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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