BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 1869|
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                                 THIRD READING


          Bill No:  AB 1869
          Author:   John A. Pérez (D), et al.
          Amended:  As introduced
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 6/20/12
          AYES:  Hernandez, Harman, Alquist, Anderson, Blakeslee, De 
            León, DeSaulnier, Rubio, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  74-0, 4/26/12 (Consent) - See last page 
            for vote


           SUBJECT  :    Office of Patient Advocate:  federal veterans 
          health benefits

           SOURCE  :     Author


           DIGEST  :    This bill adds federal veterans health benefits 
          to the list of public programs that the Office of Patient 
          Advocate (OPA) will be required to include, commencing 
          January 1, 2013, in its efforts to provide outreach and 
          education about health care coverage options.

           ANALYSIS  :    

          Existing law:

           1. Transfers OPA from the Department of Managed Health 
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             Care (DMHC) to the California Health and Human Services 
             Agency (CHSSA), effective July 1, 2012.

           2. Defines OPA's goal to help individuals secure health 
             care services to which they are entitled or for which 
             they are eligible.

           3. Requires OPA, commencing January 1, 2013, to provide 
             and assist in the provision of outreach and education 
             about health care coverage options, including public 
             programs such as Medi-Cal, Healthy Families, and 
             Medicare.

          This bill requires OPA, commencing January 1, 2013, to 
          provide and assist in the provision of outreach and 
          education about federal veterans health benefits.

           Background
           
           OPA  .  OPA is an independent state office that was 
          established in July 2000 in conjunction with DMHC to 
          represent the interests of enrollees served by health care 
          service plans regulated by DMHC.  AB 922 (Monning), Chapter 
          552, Statutes of 2011, transfers OPA and DMHC to CHHSA, 
          effective July 1, 2012, requires that existing duties and 
          responsibilities apply to CDI-regulated health insurers in 
          addition to DMHC-regulated health plans, and adds new 
          duties and responsibilities with respect to providing 
          outreach and education about health care coverage to 
          consumers.  AB 922 states that the Legislature recognizes 
          that, because of the enactment of the Patient Protection 
          and Affordable Care Act (ACA) on March 23, 2010, and the 
          implementation of various provisions by January 1, 2014, it 
          is appropriate to transfer OPA and to confer new 
          responsibilities on OPA, including assisting consumers in 
          obtaining health care coverage and obtaining health care 
          through health coverage that is regulated by multiple 
          regulators, both state and federal.

           Veterans health benefits  .  UCLA's California Health 
          Interview Survey 2009 data reveal approximately 130,000 
          persons in California who had served in the U.S. Armed 
          Forces were uninsured despite some of these individuals 
          possibly being eligible for federal Veterans Affairs health 

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          care benefits.  On January 1, 2014, individuals - including 
          veterans - will be required to maintain health coverage 
          under the ACA.  The UCLA data additionally indicate that 
          174,000 individuals who had served in the armed forces were 
          covered by Medi-Cal.  The author's office argues that since 
          Medi-Cal is supposed to be the payer of last resort, a 
          veteran who is eligible to be covered under VA health 
          benefits should be enrolled in the VA health care program 
          rather than Medi-Cal, a shift which would save the state 
          money since the state pays half the cost for Medi-Cal 
          services while the federal government pays the entire cost 
          for VA health benefits. In addition, the medical benefits 
          offered through the VA health care system are often greater 
          than the benefits offered through Medi-Cal.

           Public Assistance Reporting Information System 
          (PARIS)-Veterans data match  .  According to an April 2012 
          report to the Legislature on the PARIS -Veterans Match, a 
          two-year pilot program to improve the identification of 
          Medi-Cal beneficiaries who are veterans (or dependents or 
          survivors) using PARIS was conducted to potentially improve 
          veterans access to enhanced health benefits by using VA 
          health benefits and improve the cost-effectiveness of 
          Medi-Cal.  The PARIS-Veterans data match is one of three 
          different data matches operated by the U.S. Department of 
          Health and Human Services' Administration for Children and 
          Families and allows states to compare their beneficiary 
          information with the VA.  The report describes how the 
          pilot project, operating from July 2009 to June 2011, 
          started with three counties (Fresno, San Bernardino, and 
          San Diego) and expanded to seven additional counties 
          (Alameda, Orange, Sacramento, San Mateo, San Francisco, 
          Santa Clara, and Solano), where the Department of Health 
          Care Services (DHCS) found 16,000 positive data matches, or 
          identifications of veterans enrolled in Medi-Cal.  To 
          maximize resources, DHCS focused on redirecting to VA 
          health benefits those beneficiaries who may have had high 
          Medi-Cal expenditures, those who could have had benefits 
          restored, and survivors who appeared eligible for VA's 
          Civilian Health and Medical Program, resulting in an 
          estimated $1.634 million in cost avoidance and savings for 
          the Medi-Cal program.

           FISCAL EFFECT :    Appropriation:  No   Fiscal Com.:  Yes   

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          Local:  No

           SUPPORT  :   (Verified  7/2/12)

          American Federation of State, County and Municipal 
          Employees
          California School Employees Association
          Health Access California
          National Association of Social Workers, California Chapter
          Western Center on Law and Poverty


           ARGUMENTS IN SUPPORT  :    Health Access California argues 
          that research has identified returning veterans as one of 
          the populations that faces a life transition where loss of 
          coverage is a common problem.  Since military veterans have 
          a greater need for health coverage, particularly the 
          broader benefits for mental health and substance abuse 
          treatment that will be available the ACA, this bill can 
          provide a great service to veterans without impact to the 
          state general fund.  The Western Center on Law and Poverty 
          adds that this bill will ensure that veterans are 
          adequately served by OPA and receive the information and 
          assistance that they deserve.


           ASSEMBLY FLOOR  :  74-0, 4/26/12
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Chesbro, Conway, Cook, Davis, Dickinson, 
            Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Beth 
            Gaines, Galgiani, Garrick, Gatto, Gordon, Gorell, Grove, 
            Hagman, Hall, Hayashi, Roger Hernández, Hill, Huber, 
            Hueso, Huffman, Jeffries, Knight, Lara, Logue, Bonnie 
            Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell, 
            Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan, 
            Perea, V. Manuel Pérez, Portantino, Silva, Skinner, 
            Solorio, Swanson, Torres, Valadao, Wagner, Wieckowski, 
            Williams, Yamada, John A. Pérez
          NO VOTE RECORDED:  Cedillo, Furutani, Halderman, Harkey, 
            Jones, Smyth



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          CTW:d  7/3/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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