BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 880
                                                                  Page  1

          Date of Hearing:   May 15, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                    AB 880 (Gomez) - As Amended:  April 24, 2013 

          Policy Committee:                              HealthVote:13-5

          Urgency:     No                   State Mandated Local  
          Program:YesReimbursable:          No

           SUMMARY  

          This bill establishes the Employer Responsibility for Medi-Cal  
          Cost of Employees Act of 2013 to impose a penalty on large  
          employers of employees who work more than eight hours a week and  
          are enrolled in Medi-Cal.  Specifically, this bill:

          1)Makes it unlawful for a large employer to designate an  
            employee as an independent contractor, temporary employee,  
            reduce an employee's hours, or terminate an employee in order  
            to avoid the employer's health coverage obligations.

          2)Defines a covered employee as one who a) works for a large  
            employer (those with 500 or more employees except specified  
            governmental employers); b) enrolls in Medi-Cal based on the  
            Modified Adjusted Gross Income (MAGI) standard; c) works more  
            than eight hours per week; and d) includes leased employees or  
            others under the direction and control of the employer.

          3)Requires every large employer to pay a large employer  
            responsibility penalty of 110% of the average cost of health  
            care coverage, as specified, for every covered employee  
            defined in # 2 above. 

          4)Includes numerous provisions for implementation, including a  
            requirement that the Department of Health Care Services (DHCS)  
            match Social Security Numbers of individuals enrolled in  
            Medi-Cal with information provided by the Employment  
            Development Department (EDD) to determine whether individuals  
            are covered employees and for EDD to be responsible for  
            collection activities.

          5)Establishes the Employer Responsibility for Medi-Cal Trust  








                                                                  AB 880
                                                                  Page  2

            Fund into which penalties generated by this bill will be  
            deposited and then continuously appropriated to DHCS.  This  
            bill requires a two-thirds vote because of the appropriation.

           FISCAL EFFECT  

          1)One-time costs to EDD of approximately $1 million to develop  
            collection capabilities, including mailing information to  
            employers, computer programming changes, development of a new  
            interface with DHCS for data transmission.  Ongoing costs of  
            $420,000.

          2)One-time and ongoing costs of more than $200,000 to DHCS for  
            its part of the EDD interface.  

          3)Costs are likely to be more than offset by revenues generated  
            by the penalties in this bill. Revenues are difficult to  
            predict because this bill could lead employers to change their  
            behavior in order to avoid the penalty. For example, if  
            250,000 people meet this bill's definition of covered  
            employees, the penalties would be in the tens of millions of  
            dollars.  If some of the affected employers provide  
            appropriate health coverage, the penalty revenue to the state  
            would be lower, but state costs for Medi-Cal would also be  
            lower.

           COMMENTS  

           1)Rationale  .  This bill seeks to extend the Affordable Care  
            Act's (ACA's) employer responsibility requirement to employers  
            with employees who enroll in Medi-Cal, in order to discourage  
            these employers from shifting the cost of providing health  
            coverage for their employees onto the state.  This bill closes  
            a loophole in the ACA's employer penalty provisions.   
            Specifically, the ACA requires individuals, employers, and  
            government to share responsibility for health coverage.   
            Individuals must have health coverage or pay a penalty.   
            Employers with an average of at least 50 full time employees  
            must either provide affordable health coverage or pay a  
            penalty for each employee who accesses subsidized coverage in  
            the state health benefits exchange.  

            An employer whose employees become eligible for Medi-Cal  
            because wages and hours cause the family income to fall below  
            the MAGI standard avoid paying for the employee's health  








                                                                  AB 880
                                                                  Page  3

            insurance if Medi-Cal covers the employee. The author states  
            the penalty proposed in this bill is intended to help offset  
            that cost of the public subsidy.  The federal government  
            provides subsidies for premiums and cost-sharing through state  
            exchanges and allows states to expand their Medicaid programs  
            with 100% federal funding for the first three years.  

            The California Labor Federation  and United Food & Commercial  
            Workers Western States Council are co-sponsors of this  
            measure.  Supporters include numerous stakeholder groups  
            representing labor and consumers, including Health Access, the  
            Congress of California Seniors, and SEIU California.   
            Supporters argue large employers are reducing worker hours to  
            avoid providing insurance, shifting the cost to the state.  

           2)Background  .  The ACA was enacted in 2010, with most provisions  
            taking effect January 1, 2014. One of its main objectives is  
            to dramatically increase the number of individuals with health  
            insurance coverage in this country.  With an insurance mandate  
            on individuals and employers and an expansion of the Medi-Cal  
            program, combined with tax credits and subsidies to assist in  
            paying for coverage, the ACA should lead to the largest  
            expansion of healthcare coverage since the creation of  
            Medicare and Medicaid in the 1960s.   

           3)Opposition  .  This bill is opposed mostly by large retailers  
            and restaurant chains. The California Retailers Association  
            and California Business Properties Association argue the  
            penalty of 110% of the average cost of health insurance  
            provided by large employers is based on individual or family  
            coverage, yet it is estimated to run between $6,000 and  
            $15,745.  Citing a Kaiser Family Foundation study, this  
            opposition states the national average cost for individual  
            healthcare coverage in 2012 was $5,615.  

            The opposition states that this bill does not even provide  
            employers enough information to comply with the law.  The  
            opposition further states this bill goes beyond the scope of  
            the ACA by taxing employers that do not provide their  
            employees quality jobs with a host of benefits and will  
            discourage large employers from hiring at a time when  
            California's unemployment rate is one of the highest in the  
            country.  The California Chamber of Commerce is also opposed.
              









                                                                  AB 880
                                                                  Page  4


           Analysis Prepared by  :    Debra Roth / APPR. / (916) 319-2081