AB 1254: Health care service plans: abortion coverage.

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires a health insurance issuer offering coverage in the individual or small group market to ensure that the coverage includes the essential health benefits package, as defined. PPACA does not require that a qualified health plan provide coverage for abortion, as specified.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the regulation of health care service plans by the Department of Managed Health Care. Under existing law, the Director of Managed Health Care may, after appropriate notice and opportunity for a hearing, by order suspend or revoke a license issued under the act, or assess administrative penalties if the director determines that the licensee has committed an act or omission constituting grounds for disciplinary action.

This bill would provide that a health care service plan is not required to include abortion as a covered benefit. The bill would prohibit the director from denying a license, or disciplining a licensee, on the basis that the plan excludes coverage for abortions.