BILL NUMBER: AB 1269	ENROLLED
	BILL TEXT

	PASSED THE SENATE  SEPTEMBER 4, 2009
	PASSED THE ASSEMBLY  SEPTEMBER 9, 2009
	AMENDED IN SENATE  SEPTEMBER 1, 2009
	AMENDED IN ASSEMBLY  APRIL 14, 2009

INTRODUCED BY   Assembly Member Brownley

                        FEBRUARY 27, 2009

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


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1269, 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, 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.
   This bill would, to the extent that federal financial
participation is available, authorize an individual who is otherwise
eligible under this program but who is temporarily unemployed to
elect to remain on Medi-Cal pursuant to these provisions for a period
up to 26 weeks, as provided. This bill would also 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.
   This bill would make its provisions operative 30 days after the
date that the increase in the state's federal medical assistance
percentage (FMAP) pursuant to the federal American Recovery and
Reinvestment Act of 2009 (ARRA) is no longer available.
   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 90 days after the operative date
specified above, 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.


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 (42 U.S.C. Sec. 401 et seq.), Title XVI of the federal
Social Security Act (42 U.S.C. Sec. 1381 et seq.), 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, an
individual otherwise eligible under this section, but who is
temporarily unemployed, may elect to remain on Medi-Cal under this
section for up to 26 weeks, provided the individual continues 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) (A) For the purposes of calculating countable income under
this section, an income exemption shall be applied as necessary to
adjust the income standard so that it is the same as the income
standard that was in place on May 1, 2009.
   (B) This additional income exemption shall cease to be implemented
when the SSI/SSP program payment levels increase beyond those in
effect on May 1, 2009.
   (C) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this paragraph by means of an all-county
letter or similar instruction without taking regulatory action.
   (4) Retained earned income of an eligible individual who is
receiving health care benefits under this section shall be considered
an exempt resource when held in a separately identifiable account
and not commingled with other resources, as authorized by Section
1902(r)(2) of the federal Social Security Act (42 U.S.C. Sec. 1396a
(r)(2)).
   (5) 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, the 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, the 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 paragraphs (1) and (5), respectively, 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. Each individual shall pay a monthly premium that is
equal to 5 percent of his or her individual countable income, as
described 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 by the act that added
subdivision (k) shall be implemented no later than 90 days after the
operative date specified in that subdivision.
   (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.
   (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.
   (i) Notwithstanding any other 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.
   (k) The amendments made to this section by the act that added this
subdivision shall not become operative until 30 days after the date
that the increase in the state's federal medical assistance
percentage (FMAP) pursuant to the federal American Recovery and
Reinvestment Act of 2009 (P.L. 111-5) is no longer available under
that act or any extension of that act.
  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.