not Voting
Chávez — Yea
Dababneh — Yea
Daly — Yea
Dodd — Yea
Jones-Sawyer — Yea
Medina — Yea
Melendez — Yea
Mullin — Yea
Alejo — Yea
Bigelow — Yea
Bloom — Yea
Santiago — Yea
Ting — Yea
Wagner — Yea
Wood — Yea
Gomez — Yea
Beth Gaines — Yea
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Yea
Lorena Gonzalez — Yea
Mark Stone — Yea
Roger Hernández — Yea
Travis Allen — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gipson, Mike A. Democratic Yea
Irwin, Jacqui Democratic Yea
Dahle, Megan Republican Yea
Gallagher, James Republican Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Yea
Lackey, Tom Republican Yea

Official roll call →

Do pass.

Passed 17 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 13000
Democratic 2000
Republican 2000
Total 17000
% of votes cast 100%0%0%0%
How each member voted (17)
Member Party Vote
Bigelow — Yea
Bloom — Yea
Nazarian — Yea
Wagner — Yea
Wood — Yea
Eggman — Yea
Gomez — Yea
Chang — Yea
Holden — Yea
Quirk — Yea
Rendon — Yea
Weber — Yea
Eduardo Garcia — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gallagher, James Republican Yea
Jones, Brian W. Republican Yea

Official roll call →

Do pass as amended and be re-referred to the Committee on [Appropriations]

Passed 17 Yea · 1 Nay · 1 Other
Party YeaNayPresentNot Voting
Democratic 1000
Republican 1100
Unaffiliated 15001
Total 17101
% of votes cast 89%5%0%5%
How each member voted (19)
Member Party Vote
Maienschein — Yea
Santiago — Yea
Waldron — Yea
Burke — Yea
Bonilla — Yea
Chiu — Yea
Chávez — Yea
Nazarian — Yea
Rodriguez — Yea
Thurmond — Yea
Ridley-Thomas — Not Voting
Steinorth — Yea
Wood — Yea
Gomez — Yea
Gonzalez — Yea
Roger Hernández — Yea
Bonta, Mia Democratic Yea
Lackey, Tom Republican Yea
Patterson, Joe Republican Nay

Official roll call →

3rd Reading

Passed 37 Yea · 0 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 34003
Democratic 3000
Total 37003
% of votes cast 93%0%0%8%
How each member voted (40)
Member Party Vote
Anderson — Yea
Bates — Yea
Hernandez — Yea
Hill — Yea
Leyva — Yea
Mendoza — Yea
Morrell — Yea
Nielsen — Yea
Wieckowski — Yea
Fuller — Yea
Glazer — Yea
Allen — Yea
Cannella — Yea
Mitchell — Yea
De León — Yea
Galgiani — Yea
Runner — Not Voting
Hall — Yea
Hancock — Not Voting
Hertzberg — Yea
Beall — Yea
Block — Yea
Hueso — Yea
Huff — Yea
Lara — Yea
Leno — Yea
Liu — Yea
Monning — Yea
Moorlach — Yea
Pan — Yea
Pavley — Yea
Roth — Yea
Vidak — Yea
Wolk — Not Voting
Beth Gaines — Yea
Bill Berryhill — Yea
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea

Official roll call →

Do pass

Passed 7 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 7000
Total 7000
% of votes cast 100%0%0%0%
How each member voted (7)
Member Party Vote
Leyva — Yea
Hill — Yea
Lara — Yea
Bates — Yea
Beall — Yea
Mendoza — Yea
Nielsen — Yea

Official roll call →

Placed on suspense file

Passed 7 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 7000
Total 7000
% of votes cast 100%0%0%0%
How each member voted (7)
Member Party Vote
Bates — Yea
Beall — Yea
Leyva — Yea
Mendoza — Yea
Nielsen — Yea
Hill — Yea
Lara — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 43 do?
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) , enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA requires a health insurance issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined. PPACA requires each state, by January 1, 2014, to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers. PPACA defines a qualified health plan as a plan that, among other requirements, provides an essential health benefits package. Existing state law creates the California Health Benefit Exchange (the Exchange) to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires an individual or small group health care service plan contract or individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2014, to cover essential health benefits, defined to include rehabilitative and habilitative services and the health benefits covered by particular benchmark plans, including a certain plan offered during the first quarter of 2012. Existing law requires habilitative services to be covered under the same terms and conditions applied to rehabilitative services under the plan contract or policy, and defines habilitative services to mean medically necessary health care services and health care devices that assist an individual in partially or fully acquiring or improving skills and functions and that are necessary to address a health condition. Existing law specifies that these provisions do not apply to specified plans, including grandfathered plans. Existing law authorizes the Department of Managed Health Care and the Department of Insurance to adopt emergency regulations implementing these provisions until March 1, 2016. This bill would, for an individual or small group health care service plan contract or an individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2017, prohibit limits on habilitative and rehabilitative services from being combined and would define essential health benefits to include the health benefits covered by particular benchmark plans as of the first quarter of 2014, as specified. The bill, for plan years commencing on or after January 1, 2016, would revise the definition of "habilitative services" to conform to federal regulations. The bill would authorize the Department of Managed Health Care and the Department of Insurance to adopt emergency regulations implementing amendments made to the above-described provisions during the 2015–16 Regular Session of the Legislature until July 1, 2018. Because a willful violation of the bill's requirements by a health care service plan would be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Who sponsors SB 43?
SB 43 is sponsored by Hernandez and Monning.
What is the current status of SB 43?
This bill has been enacted into law. Introduced December 05, 2014. Enacted.
Where can I track SB 43?
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