BILL ANALYSIS Ó
SB 800
Page 1
SENATE THIRD READING
SB 800 (Lara)
As Amended September 3, 2013
Majority vote
SENATE VOTE :39-0
HEALTH 13-5 APPROPRIATIONS 12-5
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|Ayes:|Pan, Ammiano, Atkins, |Ayes:|Gatto, Bocanegra, |
| |Bonilla, Bonta, Chesbro, | |Bradford, |
| |Gomez, | |Ian Calderon, Campos, |
| |Roger Hernández, | |Eggman, Gomez, Hall, |
| |Lowenthal, Mitchell, | |Holden, Pan, Quirk, Weber |
| |Nazarian, V. Manuel | | |
| |Pérez, Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Maienschein, Mansoor, |Nays:|Harkey, Bigelow, |
| |Nestande, Wagner, Wilk | |Donnelly, Linder, Wagner |
| | | | |
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SUMMARY : Transfers specified employees of the Managed Risk
Medical Insurance Board (MRMIB) to the Department of Health Care
Services (DHCS) or the California Health Benefit Exchange
(Exchange), now called Covered California, if any statute
dissolves or terminates MRMIB. Requires DHCS to provide the
Exchange, or its designee, information about parents or
caretakers of children enrolled in the Healthy Families program
(HFP) or the targeted low-income Medi-Cal program in order to
conduct outreach to potentially eligible individuals.
Specifically, this bill :
1)Requires, in order to assist the Exchange, to conduct outreach
to individuals potentially eligible for insurance
affordability programs, DHCS to provide the Exchange, or its
designee, with the names, addresses, email addresses,
telephone numbers, or other contact information, and written
and spoken languages of individuals who are not enrolled in
Medi-Cal but are the parents or caretakers of children
enrolled in HFP or have been transitioned from HFP to its
replacement, the targeted low-income Medi-Cal program.
SB 800
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2)Makes any permanent or probationary civil service employee who
is employed by MRMIB and assigned to the Federal Temporary
High Risk Pool whose function ceases to immediately be
transferred to the Exchange and to retain his or her status,
position, and rights pursuant to existing law and the State
Civil Service Act (SCSA).
3)Requires, if any statute dissolves or terminates MRMIB, any
employee of MRMIB who immediately prior to the effective date
of the dissolution or termination of MRMIB was assigned to
HFP, the Access for Infants and Mothers Program (AIM), the
County Health Initiative Matching (CHIM) Fund, or the Major
Risk Medical Insurance Program (MRMIP) to be transferred to
DHCS and to retain his or her status, position, and rights
pursuant to existing law and the SCSA.
4)Requires if any statute dissolves or terminates MRMIB, any
employee of MRMIB who, immediately prior to the effective date
of the dissolution or termination of MRMIB was assigned to the
Federal Temporary High Risk Pool to be transferred to the
Exchange and to retain his or her status, position, and rights
pursuant to existing law and the SCSA.
5)Requires, if any statute dissolves or terminates MRMIB, an
employee's applicable reinstatement rights that would have
applied to MRMIB, to instead apply to DHCS.
6)Requires DHCS to prepare a report on the transfer of employees
and functions upon dissolution of MRMIB by February 1 of the
year following the year in which employees are transferred
with a follow up report each of the two years following the
submission of the report.
EXISTING LAW :
1)Establishes MRMIP administered by MRMIB to provide major risk
medical coverage to California residents who have been
rejected for coverage by at least one private health plan, or
if the only private health coverage that the applicant can
secure would impose substantial waivers or provide limited
coverage or afford coverage only at an excessive price.
2)Requires MRMIB to cease to provide coverage through the
Federal Temporary High Risk Pool on July 1, 2013, except as
required by the contract between MRMIB and the United States
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Department of Health and Human Services, and at that time to
cease to operate the program except as required to complete
payments to, or payment reconciliations with, participating
health plans or other contractors, process appeals, or conduct
other necessary termination activities.
3)Creates the Exchange, as an independent state entity governed
by a five-member board, to be a marketplace for Californians
to purchase affordable, quality health care coverage, claim
advanceable premium tax credits and cost-sharing subsidies,
and as a way to meet the personal responsibility requirements
of the ACA.
