BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 422
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          ASSEMBLY THIRD READING
          AB 422 (Nazarian)
          As Introduced February 15, 2013
          Majority vote 

           HEALTH              19-0                                        
           
           ------------------------------------- 
          |Ayes:|Pan, Logue, Ammiano, Atkins,   |
          |     |Bonilla, Bonta, Chesbro,       |
          |     |Gomez, Roger Hernández,        |
          |     |Lowenthal, Maienschein,        |
          |     |Mansoor, Mitchell, Nazarian,   |
          |     |Nestande, V. Manuel Pérez,     |
          |     |Wagner, Wieckowski, Wilk       |
          |     |                               |
           ------------------------------------- 
           SUMMARY  :  Adds information regarding health care coverage  
          available through the California Health Benefit Exchange  
          (Exchange), to notifications on applications for the School  
          Lunch Program, effective January 1, 2014.  Information from the  
          application may currently be used to determine eligibility for  
          the Healthy Families Program, county or local-sponsored  
          programs, as defined and as applicable, if the parent has  
          granted consent when a child does not meet eligibility  
          requirements for Medi-Cal.  

           FISCAL EFFECT  :  None

           COMMENTS  :  According to the author, current law authorizes  
          school districts to provide families with notifications about  
          the availability of school lunch programs.  These notifications  
          also inform parents about the availability of low-cost health  
          care coverage for children.  The federal Patient Protection and  
          Affordable Care Act (ACA) offers individuals and families  
          additional health care coverage options including expanded  
          Medi-Cal coverage and tax subsidies through the Exchange.  The  
          author states that this bill will update current information  
          provided to parents about the availability of low-cost health  
          care coverage to include information about the new Exchange.   
          The author points out that multiple health problems may occur in  
          the absence of health insurance, consequently affecting a  
          child's ability to learn and parents' ability to work.  In  
          addition, children who have access to medical, dental, and  








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          vision care often experience a greater sense of well-being.   
          According to the Los Angeles Unified School District, this  
          translates into improved school attendance and higher academic  
          achievement. 

          The author cites the California Simulation of Insurance Markets  
          (CalSIM) Study, conducted by the UCLA Center for Health Policy  
          Research and the UC Berkeley Labor Center, which estimates that  
          1.42 million adults will be eligible for coverage under the new  
          Medi-Cal expansion.  An additional 2.6 million adults will be  
          eligible for tax credits to purchase health insurance through  
          California's new insurance marketplace, the Exchange (now called  
          Covered California).  Although children and families may be  
          eligible for these new coverage options, many parents are  
          unaware of health coverage options.  The CalSIM model includes  
          two scenarios to estimate take-up rates in Medi-Cal and Covered  
          California, a base model which assumes current individual and  
          market behaviors, and an enhanced model which assumes additional  
          outreach, enrollment, and simplification measures are in place.   
          For example, under the base scenario 900,000 adults under 65 are  
          predicted to enroll into Medi-Cal whereas under the enhanced  
          scenario with a more aggressive enrollment and outreach strategy  
          enrollment would reach 1.4 million by 2014.  The author argues  
          that by updating information about these new coverage options  
          parents would be better informed in order to take advantage of  
          the health care coverage.  

          An April 2013 Health Tracking Poll from the Kaiser Family  
          Foundation found that much of the public remains confused about  
          the ACA.  Four in 10 Americans (42%) were unaware that the ACA  
          is still the law of the land, including 12% who believe the law  
          has been repealed by Congress, 7% who believe it has been  
          overturned by the Supreme Court and 23% who do not know whether  
          or not the ACA remains law.  The poll further found that about  
          half of the public said they do not have enough information  
          about the health reform law to understand how it will impact  
          their own family, a share that rises among the uninsured and  
          low-income households.  

          The California Exchange was established in 2010 by AB 1602 (John  
          A. Pérez), Chapter 655, Statutes of 2010, and SB 900 (Alquist),  
          Chapter 659, Statutes of 2010.  Through Covered California,  
          people with incomes between the Medi-Cal threshold and up to  
          400% of the federal poverty level are eligible for subsidies and  








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          cost-sharing reductions.  The California Healthcare Eligibility,  
          Enrollment, and Retention System (CalHEERS) is a procurement  
          conducted jointly by the Exchange, the Department of Health Care  
          Services and the Managed Risk Medical Insurance Board to build  
          the Information Technology system to support the consumer  
          application and enrollment process at the Exchange.  The portal  
          will offer eligibility determinations for both Medi-Cal and  
          federally subsidized Covered California coverage through the  
          Exchange.  It will allow enrollment through multiple access  
          points including mail, phone, and in-person applications.  It is  
          guided by a "no wrong door" policy that is intended to ensure  
          the maximum number of Californians obtain coverage appropriate  
          to their needs.  Enrollment will begin by October 2013,  
          effective January 1, 2014.  The CalHEERS business functions  
          include interfacing with the Medi-Cal eligibility data system.   
          Covered California has a budget of about $290 million to reach  
          5.3 million Californians.  Slightly less than half the money is  
          going into television ads and other traditional media buys.   
          Most of the remaining funds are going into social media, data  
          mining and on-the ground outreach.  

          Covered California is also in the process of establishing an  
          Assister's Program that will include assister enrollment  
          entities (AEEs) and individual entities.  AEEs are entities and  
          organizations eligible to be trained and registered to provide  
          in-person assistance to consumers to help them apply for Covered  
          California programs, particularly entities that have access to  
          Covered California's targeted population.  Individual assisters  
          are individuals who are employed, trained, certified, and linked  
          to AEEs to provide in-person assistance to consumers and help  
          them apply for Covered California programs and are individuals  
          who can provide assistance in a culturally and linguistically  
          appropriate manner to consumers.  A list of eligible entities  
          will be established and Covered California is looking to all  
          opportunities to build a robust network of In-Person Assisters,  
          particularly those who have prior experience with healthcare and  
          providing application assistance.  School districts are listed  
          among the recommended proposed entities. 


           Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 










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