BILL ANALYSIS Ó AB 422 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 422 (Nazarian) As Amended July 2, 2013 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |71-2 |(May 16, 2013) |SENATE: |37-0 |(September 3, | | | | | | |2013) | ----------------------------------------------------------------- Original Committee Reference: HEALTH SUMMARY : Adds information regarding health care coverage available through the California Health Benefit Exchange (Exchange), known as Covered California, to notifications that may be included at the option of the school district or county superintendent 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. The Senate amendments : 1)Add authority to include the notice as part of the existing parental notifications at the beginning of the first semester or quarter of the regular school term, as specified; 2)Require compliance with the federal Americans with Disabilities Act of 1990; and, 3)Require, upon receipt of information provided on the School Lunch Program application, for a pupil who is not already enrolled in a health insurance affordability program, the county to treat the School Lunch Program application as an application for a health insurance affordability program. For purposes of administration of the Medi-Cal program, the application date shall be the date that the School Lunch Program application is received by the county human services department. Provide that the county shall take no further action if it determines that the pupil is already enrolled in a health insurance affordability program. FISCAL EFFECT : None AB 422 Page 2 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. AB 59 (Cedillo), Chapter 894, Statutes of 2001, established a statewide pilot project to expedite enrollment into Medi-Cal for children receiving free lunches through the National School Lunch Program, referred to as expedited enrollment. A parent checks a box on the school lunch application that they wish to have their child determined eligible for Medi-Cal. The county (which performs Medi-Cal eligibility determinations) receives a copy of the school lunch application for the child. Based on the information provided, a child can be found temporarily eligible for Medi-Cal benefits. The temporary eligibility lasts until a Medi-Cal determination has been completed, and the parent must sign and complete a form for the child to continue receiving Medi-Cal. If the child is not found temporarily eligible for Medi-Cal benefits, the child may be eligible for Medi-Cal once all information is reviewed (or previously, the child may have been eligible for the Healthy Families Program). The Department of Health Care Services Medi-Cal Eligibility Division indicates that the three counties received applications through express enrollment for this school year, with a total of 14 schools using the National School Lunch Plan/Medi-Cal application. In 2011-12, 74 applications were submitted through the National School Lunch Program and granted presumptive eligibility for Medi-Cal, of whom 27 (36%) became Medi-Cal eligible. In 2012-13, 37 applications were submitted and granted presumptive eligibility, of whom 21 (57%) became Medi-Cal eligible. 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. Successful implementation will rely heavily on increasing public awareness. According to the UCLA Center for Health Policy Research, it is estimated that two out of three uninsured children are eligible for public health coverage programs but are not enrolled. Furthermore, health problems are more likely to escalate, due to the lack of health insurance, consequently affecting a child's ability to learn and parents' ability to work. According to The Children's Partnership, 63% of California children who newly enroll in a health care coverage program demonstrate improvements in academic performance and pay closer attention in class. The ACA provides expanded health care coverage to millions of Californians and this bill is a mechanism to inform and help determine AB 422 Page 3 eligibility of families into health care programs. 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 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. 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 Exchange 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. AB 422 Page 4 Analysis Prepared by : Marjorie Swartz / HEALTH / (916) 319-2097 FN: 0001444