BILL ANALYSIS Ó
AB 422
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CONCURRENCE IN SENATE AMENDMENTS
AB 422 (Nazarian)
As Amended July 2, 2013
Majority vote
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|ASSEMBLY: |71-2 |(May 16, 2013) |SENATE: |37-0 |(September 3, |
| | | | | |2013) |
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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
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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
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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.
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Analysis Prepared by : Marjorie Swartz / HEALTH / (916) 319-2097
FN: 0001444