This resource has been prepared by CHBRP to inform interested parties of existing state and federal health insurance benefit mandate laws that may relate to the subject or purpose of a proposed state health insurance benefit mandate or repeal bill.
This resource discusses deductibles and their interaction with other forms of cost sharing, as well as estimates regarding their presence among state-regulated health insurance, potential impacts of new prohibitions on their application, and related state and federal law.
This resource discusses CHBRP's 2023 estimates of sources of health insurance in California.
This resource notes the presence or absence of a pharmacy benefit among Californians enrolled in health plans regulated by the California Department of Managed Health Care (DMHC) and health policies regulated by the California Department of Insurance (CDI).
This resource identifies potential overlap between the federal benefit mandate requiring health insurance coverage of some preventive services and California state benefit mandates.
CHBRP, drawing on multi-disciplinary faculty and researchers based at the University of California, provides the California Legislature with timely, independent, and rigorous evidence-based analyses of introduced health insurance benefits-related legislation.
California State Benefit Mandates and the Affordable Care Act's Essential Health Benefits (January 2022)
This issue brief provides background on Essential Health Benefits (EHBs) in California and how they interact with current and proposed state benefit mandates. This brief also describes changes to federal EHB regulations and discusses California's options for future modifications of the state's selected set of EHBs.
This issue brief discusses the medical necessity determination process, which may involve multiple clinicians, for enrollees in health plans and health policies regulated by the Department of Managed Health Care (DMHC) or the California Department of Insurance (CDI).
This issue brief discusses laws and regulations that prohibit out-of-network (OON) providers from issuing surprise bills to enrollees in plans or policies regulated by DMHC or CDI.
This issue brief discusses cost sharing laws and limits that are applicable to outpatient prescription drug benefits regulated by the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI). This brief also discusses pharmacy benefits, cost sharing, and the laws that are relevant to them.
This issue brief includes background information on genetic biomarker testing for Californians with advanced cancer, and, where possible, the presence and the impact of prior authorization on such testing.
This issue brief analyzes and compares the health services covered by the ten plans available to California as options for California's Essential Health Benefit (EHB) benchmark effective January 1, 2017.
This issue brief describes the choices California has made to comply with the Affordable Care Act's (ACA) pediatric dental and pediatric vision Essential Health Benefit (EHB) requirement.
This issue brief demonstrates how state benefit mandates may exceed Essential Health Benefits (EHBs) and how evidence-based analysis of the impacts of such mandates may inform discussions of whether to keep or repeal them.
This issue brief provides an example of how state benefit mandates could exceed Essential Health Benefits (EHBs) and how evidence-based analysis may inform discussions of whether to keep or repeal state benefit mandates that exceed EHBs, specifically looking at immunization coverage requirements.
This policy snapshot provides an overview of a public option and details recent public option related state activity from 2018 to 2021.
This policy snapshot summarizes the state of the evidence on telehealth, and focuses on the following common types of telehealth modalities and services: live video, telephone, and eConsult.
This policy snapshot is intended to help readers understand the Affordable Care Act's (ACA) federal contraceptive coverage mandate, California's more recent state coverage laws, and the variability between those laws.
In September of 2017, President Trump discussed his intent to sign an Executive Order to allow consumers to buy health insurance "across state lines". This policy snapshot provides an overview of efforts to introduce similar legislation federally and within California within the past 10 years, along with findings from CHBRP analyses of related California legislation and how the findings inform current discussion.
This explainer provides an overview of the population aged 65 and older in California, including sources of health insurance, demographic information, and how legislation and regulations may impact insurance coverage for this population.
This explainer provides an overview of claims data, including how the data is collected, what information may be available within the datasets, and how the data are used to inform CHBRP's analyses.
This explainer aims to help clarify and explain the common cost-sharing terms often addressed in health policy legislation.
Reports on Implementing CHBRP's Authorizing Statute
This rapid review examines recent evidence both about telehealth’s efficacy by clinical area and about telehealth’s impact on utilization
The California Cost and Coverage Model: Analyses of the Financial Impacts of Benefit Mandates for the California Legislature
An Analysis of California Assembly Bill 2185: Mandating Coverage of Pediatric Asthma Self-Management Training and Education
This document outlines findings from CHBRP's 2014 survey of every state and the District of Columbia to explore the status of benefit mandate review programs and processes outside of California.