BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      SB 10


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          SENATE THIRD READING


          SB  
          10 (Lara)


          As Amended  April 28, 2016


          2/3 vote.  Urgency


          SENATE VOTE:  28-9


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Health          |12-3 |Wood, Bonilla, Burke, |Patterson,          |
          |                |     |Campos, Chiu, Gomez,  |Steinorth, Waldron  |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Roger Hernández,      |                    |
          |                |     |Nazarian,             |                    |
          |                |     |Ridley-Thomas,        |                    |
          |                |     |Rodriguez, Santiago,  |                    |
          |                |     |Thurmond              |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Appropriations  |14-6 |Gonzalez, Bloom,      |Bigelow, Patterson, |
          |                |     |Bonilla, Bonta,       |Gallagher, Jones,   |
          |                |     |Calderon, Daly,       |Obernolte, Wagner   |
          |                |     |Eggman, Eduardo       |                    |
          |                |     |Garcia, Roger         |                    |
          |                |     |Hernández, Holden,    |                    |








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          |                |     |Quirk, Santiago,      |                    |
          |                |     |Weber, Wood           |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
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          SUMMARY:  Requires the Secretary of California Health and Human  
          Services Agency (CHHSA) to apply for a waiver under Section 1332  
          of the Patient Protection and Affordable Care Act (ACA) to allow  
          persons otherwise not able to obtain coverage by reason of  
          immigration status to obtain coverage through California's  
          Health Benefit Exchange (the Exchange or Covered California).  


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee:


          1)Minor and absorbable administrative costs to Covered  
            California to apply for the waiver.  The CHHSA indicates  
            Covered California is the appropriate entity to submit the  
            waiver application (California Health Trust Fund). 


          2)Significant Information Technology (IT) costs to Covered  
            California, potentially in the millions. Costs include  
            planning, development, and testing of functionality to allow  
            for designation of undocumented status, and facilitate  
            enrollment into "California qualified health plans"  
            (California Health Trust Fund). 


          3)Potentially significant, unknown ongoing costs to Covered  
            California associated with additional enrollment and  
            maintenance of IT systems.  Covered California also notes  
            implementation would need to include revisions to their  
            marketing campaign, to explain potentially confusing  
            differences in subsidies for families of mixed immigration  








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            status.


          COMMENTS:  The author states that this bill directs the state to  
          apply for a federal waiver to allow undocumented Californians to  
          buy health insurance with their own money through Covered  
          California.  According to the author, this bill affirms  
          California's commitment to embrace and integrate our immigrant  
          community, to lead where the federal government has failed, and  
          to acknowledge the hard work and sacrifice of a community that  
          contributes billions of dollars to our gross domestic product.   
          If successful, this bill will allow 390,000 immigrants who earn  
          an income too high to qualify for Medi-Cal to purchase  
          healthcare through the Exchange under the ACA.  This bill will  
          make California the first state in the nation to make this  
          petition to the federal government.  


          Under existing state and federal law, undocumented adults who  
          are otherwise income-qualified for Medi-Cal are not eligible for  
          full scope services, and are instead eligible for "limited  
          scope" Medi-Cal benefits.  Limited scope services are long-term  
          care, pregnancy-related benefits, and emergency services.   
          Undocumented immigrants are also prohibited from purchasing  
          coverage on the Exchange under federal law, and are ineligible  
          for federal subsidies.  However, California law requires health  
          plans and insurers to make the same health plans and policies  
          available on and off the Exchange, and currently, all  
          Californians can enroll off the Exchange; however, these  
          products would not be subsidized with advanced premium tax  
          credit or cost sharing reductions.  The University of  
          California, Berkeley, Center for Labor Research and Education  
          indicated that more than 2.7 million Californians are expected  
          to remain uninsured under the ACA in 2019.  


          Current California law extended full-scope Medi-Cal benefits to  
          children.  Specifically, SB 75 (Committee on Budget and Fiscal  
          Review), Chapter 18, Statutes of 2015, requires the Department  








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          of Health Care Services to provide full-scope Medi-Cal benefits  
          to children, under age 19, who do not have satisfactory  
          immigration status or are unable to establish satisfactory  
          immigration status.  Implementation began on May 16 and  
          full-scope eligibility will be retroactive to May 1.  


          The federal ACA included a provision (Section 1332) that allows  
          certain ACA requirements to be waived and allows states to  
          pursue broad alternative approaches to expand coverage, or  
          targeted changes like the one proposed in this bill.  Waivers  
          must meet several federal requirements related to affordability  
          and coverage and must not increase the federal deficit over 10  
          years.  Federal guidance related to Section 1332 waivers was  
          released last year, and waivers can be effective as early as  
          January 1, 2017.   


          Covered California engaged stakeholders to discuss potential  
          Section 1332 waiver proposals and notes that a Section 1332  
          waiver would require considerable Covered California staff time  
          and resources.  Covered California states that there was  
          significant public comment in support of expanding coverage to  
          additional populations such as undocumented Californians  
          specifically that all members of mixed immigration status  
          families would be able to apply for coverage directly through  
          Covered California.  This proposal would simplify the family  
          health insurance shopping and enrollment experience.  Covered  
          California also notes that there was not conclusive data  
          presented regarding the demand for Covered California enrollment  
          from undocumented Californians.  Expert opinion indicated that  
          there could be an increase in overall enrollment in Covered  
          California due to mixed families being more likely to apply  
          through one-stop shopping and because of reduced fears related  
          to immigration status of undocumented family members.  The  
          estimated potential enrollment presented to Covered California  
          during the stakeholder discussions was 50,000.  










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          This bill is supported by numerous health care, immigration,  
          labor, and other advocacy organizations.  There is no registered  
          opposition on file.




          Analysis Prepared by:                                             
                          Kristene Mapile / HEALTH / (916) 319-2097  FN:  
          0003012