BILL NUMBER: AB 851	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 4, 2008
	AMENDED IN ASSEMBLY  JANUARY 7, 2008

INTRODUCED BY   Assembly Member Brownley

                        FEBRUARY 22, 2007

   An act to amend Section 14007.9 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 851, as amended, Brownley. Medi-Cal: eligibility.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. The
Medi-Cal program is partially governed and funded by federal Medicaid
provisions.
   Existing law, until September 1, 2008, and subject to the receipt
of federal financial participation, requires the department to adopt
a federal option under which any employed individual with a
disability who meets specified income and resource requirements,
shall be eligible for benefits under the Medi-Cal program, subject to
the payment of premiums. These provisions are repealed on January 1,
2009.
   This bill would delete the inoperative and repeal dates of these
provisions and thereby would extend their operation indefinitely.
   This bill would  , to the extent federal financial
participation is available,  authorize individuals who are
otherwise eligible under this program but who are temporarily
unemployed to elect to remain on Medi-Cal pursuant to these
provisions for a period up to  52   26 
weeks, as provided. This bill would also  , to the extent
federal financial participation is available, provide
additional resource exemptions in determining Medi-Cal eligibility
under these provisions. The bill would extend specified resource
exemptions to apply for the beneficiary under any other Medi-Cal
program under which the beneficiary later becomes eligible for
medical assistance where that eligibility is based on age, blindness,
or disability. 
   Existing law requires individuals who are eligible for Medi-Cal
benefits pursuant to these provisions to be subject to premiums that
are determined by a sliding scale that is based on countable income,
as provided.  
   This bill, not later than March 1, 2009, would, instead, require
each individual to pay a monthly premium that is equal to 5% of his
or her individual or spousal countable income, as described, except
that the premium cannot fall below or exceed a specified minimum and
maximum premium payment, as provided.  
   The bill would require the above-described provisions to be
implemented only to the extent that federal financial participation
is available, and only to the extent that the department seeks and
obtains approval of all necessary state plan amendments. 
   Because counties are required to make Medi-Cal eligibility
determinations and this bill would extend the expansion of Medi-Cal
eligibility, the 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, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14007.9 of the Welfare and Institutions Code is
amended to read:
   14007.9.  (a) (1) The department shall adopt the option made
available under Section 1902(a)(10)(A)(ii)(XIII) of the federal
Social Security Act (42 U.S.C. Sec. 1396a(a)(10)(A)(ii)(XIII)). In
order to be eligible for benefits under this section, an individual
shall be required to meet all of the following requirements:
   (A) His or her net countable income is less than 250 percent of
the federal poverty level for one person or, if the deeming of
spousal income applies to the individual, his or her net countable
income is less than 250 percent of the federal poverty level for two
persons.
   (B) He or she is disabled under Title II of the  federal 
Social Security Act (Subch. 2 (commencing with Sec. 401), Ch. 7,
Title 42 U.S.C.), Title XVI of the  federal  Social Security
Act (Subch. 16 (commencing with Sec. 1381), Ch. 7, Title 42,
U.S.C.), or Section 1902(v) of the  federal  Social Security
Act (42 U.S.C. Sec. 1396a(v)). An individual shall be determined to
be eligible under this section without regard to his or her ability
to engage in, or actual engagement in, substantial gainful activity,
as defined in Section 223(d)(4) of the  federal  Social
Security Act (42 U.S.C. Sec. 423(d)(4)).
   (C) Except as otherwise provided in this section, his or her net
nonexempt resources, which shall be determined in accordance with the
methodology used under Title XVI of the federal Social Security Act
(42 U.S.C. Sec. 1381 et seq.), are not in excess of the limits
provided for under those provisions.
   (2) To the extent federal financial participation is available,
individuals otherwise eligible under this section, but who are
temporarily  not working   unemployed  ,
may elect to remain on Medi-Cal under this section for up to 
52   26  weeks, provided the individuals continue
to pay premiums during the temporary period of unemployment.
   (b) (1) Countable income shall be determined under Section 1612 of
the  federal  Social Security Act (42 U.S.C. Sec. 1382a),
except that the individual's disability income, including all federal
and state disability benefits and private disability insurance,
shall be exempted. Resources excluded under Section 1613 of the 
federal  Social Security Act (42 U.S.C. Sec. 1382b) shall be
disregarded.
   (2) Resources in the form of employer or individual retirement
arrangements authorized under the Internal Revenue Code shall be
exempted as authorized by Section 1902(r) of the  federal 
  Social Security Act (42 U.S.C. Sec. 1396a(r)).
   (3) To the extent that federal financial participation is
available under Section 1902(r)(2) of the federal Social Security
Act, (42 U.S.C. Sec. 1396a(r)(2))  ,  retained earned income
of an eligible individual who is receiving health care benefits
under this section shall be considered  exempt  
an exempt resource  when held in a separately identifiable
account and not commingled with other resources. 
   (c) To the extent permitted under federal law, social security
disability benefits that are received by an individual when he or she
is 65 years of age or older shall be exempt.  
   (d) (1) All resources exempted pursuant to paragraph (2) of
subdivision (b) shall continue to be exempt for the beneficiary under
any other Medi-Cal program that is subject to Section 1902(r)(2) of
the Social Security Act (42 U.S.C. Sec. 1396a(r)(2)) under which the
beneficiary later becomes eligible for medical assistance where that
eligibility is based on age, blindness, or disability. 

