BILL ANALYSIS                                                                                                                                                                                                    Ó



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          Date of Hearing:  May 6, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          1114 (Bonilla) - As Amended April 16, 2015


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          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,  








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          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  








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            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














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