BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Kevin de León, Chair
SB 800 (Lara) - California Health Benefit Exchange: outreach
services.
Amended: April 24, 2013 Policy Vote: Health 9-0
Urgency: Yes Mandate: No
Hearing Date: May 23, 2013 Consultant: Brendan McCarthy
SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
Bill Summary: SB 800 would require the Department of Health Care
Services to provide contact information to the California Health
Benefit Exchange for parents and caretakers of children enrolled
in the Healthy Families Program (or have been transitioned from
Health Families to Medi-Cal).
Fiscal Impact:
Minor administrative costs to the Department of Health Care
Services and/or the Major Risk Medical Insurance Board to
provide contact information (General Fund).
Likely costs in the low hundreds of thousands for the
California Health Benefit Exchange to contact parents and
caretakers (federal funds).
Potential increased costs in the Medi-Cal program in the
millions to low tens of millions (federal funds) for one
year. See below.
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 percent of the federal
poverty level, as well as blind, disabled, and certain other
populations.
In addition, the state Health Families Program provides health
care coverage for children from families with incomes too high
to qualify for traditional Medi-Cal benefits. Children from
households with incomes between 100% and 250% of the federal
poverty level are eligible for Health Families, with a
cost-sharing requirement based on household income. Beginning
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last year, the state has been transitioning children from Health
Families to Medi-Cal.
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 percent of the federal poverty level (effectively 138
percent of the federal poverty level as calculated under the
Affordable Care Act).
The Affordable Care Act provides a significantly enhanced
federal match for the Medicaid expansion. Under the law, the
federal government will pay for 100 percent of the cost of the
Medicaid expansion in 2013-14 declining to a 90 percent federal
match in the 2020 federal fiscal year and thereafter.
Proposed Law: SB 800 would require the Department of Health Care
Services to provide contact information to the California Health
Benefit Exchange for parents and caretakers of children enrolled
in the Healthy Families Program (or have been transitioned from
Health Families to Medi-Cal).
Related Legislation:
SB 28 (Hernandez) would require notification of subscribers
of two state-run health plans about coverage options that
will be available through the state's Health Benefit
Exchange. That bill is on the Senate Floor.
SB 249 (Leno) would permit the Department of Public Health
to share records relating to the diagnosis or care of
beneficiaries enrolled in certain health care programs with
specified entities. That bill will be heard in this
committee.
SB X1 1 (Hernandez) and AB X1 1 (J. Perez) would extend
Medi-Cal eligibility to all non-pregnant, non-Medicare
eligible, childless adults with income below 138 percent of
the federal poverty level, as authorized by the federal
Affordable Care Act.
Staff Comments: The intention of the bill is to provide the
parents and caretakers of Healthy Families children with
information about coverage options that will be available to
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them after January 1, 2014. Under current law, individuals up to
400% of the federal poverty level will be eligible for
subsidized coverage through the Exchange. In addition, the state
is considering expanding the eligibility for Medi-Cal to 138% of
the federal poverty level. Should the state decide to expand
Medi-Cal eligibility, a significant number of the parents of
Healthy Families children are likely to qualify for enrollment.
To the extent that this bill results in those individuals
learning of their eligibility for expanded Medi-Cal, enrollment
could increase, increasing costs. If even a modest share of
Healthy Families parents enroll in Medi-Cal earlier than they
would have because of the notifications provided in this bill,
the costs could be in the low tens of millions. Those costs
would be born entirely by the federal government, since the
Medi-Cal expansion will be funded entirely with federal funds
initially.
Any increase in Medi-Cal enrollment due to this bill would only
be temporary, as annual redeterminations of eligibility for
Healthy Families going forward are likely to lead eligible
parents to enroll in Medi-Cal.
Proposed Author Amendments: Would add an urgency clause to the
measure.