BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                                 THIRD READING


          Bill No:  AB 1269
          Author:   Brownley (D)
          Amended:  9/1/09 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  8-3, 7/8/09
          AYES:  Alquist, Cedillo, DeSaulnier, Leno, Maldonado,  
            Negrete McLeod, Pavley, Wolk
          NOES:  Strickland, Aanestad, Cox
           
          SENATE APPROPRIATIONS COMMITTEE  :  8-5, 8/27/09
          AYES:  Kehoe, Corbett, Hancock, Leno, Oropeza, Price, Wolk,  
            Yee
          NOES:  Cox, Denham, Runner, Walters, Wyland
           
          ASSEMBLY FLOOR  :  50-29, 6/2/09 - See last page for vote


           SUBJECT  :    Medi-Cal eligibility:  California Working  
          Disabled Program

           SOURCE :     Author


           DIGEST  :    This bill expands the Medi-Cal California  
          Working Disabled Program (CWD) by allowing additional  
          resource exemptions when determining initial and continued  
          eligibility for the program.  The exempted resources would  
          include Social Security disability benefits and income, as  
          well as retained earned income which is held in a separate  
          account, provided that federal financial participation is  
          available.  This bill also allows 26 weeks of continued  
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          eligibility for the Medi-Cal program when a disabled  
          participant is temporarily unemployed, provided they  
          continue to make premium payments.  In addition, this bill  
          replaces the current sliding scale for premiums with a  
          monthly premium set at five percent of the individual's  
          countable income subject to a $20 minimum and a $250  
          maximum.  This bill delays implementation until the federal  
          American Recovery and Reinvestment Act of 2009 (ARRA)  
          enhanced Federal Medical Assistance Percentage provisions  
          sunset, which will likely be January 1, 2011, so as to not  
          jeopardize ARRA funds.  The federal Centers for Medicare  
          and Medicaid Services, the Medicaid regulating body, could  
          construe this bill to limit eligibility for CWD.  In return  
          for receiving ARRA funds, ARRA prohibits states from  
          negatively impacting Medi-Cal eligibility.  This bill  
          specifies that if any provision of this bill, 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.

           ANALYSIS  :    Existing law established the CWD in 2000 and,  
          in 2008, the Budget Act made the program permanent.  CWD  
          provides Medi-Cal health benefits to working disabled  
          individuals with a net family income of up to 250 percent  
          of the federal poverty level, or $25,525 for an individual.  
           CWD enrollees pay monthly premiums of $20-$375 depending  
          on the enrollee's countable income.

          This bill permits CWD enrollees who were temporarily  
          unemployed to retain Medi-Cal coverage for up to 26 weeks  
          provided the enrollee continued to pay premiums during this  
          period.  Currently, CWD enrollees whose employment was  
          terminated due to good cause may retain Medi-Cal coverage  
          for up to two months. 

          Additionally, this bill makes several changes to the  
          determination of CWD eligibility.  It adds the following  
          types of income to those exempted when determining CWD  
          eligibility:  (1) retained earned income held in a  
          separately identifiable account, and (2) social security  
          disability income that would convert to social security  

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          retirement income upon the retirement of an individual.   
          This bill requires the Department of Health Care Services  
          (DHCS) to submit a state plan amendment to the Centers for  
          Medicare and Medicaid specifically for the second exemption  
          and would provide that the exemption would go into effect  
          only if the state plan amendment was approved.

          This bill requires that all resources in the form of  
          employer or individual retirement arrangements that are  
          currently exempt for CWD eligibility determination would be  
          exempt when determining a CWD enrollee's eligibility for  
          any other Medi-Cal program for which the enrollee may  
          eligible provided the eligibility is based on age,  
          blindness, or disability.  This bill requires DHCS to seek  
          a state plan amendment for this provision and that this  
          provision would be implemented only if the state plan  
          amendment were approved by the Centers for Medicare and  
          Medicaid.

          This bill provides that an individual's countable income  
          would be used to determine the amount of his/her monthly  
          premium and requires that disability income and converted  
          retirement income made exempt for purposes of CWD  
          eligibility determination be considered countable income  
          for purposes of determining the premium amount.

          This bill eliminates the determination of a sliding premium  
          scale, and instead requires that each individual pay five  
          percent of his/her individual countable income as a  
          premium.  The minimum monthly premium would be $20 and $250  
          would be the maximum.

