BILL ANALYSIS Ó AB 422 Page 1 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 AB 422 Page 2 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 AB 422 Page 3 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 AB 422 Page 4 FN: 0000409