BILL ANALYSIS
SB 1431
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Date of Hearing: August 4, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 1431 (Simitian) - As Amended: April 7, 2010
Policy Committee: HealthVote:18-1
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill conforms state law to a federal option to increase
income eligibility for children's health coverage from 300% of
federal poverty level (FPL) to 400% FPL to allow counties to
draw down additional County Health Initiative Matching Fund
(CHIM) support with non-GF intergovernmental transfers
(generally local funds). In addition, this bill modifies CHIM
eligibility to account for enrollment freezes and other access
issues created in the Healthy Families Program (HFP) due to
budget shortfalls.
FISCAL EFFECT
1)No GF impact for the Managed Risk Medical Insurance Board
(MRMIB) to expand the administration of CHIM to support the
counties access to federal funding.
2)Premium expenditures of $300,000 (50% federal/50% local) to
$500,000 (50% federal/50% local) to extend coverage to 300 to
500 previously ineligible children.
COMMENTS
1)Rationale . This bill is sponsored by San Mateo County to
conform state law to a federal option that recently became
available to increase income eligibility in children's health
programs to allow the receipt of additional federal funding.
This bill also addresses concerns about limited future
eligibility in the Healthy Families Program due to funding
shortfalls. In 2009 the program had a shortfall of almost $200
million GF and faced major reductions or elimination prior to
alternative financing scenarios emerged.
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2)Children's Health Coverage Programs . According to the
University of California Los Angeles Center for Health Policy
Research, more than 8 million Californians were uninsured
during some or all of 2009. Of the uninsured, about 1.5
million are children. The majority of these children are in
families with one or two working parents without
employer-based health coverage. The Medi-Cal program and HFP
each provide health benefits to low-income children. Family
income eligibility for children in Medi-Cal is at or below
200% FPL for infants to age one, 133% FPL for children ages
one through five, and 100% FPL for children ages six through
18. Children in families with incomes above these amounts but
below 250% FPL may be eligible for HFP.
3)The County Children's Health Initiative Program was
established by AB 495 (Diaz), Chapter 648, Statues of 2001
which established CHIM in the State Treasury allows for the
intergovernmental transfer of local funds used for County
Children's Health Initiatives (CHI) to draw down federal
financial participation for eligible children. Santa Clara
County established the first CHI in 2001 to provide universal
coverage to low-income children not eligible for Medi-Cal or
the Healthy Families Program. Currently 29 counties
participate in CHI and use a variety of local government and
foundation support to provide health care coverage and
application and enrollment assistance.
4)Healthy Families Funding . In 2009, the Healthy Families
Program had a shortfall of $194 million GF as a result of
budget reductions. The program was closed to new enrollments
and waiting lists of up to 70,000 children accrued. MRMIB
estimated more than 600,000 children would have to be removed
from the program.
A three-part funding solution was proposed and adopted. The
California Children and Families Commission provided $81
million to cover children ages birth to five; $157 million in
gross premiums taxes on Medi-Cal managed care plans was
collected to draw down $97 million in additional federal
funds; and savings from program changes closed the funding
gap.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081
SB 1431
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