BILL ANALYSIS Ó AB 1114 Page 1 Date of Hearing: May 6, 2015 ASSEMBLY COMMITTEE ON APPROPRIATIONS Jimmy Gomez, Chair AB 1114 (Bonilla) - As Amended April 16, 2015 ----------------------------------------------------------------- |Policy |Health |Vote:|18 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: NoReimbursable: No SUMMARY: This bill clarifies the type of documents related to state health insurance affordability programs that must be accessible, standardized, and provided in multiple languages. Specifically, it defines such "forms, letters, and notices" as application, AB 1114 Page 2 renewal, and other forms and letters needed to obtain or retain eligibility, benefits, or services from an insurance affordability program, and all notices affecting the legal rights of applicants, beneficiaries, and enrollees. FISCAL EFFECT: 1)Implementation costs for translation and information technology (IT) services to Covered California / Department of Health Care Services, which are joint sponsors of the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS), potentially in the range of $2 million (GF/federal/special funds). The vast majority of this cost is for IT. 2)Unknown, potential ongoing cost pressure to the state (GF/federal/special funds) for county administrative costs. Counties determine eligibility for Medi-Cal and Covered California, and would incur additional costs if additional translations are necessary beyond the standard translations included in the automated CalHEERS system. COMMENTS: 1)Purpose. According to the author, this bill is necessary to ensure renewal notices for state health insurance affordability programs are provided in multiple languages. 2)Background. Pursuant to the federal Affordable Care Act (ACA), California has a "no wrong door" for state health insurance affordability programs, whereby applicants can be found eligible for Medi-Cal or premium subsidies through Covered California, depending on income. Although related application forms for the programs are currently available in 12 AB 1114 Page 3 languages, renewal forms for these programs in multiple languages, though they exist, are not currently being used. 3)Recent Litigation. On November 17, 2014, the Western Center on Law & Poverty and other consumer advocacy groups filed a petition for a writ of mandate against DHCS due to its failure to use 2014 Medi-Cal renewal forms that were in languages other than English and Spanish. The plaintiffs alleged DHCS was in acting in violation of existing federal and state law that requires more expansive language accessibility. On February 19, 2015, the court denied part of the motion, citing that existing law on renewal forms does not explicitly require such translation. 4)Staff Comments. Covered California states their strategic plan for CalHEERS includes translation and automation in all threshold languages. However, this bill will take effect in 2016, requiring them to implement these provisions faster than planned. Given technical and clarity issues with notices that Covered California is still sorting through, the accelerated implementation could lead to inefficiency-for example, increased costs to re-translate notices or re-deploy and re-test in multiple languages rather than ironing out issues in English, then translating. Given this, the author may wish to consider whether a phased-in or delayed implementation is worthwhile in order to better align with the existing Covered California strategic IT implementation plans. Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081 AB 1114 Page 4