BILL NUMBER: AB 1113 AMENDED
BILL TEXT
AMENDED IN SENATE SEPTEMBER 7, 2007
AMENDED IN SENATE SEPTEMBER 4, 2007
AMENDED IN SENATE JULY 18, 2007
AMENDED IN ASSEMBLY APRIL 24, 2007
AMENDED IN ASSEMBLY APRIL 12, 2007
INTRODUCED BY Assembly Member Brownley
(Principal coauthor: Senator Migden)
FEBRUARY 23, 2007
An act to amend Section 14007.9 of the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1113, 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 These provisions are repealed on January 1,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 extend the inoperative date of these
provisions until September 1, 2013, and the repeal date of these
provisions to January 1, 2014 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 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.
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:
(1)
(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.
(2)
(B) He or she is disabled under Title II of the Social
Security Act (Subch. 2 (commencing with Sec. 401), Ch. 7, Title 42
U.S.C.), Title XVI of the Social Security Act (Subch. 16 (commencing
with Sec. 1381), Ch. 7, Title 42, U.S.C.), or Section 1902(v) of the
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 Social
Security Act (42 U.S.C. Sec. 423(d)(4)).
(3)
(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, may elect to remain on Medi-Cal under this
section for up to 52 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 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 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 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, retained earned income of an eligible individual who is
receiving health care benefits under this section shall be considered
exempt 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 or income that is received by individuals at and
after 65 years of age shall be exempt for those individuals who
qualified for Medi-Cal under this section before 65 years of age.
(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 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.
(c)
(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.
(d)
(f) 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.
(e)
(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.
(f)
(h) 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.
(g)
(i) 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.
(h)
(j) 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.).
(i) Subject to subdivision (h), this section shall be implemented
commencing April 1, 2000.
(j) This section shall become inoperative on September 1, 2013,
and as of January 1, 2014, is repealed, unless a later enacted
statute that is enacted on or before January 1, 2014, extends or
deletes the dates on which it becomes inoperative and is repealed.
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.