BILL NUMBER: SB 677 AMENDED
BILL TEXT
AMENDED IN SENATE MAY 23, 2011
AMENDED IN SENATE MARCH 22, 2011
INTRODUCED BY Senator Hernandez
FEBRUARY 18, 2011
An act to add Sections 14005.43 and 14005.44 to the Welfare and
Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
SB 677, as amended, Hernandez. Medi-Cal: eligibility.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions.
This bill would provide, to the extent required by federal law,
that the department shall not apply an assets or resources test for
purposes of determining eligibility for Medi-Cal or under a Medi-Cal
waiver, except as specified. This bill would also require, to the
extent required by federal law, the department to use the modified
adjusted gross income of an individual, or the household income of a
family, if applicable, for the purposes of determining income
eligibility for Medi-Cal or under a Medi-Cal waiver, except as
specified. The bill would provide that these provisions shall become
operative on January 1, 2014. Because each county is responsible for
making Medi-Cal eligibility determinations, the bill would increase
the duties of county officials and would thereby impose a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. It is the intent of the Legislature to implement the
provisions of Section 2002 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148), as amended by the federal
Health Care and Education Reconciliation Act of 2010 (Public Law
111-152), that prohibit the use of an assets or resources test in the
Medi-Cal program and that require the use of modified adjusted gross
income in determining Medi-Cal eligibility for certain individuals.
SEC. 2. Section 14005.43 is added to the Welfare and Institutions
Code, to read:
14005.43. (a) Notwithstanding any other provision of state law
and only to the extent required by federal law, the
department shall not apply an assets or resources test for purposes
of determining eligibility for Medi-Cal or under any Medi-Cal waiver,
except for individuals described in Section 1396a(e)(14)(D) of Title
42 of the United States Code.
(b) This section shall become operative on January 1, 2014.
SEC. 3. Section 14005.44 is added to the Welfare and Institutions
Code, to read:
14005.44. (a) For the purposes of this section, "modified
adjusted gross income" and "household income" have the meanings given
to those terms in Section 36B(d)(2) of the Internal Revenue Code of
1986.
(b) (1) Notwithstanding any other provision of state law
and to the extent required by federal law , for the
purposes of determining income eligibility for Medi-Cal or under any
Medi-Cal waiver for which a determination of income is required,
including with respect to the imposition of premiums and cost
sharing, the department shall use the modified adjusted gross income
of an individual and, in the case of an individual in a family
greater than one, the household income of the family.
(2) The department shall establish income eligibility thresholds
for populations to be eligible for Medi-Cal or under a Medi-Cal
waiver using modified adjusted gross income and household income that
are not less than the effective income eligibility levels that
applied under Medi-Cal or a Medi-Cal waiver on the date of enactment
of the federal Patient Protection and Affordable Care Act (Public Law
111-148).
(3) For purposes of complying with the maintenance of effort
requirements in Section 1396a(gg) of Title 42 of the United States
Code, during the transition to the use of modified adjusted gross
income and household income, the department shall, working with the
Secretary of the United States Department of Health and Human
Services, establish an equivalent income test that ensures
individuals eligible for Medi-Cal or under a Medi-Cal waiver on the
date of enactment of the federal Patient Protection and Affordable
Care Act (Public Law 111-148) do not lose coverage under Medi-Cal or
the applicable Medi-Cal waiver.
(c) Except as provided in Section 1396a(e)(14)(I) of Title 42 of
the United States Code relating to a 5 percent income disregard, no
type of expense, block, or other income disregard shall be applied by
the department to determine income eligibility for Medi-Cal or under
any Medi-Cal waiver, or for any other purpose applicable under
Medi-Cal or any Medi-Cal waiver for which determination of income is
required.
(d) This section shall not apply to individuals described in
Section 1396a(e)(14)(D) of Title 42 of the United States Code.
(e) This section shall be implemented only to the extent required
by federal law.
(e)
(f) This section shall become operative on January 1,
2014.
SEC. 4. The State Department of Health Care
Services shall adopt regulations to implement Sections 2 and 3 of
this act in accordance with the requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code.
SEC. 4. SEC. 5. If the Commission on
State Mandates determines that this act contains costs mandated by
the state, reimbursement to local agencies and school districts for
those costs shall be made pursuant to Part 7 (commencing with Section
17500) of Division 4 of Title 2 of the Government Code.