Plain English Breakdown
The official summary contains a typo or conflict listing both '2026' and '2027' as the effective date; the final version of the text lists 2027 last.
AB-298: Health Care Coverage Cost Sharing
This law stops large group health plans from charging deductibles, copayments, or coinsurance for in-network medical services given to people under 21 years old.
What This Bill Does
- Prohibits large group health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2027, from requiring cost sharing for in-network health care services provided to enrollees under age 21.
- Bans individuals or entities from billing or seeking reimbursement for in-network health care services provided to enrollees under the age of 21.
- Notes that a willful violation of these rules by a health care service plan is considered a crime because existing law already makes such violations criminal.
- States that no state reimbursement is required from this act for local agencies.
Who It Names or Affects
- Large group health insurance policies and contracts issued, amended, or renewed on or after January 1, 2027.
- Enrollees or insured individuals under the age of 21 receiving in-network care.
- Health care service plans regulated by the Department of Managed Health Care.
Terms To Know
- Cost sharing
- Money a patient must pay, such as deductibles, copayments, or coinsurance.
- In-network services
- Health care services provided by providers who have agreed to work with the insurance plan at set prices.
Limits and Unknowns
- The law includes exceptions where cost sharing may still be allowed as specified elsewhere in the bill.
- The official text shows conflicting dates (2026 and 2027) for when the rules take effect, though 2027 is listed last.