BILL ANALYSIS �
AB 50
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Date of Hearing: May 24, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 50 (Pan) - As Amended: May 13, 2013
Policy Committee: HealthVote:13-5
Urgency: Yes State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires the Department of Health Care Services (DHCS)
to establish, pursuant to the federal Affordable Care Act (ACA),
a process to allow a hospital to make a preliminary
determination of a person's Medi-Cal eligibility. Makes other
technical and clarifying ACA implementation changes.
FISCAL EFFECT
Minor and absorbable costs, potentially offset by savings from
federal matching funds being made available earlier.
COMMENTS
1)Rationale . The ACA authorizes states to allow hospitals to
make a determination of presumptive eligibility (PE). This
provision is not currently included in other health reform
implementation measures. This bill also makes changes to
eliminate obsolete Medi-Cal enrollment procedures and to
include the use of certain demographic data as optional
questions in the new simplified application process that will
be used to implement the ACA. This bill is supported by
several organizations including the American Federation of
State, County and Municipal Employees, AFL-CIO, Health Access
California, Western Center on Law and Poverty, and the
California Pan-Ethnic Health Network.
2)Background . Among other provisions, the ACA permits states to
expand Medicaid, effective January 2014, to childless adults
between the ages of 19 and 65, with income up to 133% of the
federal poverty level (FPL). A standard 5% income disregard
makes the effective level 138% FPL. For newly eligible
AB 50
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individuals, the ACA provides full 100% federal funding from
2014 to 2016; 95% for 2017; 94% for 2018; 93% for 2019; and,
90% for 2020 and beyond. In addition, the ACA requires that
existing eligibility categories for families and children be
revised and simplified so that income eligibility for all,
with the exception of seniors and people with disabilities,
will be based on a Modified Adjusted Gross Income (MAGI)
standard. Eligibility is to be determined without assets or
resource tests. Under the expansion, it is estimated between
1.2 and 1.6 million adults will become newly enrolled in
Medi-Cal in California.
3)Related legislation .
a) AB 1 X1 (John A. P�rez) and SB 1 X1 (Ed Hernandez and
Steinberg) implement various ACA provisions related to
Medi-Cal eligibility and program simplification including
the use of MAGI and eligibility expansion in the Medi-Cal
program. Each bill is pending in the Health Committee of
the second house.
b) SB 3 X1 (Ed Hernandez) requires the California Health
Benefit Exchange (known as Covered California) to establish
a "bridge" plan product by contracting with Medi-Cal
managed care plans for individuals losing Medi-Cal coverage
(for example, because of an increase in income), the
parents of Medi-Cal children, and individuals with incomes
below 200% FPL. SB 3 X1 is pending in the Assembly Health
Committee.
c) AB 2 X1 (Pan), Chapter 1, Statutes of 2013-14 First
Extraordinary Session and SB 2 X1 (Hern�ndez), Chapter 2,
Statutes of 2013-14 First Extraordinary Session, enact
substantially similar provisions to implement ACA insurance
provisions related to health insurance regulated under the
Insurance Code and the Health and Safety Code,
respectively.
d) SB 28 (Ed Hernandez and Steinberg) facilitates outreach
to individuals, currently enrolled in California's two
high-risk health insurance pools, to let these individuals
know they may be eligible for subsidized coverage Covered
California or no-cost coverage through Medi-Cal. SB 28 is
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pending referral in the Assembly.
Analysis Prepared by : Debra Roth / APPR. / (916) 319-2081