BILL ANALYSIS Ó
SB 800
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Date of Hearing: August 21, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
SB 800 (Lara) - As Amended: August 19, 2013
Policy Committee: HealthVote:13-5
Urgency: Yes State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires the Department of Health Care Services (DHCS)
to provide the California Health Benefits Exchange (Exchange)
with contact information of parents of children enrolled in the
Healthy Families Program (HFP) or Medi-Cal, as specified, in
order to assist the Exchange in conducting outreach.
It also requires, if any statute dissolves or terminates the
Managed Risk Medical Insurance Board (MRMIB), all civil service
employees at MRMIB to transfer either to the Exchange (in the
case of employees assigned to the Preexisting Condition
Insurance Program (PCIP)) or to DHCS (in the case of employees
assigned to other programs).
FISCAL EFFECT
1)The overall cost impact of the transfer of employees should be
minor. To the extent workload justifies new positions at the
Exchange and continuing workload at DHCS, and the employees
are transferred to these agencies, this bill may even result
in administrative cost savings or efficiencies, given MRMIB
employees are experienced in health program administration.
However, although administrative cost savings may occur if
this bill's transfer of employees substitutes for hiring of
new employees, it is not clear whether the higher level of
staffing at DHCS and the Exchange is justified by workload,
given the recent transition of HFP enrollees to Medi-Cal and
the impending closure of the PCIP program. Employees may be
reassigned to other duties after the transfer if their
functions cease.
SB 800
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Because the Exchange is staffing up considerably at this time,
it appears the Exchange would be able to absorb the existing
28 employees assigned to the PCIP program and benefit from the
transfer of knowledgeable staff. However, it is not clear
whether workload justifies the transfer of up to 76 employees
to DHCS. This bill does not require the Exchange or DHCS to
report back to the Legislature on how staff are being utilized
after the transfer and whether ongoing workload justifies the
continuation of the increased position authority.
2)Potentially significant state Medi-Cal costs, if more
individuals enroll in Medi-Cal more quickly than would
otherwise occur, as a result of outreach provided with
information required to be transferred by this bill. If
individuals are found to be eligible for Medi-Cal under
existing eligibility rules, the cost associated with these
individuals will be funded 50% through the GF. Medi-Cal costs
for newly eligible individuals are 100% federally funded
through 2016.
Total costs associated with new enrollment are unknown, and
would depend on the intensity and success of an Exchange
outreach campaign targeting parents. Any increased costs can
be considered one-time, as outreach conducted pursuant to this
bill would likely only speed up their enrollment in Medi-Cal.
If even a very low percentage of those contacted pursuant to
this bill enrolled in Medi-Cal as a result, total costs could
be in the millions. However, it is difficult to attribute a
precise level of increased enrollment to this bill
specifically, as intensive marketing campaigns will be taking
place throughout the state simultaneously with any outreach
conducted pursuant to this bill.
COMMENTS
1)Rationale . This bill seeks to provide the parents and
caretakers of children enrolled in public health insurance
programs with family income between 100-250% of the federal
poverty level information about coverage options that will be
available to them after January 1, 2014. Under current law,
individuals in families earning up to 400% of the federal
poverty level will be eligible for subsidized coverage through
the Exchange. In addition, the state recently expanded
Medi-Cal eligibility to all legal residents with family income
up to 138% of the federal poverty level. This bill allows, but
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does not require, the Exchange to make use of contact
information to provide outreach to potentially eligible
parents. DHCS must be required to provide this information by
law in order to comply with federal privacy rules regarding
confidential health information.
In addition, the bill ensures knowledgeable and experienced
staff from MRMIB are transferred to other agencies that can
make use of their skills in health program administration.
2)Related Legislation . AB 1 X1 (John A. Pérez), Chapter 3,
Statutes of 2013 First Extraordinary Session and SB 1 X1 (Ed
Hernandez and Steinberg), Chapter 4, Statutes of 2013 First
Extraordinary Session, implement various provisions of the
federal Affordable Care Act regarding Medi-Cal eligibility and
program simplification, including expansion of eligibility in
the Medi-Cal program.
SB 3 X1 (Ed Hernandez), Chapter 5, Statutes of 2013 First
Extraordinary Session requires the Exchange to establish a
"bridge plan" product by contracting with Medi-Cal managed
care plans for individuals losing Medi-Cal coverage (for
example, because of an increase in income), the parents of
Medi-Cal children, and individuals with incomes below 200%
FPL.
AB 1494 (Committee on Budget, Chapter 28, Statutes of 2012)
transfers HFP enrollees to Medi-Cal beginning January 1, 2013.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081