          This bill specifies that if any provision of this bill, 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.

           Prior Legislation

           AB 1183 (Assembly Budget Committee), Chapter 758, Statutes  
          of 2008, made the CWD program permanent by deleting the  

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          September 1, 2008 sunset date.

          AB 851 (Brownley), 2007-08 Session, which was similar to  
          this bill, was held on the Senate Appropriations suspense  
          file.

          AB 1113 (Brownley), 2007-08 Session, which was similar to  
          this bill, was vetoed by Governor Schwarzenegger.  In his  
          veto message, the Governor stated:  "While I strongly  
          support the California 250 Percent Working Disabled Program  
          and appreciate its role in promoting work among persons who  
          are aged and disabled, I cannot support this bill. This  
          bill contains a drafting error that would result in unequal  
          treatment of similarly situated aged persons, in direct  
          conflict with federal Medicaid law. Given my strong support  
          of services for persons with disabilities to allow them to  
          safely remain at home and lead productive and independent  
          lives, I am directing the DHCS to pursue legislation to  
          continue and improve this important program."
           
          AB 155 (Migden), Chapter 820, Statutes of 1999, established  
          the CWD program. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

          According to the Senate Appropriations Committee:

                         Fiscal Impact (in thousands)

           Major Provisions      2009-10     2010-11     2011-12     Fund  

          Increase CWD caseload         $0        $20-$30    
          $300-$350           General*/
          benefits                                           
          Federal*

           * October 1, 2008-December 31, 2010          FMAP = 38% GF  
            / 62% FF
             January 1, 2011 - ongoing         FMAP = 50% GF / 50% FF

             FMAP - the percent of total costs paid by the federal  
            government


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           SUPPORT  :   (Verified  9/1/09)

          Abilicorp
          AIDS Project Los Angeles
          American Federation of State, County and Municipal  
          Employees 
          Association of California State Employees with Disabilities
          California Communities United Institute
          California Foundation for Independent Living Centers
          California Medical Association
          California Primary Care Association
          Disability Rights California
          Easter Seals of Southern California
          Health Access
          National Multiple Sclerosis Society
          Pacific Clinics
          Project Return Peer Support Network
          Resources for Independent Living
          San Francisco AIDS Foundation
          Southern California HIV Advocacy Coalition
          World Institute on Disability


           ARGUMENTS IN SUPPORT  :    Supporters argue that this bill  
          will encourage people to enter the labor force and the CWD  
          program, because if they become unemployed they could  
          continue to receive their coverage.  They argue that many  
          individuals are afraid to enter the labor force for fear of  
          losing their affordable Medi-Cal coverage.  Supporters  
          argue that the other eligibility changes will allow more  
          people with disabilities to become more independent and  
          productive while ensuring that they have access to critical  
          health services.  Supporters note that it makes fiscal  
          sense to encourage disabled people to work and contribute  
          to the cost of health coverage.


           ASSEMBLY FLOOR  :
          AYES:  Ammiano, Arambula, Beall, Blumenfield, Brownley,  
            Buchanan, Caballero, Charles Calderon, Carter, Chesbro,  
            Cook, Coto, Davis, De La Torre, De Leon, Eng, Evans,  
            Feuer, Fong, Fuentes, Furutani, Galgiani, Hall, Hayashi,  
            Hernandez, Hill, Huffman, Jones, Krekorian, Lieu, Bonnie  
            Lowenthal, Ma, Mendoza, Monning, Nava, John A. Perez, V.  

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            Manuel Perez, Portantino, Price, Ruskin, Salas, Saldana,  
            Skinner, Solorio, Swanson, Torlakson, Torres, Torrico,  
            Yamada, Bass
          NOES:  Adams, Anderson, Bill Berryhill, Tom Berryhill,  
            Blakeslee, Conway, DeVore, Duvall, Emmerson, Fletcher,  
            Fuller, Gaines, Garrick, Gilmore, Hagman, Harkey, Huber,  
            Jeffries, Knight, Logue, Miller, Nestande, Niello,  
            Nielsen, Silva, Smyth, Audra Strickland, Tran, Villines
          NO VOTE RECORDED:  Block


          DLW:mw  9/1/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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