BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 1869| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ CONSENT 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 CONTINUED AB 1869 Page 2 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 CONTINUED AB 1869 Page 3 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 CONTINUED AB 1869 Page 4 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 CTW:d1 7/3/12 Senate Floor Analyses CONTINUED AB 1869 Page 5 SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED