BILL ANALYSIS Ó Senate Appropriations Committee Fiscal Summary Senator Kevin de León, Chair AB 1208 (Pan) - Insurance affordability programs: application form. Amended: September 6, 2013 Policy Vote: Health 6-2 Urgency: No Mandate: No Hearing Date: September 12, 2013 Consultant: Brendan McCarthy This bill does not meet the criteria for referral to the Suspense File. This bill was referred to this committee pursuant to Senate Rule 29.10(c). Bill Summary: AB 1208 would permit the application form for insurance affordability programs (including Medi-Cal and health care coverage through the California Health Benefit Exchange) to include questions on sexual orientation and gender identity. After January 1, 2015, the bill would require the application to include specified demographic questions. Fiscal Impact: One-time costs of $100,000 to $150,000 to modify information technology systems to allow the health care coverage application system for Medi-Cal and the California Health Benefit Exchange to include required demographic questions in the application (federal funds or special funds). Background: Under state and federal law, the Department of Health Care Services operates the Medi-Cal program, which provides health care coverage to pregnant women, children and their parents with incomes below 100% of the federal poverty level, as well as blind, disabled, and certain other populations. The federal Affordable Care Act allows states to expand Medicaid (Medi-Cal in California) eligibility to persons under 65 years of age, who are not pregnant, not entitled to Medicare Part A or enrolled in Medicare Part B, and whose income does not exceed 133% of the federal poverty level (effectively 138% of the AB 1208 (Pan) Page 1 federal poverty level as calculated under the Affordable Care Act). California has opted to expand eligibility for Medi-Cal up to 138% of the federal poverty level. The Affordable Care Act provides a significantly enhanced federal match for the Medicaid expansion. Under the law, the federal government will pay for 100% of the cost of the Medicaid expansion in 2013-14 declining to a 90% federal match in the 2020 federal fiscal year and thereafter. AB X1 1 (J. Perez, Statutes of 2013) and SB X1 1 (Hernandez and Steinberg, Statutes of 2013) implement the expansion of Medi-Cal and include a number of changes to the eligibility and enrollment process for the Medi-Cal program. AB X1 1 and SB X1 1 require a single application paper, electronic, or telephone application for Medi-Cal and health care coverage through the California Health Benefit Exchange. Current law authorizes the single application to include questions about the applicant's demographic characteristics. Those questions are voluntary for the applicant to answer. Proposed Law: AB 1208 would permit the application form for insurance affordability programs (including Medi-Cal and health care coverage purchased through the California Health Benefit Exchange) to include questions on sexual orientation and gender identity. After January 1, 2015, the bill would require the application for to include specified demographic questions - including questions regarding the applicant's race, ethnicity, primary language, disability status, sexual orientation, gender identity or expression. Applicants would not be required to answer those demographic questions to complete the application. Related Legislation: AB 50 (Pan) formerly included language identical to this bill. Those provisions were amended out of that bill. That bill has been enrolled.