4)Establishes, under state and federal law, the Medicaid program
(Medi-Cal in California) as a joint federal and state program
offering a variety of health and long-term services to
low-income women and children, low-income residents of
long-term care facilities, seniors, and people with
disabilities. Medi-Cal is administered by DHCS.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, the overall cost impact of the transfer of employees
should be minor. Employees may be reassigned to other duties
after the transfer if their functions cease. It is not clear
whether workload justifies the transfer of up to 76 employees to
DHCS. 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 General Fund. Medi-Cal costs for newly eligible
individuals are 100% federally funded through 2016.
COMMENTS : According to the author, this bill ensures access to
affordable care for California families, by ensuring the
successful and efficient implementation of the ACA in two ways.
First, this bill helps to promote health care access for as many
people as possible by facilitating effective outreach. This
bill also expedites the transfer of experienced staff with
relevant program knowledge who can provide the necessary
expertise to Covered California. This bill facilitates the
transfer of information about parents of the children enrolled
in HFP or being transitioned into Medi-Cal, to Covered
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California so that Covered California can conduct outreach to
these individuals. Outreach for this population is essential
because, by definition of their children's participation in HFP,
they are extremely likely to be able to access federal subsidies
making health care coverage possible. This bill further ensures
the successful implementation of the ACA by ensuring that
Covered California can obtain knowledgeable and experienced
staff. This bill provides for the transfer of a similarly
aligned workforce at MRMIB that will readily transition to
Covered California should MRMIB be dissolved. As a result of
the expanded ACA coverage options, many of MRMIB's participants
will obtain coverage elsewhere and many of MRMIB's programs and
enrollment functions will have transitioned to other
departments. This bill ensures Covered California will have
staff with the skills and expertise necessary to successfully
launch enrollment and outreach while simultaneously providing
employment security and certainty to a valuable resource of
knowledgeable and experienced staff.
MRMIB, an independent agency in state government has a long
history administering health insurance programs in California
such as HFP, AIM, MRMIP, and the Federal Temporary High Risk
Pool established under the ACA. The Federal Temporary High Risk
Pool is being phased out by the federal and state governments in
anticipation of the ACA. Actions initiated by Governor Brown's
Administration have raised questions about the future of MRMIB.
AB 1494 (Budget Committee), Chapter 28, Statutes of 2012,
enacted a transition of the approximately 860,000 HFP
subscribers into the Medi-Cal program to begin no sooner than
January 1, 2013, in four Phases throughout 2013. Children in
HFP will transition into Medi-Cal's new optional Targeted Low
Income Children's Program covering children whose family income
is up to and including 250% of the federal poverty level. As of
January 1, 2013, all newly eligible children are being enrolled
in Medi-Cal. The Governor's 2013-14 Budget Summary proposed to
phase out MRMIB, but the Legislature declined to adopt this
proposal.
Enrollment in some MRMIB programs may decline because of the
ACA. For example, some MRMIP subscribers could receive better
coverage and potentially pay lower premiums in Covered
California. Depending on income, many MRMIP enrollees will
likely be able to obtain more affordable coverage with better
benefits in Covered California (where premium and cost-sharing
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subsidies are available). However, not all MRMIP enrollees will
be eligible to participate in Covered California. Other MRMIB
programs such as AIM and CHIM will need to continue based on
federal requirements to maintain existing programs.
Proponents argue that this bill will allow the state to target
outreach efforts for enrollment in subsidized coverage and help
ensure more of California's uninsured become aware of the
coverage options available to them under the ACA starting next
year. Proponents state that it is more important than ever to
educate people about expanding subsidized health coverage
programs and take steps to enroll them in coverage. This is a
win-win-win. Tax subsidies are 100% federally funded and
coverage for the Medi-Cal expansion population is also 100%
federally funded through 2017, with the federal share gradually
reducing to 90% in 2020. The state, the health care economy,
and Californians will benefit immeasurably from these federally
funded health benefits.
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097
FN: 0002216