BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1431|
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THIRD READING
Bill No: SB 1431
Author: Simitian (D), et al
Amended: 4/7/10
Vote: 21
SENATE HEALTH COMMITTEE : 7-2, 4/14/10
AYES: Alquist, Aanestad, Cedillo, Leno, Negrete McLeod,
Pavley, Romero
NOES: Strickland, Cox
SENATE APPROPRIATIONS COMMITTEE : 7-3, 5/27/10
AYES: Kehoe, Alquist, Corbett, Leno, Price, Wolk, Yee
NOES: Denham, Walters, Wyland
NO VOTE RECORDED: Cox
SUBJECT : County Health Initiative Matching Fund
SOURCE : San Mateo County Board of Supervisors
DIGEST : This bill expands eligibility for children
enrolling in the County Health Initiative Matching Fund
program which uses local funds to match federal Children's
Health Insurance Program funds.
ANALYSIS : Existing federal law establishes the
Children's Health Insurance Program (CHIP) which provides
federal matching funds for state health insurance programs.
Provides that the federal share of these state programs
generally shall be 65 percent and the state share 35
percent. Provides specific guidance for determining
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eligibility for CHIP while preserving flexibility for
states to administer these programs according to the needs
of the state.
Existing state law:
1. Establishes the Healthy Families program to provide
affordable insurance, including health, dental and
vision coverage, to children who do not have health
insurance, do not qualify for free Medi-Cal and are in
families at or below 250 percent of the federal poverty
level (FPL). Provides that Managed Risk Medical
Insurance Board (MRMIB) administers Healthy Families.
2. Authorizes the County Health Initiative Matching Fund,
administered by MRMIB, to fund children's health
coverage using local funds as the state match to draw
down federal CHIP dollars. Requires MRMIB, in
consultation with the Department of Health Care
Services, to administer the fund for the express purpose
of allowing local funds to be used to match federal
funds. Authorizes MRMIB to expend moneys from the fund
for state administrative purposes.
3. Limits eligibility for receiving funds to counties and
county-created entities. Requires that only specific
sources of local funds are eligible for the program.
Specifies the process for counties to apply and receive
funding under the program and the criteria that MRMIB
shall use to evaluate proposals. Limits eligibility
within the federally funded coverage programs to
children in families whose income is at or below 300
percent of the FPL or adults whose family income is at
or below 200 percent of the FPL. Further restricts
eligibility to those who do not qualify for Healthy
Families or Medi-Cal without a share of cost.
4. Requires that funds from the Children's Health
Initiative Matching Fund only be matched with CHIP funds
that are not needed for Healthy Families and would
otherwise revert to the federal government. Provides
that the state shall be held harmless from any
disallowances and provides that any applicant shall be
liable for such federal disallowances.
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This bill increases the eligibility for the County Health
Initiative Matching Fund to children in families whose
income is at or below 400 percent of the FPL. Provides
that a child is eligible even if they meet the requirements
for Healthy Families but is unable to enroll when MRMIB has
restricted entry into the program because of insufficient
funds.
Prior Legislation
AB 1130 (Diaz), Chapter 687, Statutes of 2003, renames the
Children's Health Initiative Matching Fund to be the County
Health Initiative Matching Fund and is the implementing
legislation for AB 495.
AB 1524 (Richman), Chapter 866, Statutes of 2003, expands
the scope of the County Health Initiative Matching Fund to
include health insurance coverage for adults.
AB 495 (Diaz), Chapter 648, Statutes of 2001, establishes
the Children's Health Initiative Matching Fund to allow
local funds from counties with children's health
initiatives to draw down federal dollars from California's
CHIP allotment.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12
2012-13 Fund
Health care for newly $68-$90
$135-$180$135-$180 Federal
eligible County-CHIP $68-$90
$135-$180$135-$180 Local
children
SUPPORT : (Verified 5/28/10)
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San Mateo County Board of Supervisors (source)
California Children's Health Initiatives
California Chiropractic Association
California Medical Association
California School Employees Association
California State Association of Counties
City and County of San Francisco
Health Improvement Partnership of Santa Cruz County
Peninsula Interfaith Action
Santa Clara County Board of Supervisors
ARGUMENTS IN SUPPORT : According to the author's office,
this bill allows counties who participate in the County
Health Initiative Matching Fund program to provide health
care coverage to qualified low-income children who are
unable to enroll in the Healthy Families Program or whose
family income is at or below 400 percent of the FPL. The
author's office states the bill addresses the possibility
of the current budget shortfall, and allows participating
counties to provide health care to children who may qualify
for Healthy Families but, due to budget constraints, are
not provided care.
Second, when the enabling legislation (AB 495 [Diaz],
Chapter 648, Statutes of 2001) was signed into law, the
federal government provided matching funds for low-income
individuals who were at or below 300 percent of the FPL.
In 2009, however, the federal government increased its
matching dollars to include those who were at or below 400
percent of the FPL. SB 1431 amends the County Health
Initiative Matching Fund Program so that participating
counties can take full advantage of the expanded
eligibility.
Supporters argue that this bill is important because it
will allow counties that are able to raise the eligibility
level for the children's health initiative programs to
allow these programs to draw down federal funding for
children's health care. Supporters also point out that it
conforms state law to newly enacted federal law
(Children's Health Insurance Program Reauthorization Act of
2009 [CHIPRA]). They also note that if the state ever did
limit funding for Healthy Families it would allow local
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programs to draw down federal funding and continue covering
children.
CTW:mw 6/1/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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