BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          AB 792 (Bonilla)
          
          Hearing Date: 8/25/2011         Amended: 8/17/2011
          Consultant: Katie Johnson       Policy Vote: Health 5-3 
          Judiciary 3-2
          _________________________________________________________________
          ____
          BILL SUMMARY: AB 792 would require courts, health care service 
          plans, health insurers, and employers to provide a notice of the 
          availability of coverage in the California Health Benefit 
          Exchange (Exchange), effective January 1, 2014.
          _________________________________________________________________
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund

           Potential state        potentially significant, depending 
          onGeneral/ 
          cost avoidance         actual take up of coverage       Federal/
          or cost                                                 Other
          _________________________________________________________________
          ____

          STAFF COMMENTS:  SUSPENSE FILE.
          
          This bill would require on various effective dates commencing 
          January 1, 2012, and ongoing, as specified, the courts, health 
          care service plans, health insurers, and employers, to provide a 
          notice of the availability of coverage in the California Health 
          Benefit Exchange (Exchange), effective January 1, 2014. Any 
          costs to the courts would be minor and absorbable.

          This bill would require health plans, health insurers, and 
          employers, for employees or dependents who have experienced a 
          death, loss of employment or a reduction in hours, divorce or 
          the loss of dependent status that results in a loss of health 
          insurance, to transfer information to the Exchange to initiate 
          an application for enrollment in the Exchange if the individual 
          consents.  This bill would require an individual electing to 
          decline coverage from the Exchange to do so in writing.  

          There could be cost avoidance to the extent that individuals who 








          AB 792 (Bonilla)
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          would have otherwise enrolled in state programs such as the 
          Major Risk Medical Insurance Program (MRMIP), Access for Infants 
          and Mothers program (AIM), the Preexisting Condition Insurance 
          Program (PCIP), and the AIDS Drug Assistance Program (ADAP), 
          purchase health care coverage through the Exchange. However, to 
          the extent that individuals, upon application to the Exchange, 
          are found eligible for state programs such as those listed above 
          or Medi-Cal or the Healthy Families Program, there could be 
          significant state health care coverage costs.

          ADAP and other publicly funded programs administered by the 
          California Department of Public Health costs would be shared 
          amongst a variety of state and federal funds; Medi-Cal costs 
          would be shared 50 percent General Fund and 50 percent federal 
          funds, except that newly eligible Medi-Cal individuals' coverage 
          would be paid by 100 percent federal funds until 2016; Healthy 
          Families Program costs would be shared 35 percent General Fund 
          and 65 percent federal funds; AIM would be shared  35 percent 
          state Proposition 99 funds and 65 percent federal funds; MRMIP 
          would be shared state Proposition 99 funds and subscriber 
          premiums; PCIP would be funded 100 percent federal funds and 
          shares of enrollee premiums; Family Planning, Access, Care, and 
          Treatment program costs would be shared 10 percent General Fund 
          and 90 percent federal funds. Exchange costs would consist of 
          enrollee premiums and potentially federal subsidies.

          Federal Exchange Funding
          On August 12, 2011, California was awarded a Level One Exchange 
          establishment grant by the federal Department of Health and 
          Human Services in the amount of $39,421,383 for the purposes of 
          developing policy goals, securing consultants and experts, and 
          engaging stakeholders in the Exchange planning process. It is 
          unclear whether or not these funds could be utilized to 
          implement this bill. The state previously received a $1 million 
          Exchange Planning Grant to start up the Exchange on September 
          29, 2010.

          The August 17 amendments remove the requirement on EDD to 
          furnish notices and reduce the costs of the bill accordingly. 
          There would continue to be cost avoidance to the extent that 
          individuals who would have otherwise enrolled in state programs 
          such as MRMIP, AIM, PCIP, and ADAP, purchase health care 
          coverage through the Exchange. Additionally, there would 
          continue to be significant costs to the extent that individuals, 








          AB 792 (Bonilla)
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          upon application to the Exchange, are found eligible for state 
          programs such as those listed above or Medi-Cal or the Healthy 
          Families Program.