   (2) (A) If this subdivision or its application is held invalid by
a final judicial determination, that invalidity shall not affect
other provisions or applications of this section that can be given
effect without the invalid provision or application. 

   (B) This subdivision shall not be construed to expand resource
exemptions to any other individuals under any other Medi-Cal program.
 
   (4) Social security disability income that converts to social
security retirement income upon the retirement of an individual,
including any increases in the amount of that income, shall be
exempt. The department shall submit a state plan amendment for this
specific exemption, and the exemption shall be implemented only if
and to the extent that such state plan amendment is approved. 

   (c) All resources exempted pursuant to paragraph (2) of
subdivision (b) for an individual who is receiving health care
benefits under this section shall continue to be exempt under any
other Medi-Cal program that is subject to Section 1902(r)(2) of the
federal Social Security Act (42 U.S.C. Sec. 1396a(r)(2)) under which
the beneficiary later becomes eligible for medical assistance where
that eligibility is based on age, blindness, or disability. The
department shall submit a state plan amendment for this specific
exemption, and the exemption shall be implemented only if and to the
extent that such state plan amendment is approved.  
   (d) After an individual is determined eligible for Medi-Cal
benefits under this section, the individual's countable income, as
determined under Section 1612 of the federal Social Security Act (42
U.S.C. Sec. 1382a), shall be used to determine the amount of the
individual's required premium payment, as described in subdivision
(f). Disability income and converted retirement income made exempt
under paragraph (1) of subdivision (b) for eligibility purposes shall
be considered countable income for purposes of determining the
amount of the required premium payment.
   (e) Medi-Cal benefits provided under this chapter pursuant to this
section shall be available in the same amount, duration, and scope
as those benefits are available for persons who are eligible for
Medi-Cal benefits as categorically needy persons and as specified in
Section 14007.5.
   (f)    (1)  Individuals eligible for Medi-Cal
benefits under this section shall be subject to the payment of
premiums determined under this subdivision.  The department
shall establish sliding-scale premiums that are based on countable
income, with a minimum premium of twenty dollars ($20) per month and
a maximum premium of two hundred fifty dollars ($250) per month, and
shall, by regulations, annually adjust the premiums. Prior to
adjustment of any premiums pursuant to this subdivision, the
department shall submit a report of proposed premium adjustments to
the appropriate committees of the Legislature as part of the annual
Budget Act process. 
    (g)    The department
shall adopt regulations specifying the process for discontinuance of
eligibility under this section for nonpayment of premiums for more
than two months by a beneficiary.   Each individual
shall pay a monthly premium that is equal to 5 percent of his or her
individual countable income, as defined in subdivision (d), or if the
deeming of spousal income of an ineligible spouse applies, a monthly
premium that is equal to 5 percent of the total countable income of
both spouses, except that the minimum premium payment per eligible
individual shall be twenty dollars ($20) per month, and the maximum
premium payment per eligible individual shall be two hundred fifty
dollars ($250) per month. 
    (2) The amendments made to this subdivision during the 2008
portion of the 2007-08 Regular Session shall be implemented no later
than March 1, 2009.  
   (h) 
    (g)  In order to implement the collection of premiums
under this section, the department may develop and execute a contract
with a public or private entity to collect premiums, or may amend
any existing or future premium-collection contract that it has
executed. Notwithstanding any other provision of law, any contract
developed and executed or amended pursuant to this subdivision is
exempt from the approval of the Director of General Services and from
the Public Contract Code. 
   (i) 
    (h)  Notwithstanding the rulemaking provisions of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code, the department shall implement,
without taking any regulatory action, this section by means of an
all-county letter or similar instruction. Thereafter, the department
shall adopt regulations in accordance with the requirements of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code. 
   (j) 
    (i)  Notwithstanding any other provision of law, this
section shall be implemented only if, and to the extent that, the
department determines that federal financial participation is
available pursuant to Title XIX of the federal Social Security Act
(42 U.S.C. Sec. 1396 et seq.)  and only to the   extent
that the department seeks and obtains approval of all necessary
Medicaid state plan amendments  . 
   (j) If any provision of this section, or its application, is held
invalid by a final judicial determination, it shall cease to be
implemented. A determination of invalidity shall not affect other
provisions or applications of this section that can be given effect
without the implementation of the invalid provision or application.

  SEC. 2.  If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.