BILL ANALYSIS
AB 1269
Page 1
ASSEMBLY THIRD READING
AB 1269 (Brownley)
As Amended April 14, 2009
Majority vote
HEALTH 13-6 APPROPRIATIONS 12-5
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|Ayes:|Jones, Ammiano, Block, |Ayes:|De Leon, Ammiano, Charles |
| |Carter, | |Calderon, Davis, Fuentes, |
| |De La Torre, De Leon, | |Hall, John A. Perez, |
| |Hall, Hayashi, Hernandez, | |Price, Skinner, Solorio, |
| |Bonnie Lowenthal, Nava, | |Torlakson, Krekorian |
| |V. Manuel Perez, Salas | | |
| | | | |
|-----+--------------------------+-----+---------------------------|
|Nays:|Fletcher, Adams, Conway, |Nays:|Nielsen, Duvall, Harkey, |
| |Emmerson, Gaines, Audra | |Miller, |
| |Strickland | |Audra Strickland |
| | | | |
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SUMMARY : Extends eligibility for the Medi-Cal California
Working Disabled Program (CWD Program) to improve continuity of
care. Specifically, this bill :
1)Permits individuals otherwise eligible for the CWD Program,
but who are temporarily not working, to remain in the program
for up to 26 weeks, provided the individuals continue to pay
premiums during the nonworking period.
2)Exempts consideration of Social Security income from
eligibility calculations while on the CWD Program. Allows
accumulated savings to be exempted from future eligibility
determinations in other Medi-Cal programs. Exempts Social
Security income received by disabled individuals 65 years or
older from Medi-Cal eligibility determinations.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)The actual fiscal impact of this bill may be less than current
and prior estimates, depending how many enrollees transfer
from other Medi-Cal programs versus new enrollees who have
either been uninsured or covered by private insurance. Due to
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the low annual income ($27,000 in 2009) and assets required
for eligibility, as well as the significant disabilities of
individuals in this program, most of the CWD beneficiaries
will remain eligible for other Medi-Cal programs, regardless
of employment status. Several provisions of this bill should
reduce churning, the cycling on and off of coverage or between
coverage programs.
2)Annual increased costs of less than $300,000 (50% General
Fund) to the extent the eligibility changes regarding income
and asset disregards increase CWD enrollment.
COMMENTS : According to the author, this bill, which provides
affordable health coverage for working disabled individuals, is
intended to extend program eligibility so more disabled
individuals can join the workforce and keep their health
coverage without penalties. The author states this bill is
expected to increase the number of participating disabled
individuals by extending Medi-Cal coverage during periods of
unemployment and by exempting savings and benefits from other
public sources when determining eligibility. The author notes
that the provision in this bill to continue eligibility when an
enrollee is unable to work is similar to the federal
Consolidated Omnibus Budget Reconciliation Act of 1986
(Cal-COBRA) which allows individuals to keep job-based insurance
for eighteen months after they leave employment if the
individual pays the full cost of the coverage.
The CWD Program was first implemented in 2000. Working
individuals with disabilities and with net countable family
incomes below 250% the federal poverty level and assets limited
to $2,000 for individuals and $3,000 for couples are eligible to
enroll. The CWD Program uses federal Supplemental Security
Income rules for income, including earned income disregards.
Enrollees pay monthly premiums of $20 to $375 based on income
and marital status. All of the applicant's disability related
income is exempt from income calculation. Certain retirement
accounts and property are also exempt from the asset
calculation. Enrollees who lose their employment due to "good
cause" can retain CWD Program coverage for two months.
Currently 3,700 individuals are enrolled in the CWD Program.
According to a 2007 Mathematica Policy Research issue brief
prepared for the federal Centers for Medicare and Medicaid
Services, as of June 30, 2006, 33 states (including California)
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reported covering 75,443 individuals in similar Medicaid buy-in
programs.
Health Access California, in support of this bill, argues that
easing eligibility in this program is vital to enabling persons
with disabilities to keep affordable health coverage while
working. The California Medical Association, also in support of
the bill, points out that it makes fiscal sense to encourage
disabled people to work and contribute to the cost of their own
health coverage.
Analysis Prepared by : John Miller/ HEALTH / (916) 319-2097
FN: 0001166