BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 1296 (Bonilla)
Hearing Date: 8/15/2011 Amended: 7/13/2011
Consultant: Katie Johnson Policy Vote: Health 6-3
_________________________________________________________________
____
BILL SUMMARY: AB 1296 would establish the Health Care
Eligibility, Enrollment, and Retention Act. The bill would
require the California Health and Human Services Agency (CHHS),
by January 1, 2012, in consultation with other state departments
and stakeholders, to have undertaken a planning process to
develop plans and procedures to implement these provisions
relating to enrollment in public programs and federal law. The
bill would require that an individual would have the option to
apply for public programs through a variety of avenues, would
specify the application form, establish presumptive eligibility
for all populations, and establish other requirements related to
renewal and transfer of coverage between programs.
_________________________________________________________________
____
Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
CHHS planning process likely in the hundreds of thousands of
General/*
dollars through January 1, 2014, and
Federal
possibly beyond
Information technology unknown, likely in the millions of
dollars General/**
systems Federal
Presumptive eligibility unknown, at least in the
millions of dollars General/*
expansion and other Federal
enrollment requirements
Ongoing administration likely significant
General/* Federal
*50 percent General Fund, 50 percent federal funds, unless
additional federal or private funds are made available.
AB 1296 (Bonilla)
Page 1
**50 percent General Fund, 50 percent federal funds, but could
be 10 percent General Fund and 90 percent federal funds,
depending on federal allowable costs.
_________________________________________________________________
____
STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
This bill would require CHHS, by January 1, 2012, in
consultation with the Department of Health Care Services (DHCS),
the Managed Risk Medical Insurance Board (MRMIB), the California
Health Benefit Exchange (Exchange), counties, health care
service plans, consumer advocates, and other stakeholders, to
have commenced a planning process to develop plans and
procedures to implement the enrollment and renewal requirements
established by these provisions and by the federal Patient
Protection and Affordable Care Act (PPACA). CHHS would be
required to provide information on the process regarding policy
changes needed to develop the eligibility, enrollment, and
retention system for health care coverage to the Legislature by
April 1, 2012. This bill would require DHCS to develop a
standardized application for all public health coverage
programs. These provisions, except where otherwise specified,
would become operative January 1, 2014.
This bill would permit an individual to have the option to apply
for public health coverage programs in person, by mail, online,
or by telephone. This bill would specify that there should be a
program of accelerated enrollment through which children and
pregnant women may enter public coverage at the point of medical
service, that infants would be deemed eligible without an
application at a hospital, real-time verification, information
pre-population, and presumptive eligibility for children,
pregnant women, and other adults, among other specified
requirements.
There would likely be significant General Fund and federal funds
costs to immediately enroll individuals in public coverage
programs that would be shared about 50 percent General Fund and
50 federal funds, unless the enrollees are newly eligible, where
the costs would be paid 100 percent federal funds until 2016.
Additionally, there would be information technology (IT) costs
likely in the millions of dollars to design a system to comply
AB 1296 (Bonilla)
Page 2
with these provisions. IT costs could be shared at a federal
medical assistance percentage of up to 90 percent, or 10 percent
General Fund and 90 percent federal funds. Actual costs of
start-up and ongoing administration and sharing ratios are
unknown and are in a large part dependent on how CHHS, DHCS,
MRMIB, and the Exchange would choose to operationalize these
provisions.