BILL ANALYSIS                                                                                                                                                                                                    Ó

          |SENATE RULES COMMITTEE            |                          SB 4|
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                                UNFINISHED BUSINESS 

          Bill No:  SB 4
          Author:   Lara (D), et al.
          Amended:  9/10/15  
          Vote:     21  

           SENATE HEALTH COMMITTEE:  7-0, 4/15/15
           AYES:  Hernandez, Hall, Mitchell, Monning, Pan, Roth, Wolk
           NO VOTE RECORDED:  Nguyen, Nielsen

           AYES:  Lara, Beall, Hill, Leyva, Mendoza
           NOES:  Bates, Nielsen

           SENATE FLOOR:  28-11, 6/2/15
           AYES:  Allen, Beall, Block, Cannella, De León, Galgiani,  
            Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso,  
            Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell,  
            Monning, Pan, Pavley, Roth, Vidak, Wieckowski, Wolk
           NOES:  Anderson, Bates, Berryhill, Fuller, Gaines, Huff,  
            Moorlach, Morrell, Nielsen, Runner, Stone
           NO VOTE RECORDED:  Nguyen

          ASSEMBLY FLOOR:  Not available

           SUBJECT:   Health care coverage: immigration status

          SOURCE:    Author

          DIGEST:  This bill requires undocumented individuals under 19  
          years of age enrolled in Medi-Cal at the time the Director of  
          Health Care Services (director) makes the determination to be  
          enrolled in full scope of Medi-Cal benefits, if otherwise  
          eligible, pursuant to an eligibility and enrollment plan. 


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          Assembly Amendments delete provisions extending eligibility for  
          full-scope Medi-Cal benefits to individuals under age 19 who are  
          otherwise eligible for those benefits but for their immigration  
          status (these provisions were included in the health budget  
          trailer bill), provisions extending Medi-Cal eligibility for  
          full-scope Medi-Cal benefits to individuals age 19 and older if  
          sufficient funding is available, and provisions requiring the  
          Secretary of California Health and Human Services Agency to  
          apply to the federal Department of Health and Human Services for  
          a Section 1332 innovation waiver in order to allow persons  
          otherwise not able to obtain coverage through Covered California  
          because of their immigration status to obtain coverage without  
          premium or cost-sharing subsidies.

          Existing law:

          1)Establishes the Medi-Cal program, administered by the  
            Department of Health Care Services (DHCS), under which low  
            income individuals are eligible for medical coverage. Medi-Cal  
            provides coverage to adults to adults and parents with incomes  
            up to 138 percent of the federal poverty level (FPL) who are  
            under age 65, and to children with incomes up to 266 percent  
            of the FPL.  

          2)Makes individuals who are under 19 years of age and who does  
            not have satisfactory immigration status or who are unable to  
            establish satisfactory immigration status eligible for the  
            full scope of Medi-Cal benefits, if he or she is otherwise  
            Medi-Cal eligible after the director determines that systems  
            have been programmed for implementation, but no sooner than  
            May 1, 2016. This provisions was contained this year's health  
            budget trailer bill. 

          3)Requires, to the extent permitted by state and federal law, an  
            undocumented individual under age 19 eligible under SB 97 to  
            enroll in a Medi-Cal managed care health plan.


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          This bill:

          1)Requires undocumented individuals under 19 years of age  
            enrolled in Medi-Cal at the time the director makes the  
            determination to be enrolled in the full scope of Medi-Cal  
            benefits, if otherwise eligible, pursuant to an eligibility  
            and enrollment plan. 

          2)Requires this plan to include outreach strategies developed by  
            the DHCS in consultation with interested stakeholders,  
            including, but not limited to, counties, health care service  
            plans, consumer advocates, and the Legislature. 

          3)Prohibits undocumented individuals under 19 years of age  
            enrolled in Medi-Cal from being required to file a new  
            application for Medi-Cal.

          4)Prohibits enrollment in a Medi-Cal managed care plan from  
            precluding a beneficiary from being enrolled in any other  
            children's Medi-Cal specialty program that he or she would  
            otherwise be eligible for. 

          5)Makes legislative findings that no child in California should  
            endure suffering and pain due to a lack of access to health  
            care services, expanding access and increasing enrollment in  
            comprehensive health care coverage benefits the health and  
            welfare of all Californians, and through the enactment of SB  
            75 (Committee on Budget and Fiscal Review, Chapter 18,  
            Statutes of 2015), the Legislature extended eligibility for  
            full-scope Medi-Cal benefits to all children in California,  
            regardless of immigration status.
           1)Author's statement. According to the author, this bill, the  
            "Health for All Act", expands access to healthcare coverage  
            for undocumented Californian children.  The bill makes  
            important changes to ensure successful implementation of the  
            recent Health for All Kids budget action that will cover all  
            income-eligible children under the state Medi-Cal program.

          Related Legislation


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          SB 75 (Committee on Budget and Fiscal Review, Chapter 18,  
          Statutes of 2015), the health budget trailer bill, extended  
          full-scope coverage to undocumented individuals under age 19 who  
          are Medi-Cal eligible except for the immigration status,  
          effective no sooner than May 1, 2015. Prior to this change,  
          these individuals were eligible for limited-scope coverage,  
          which is primarily coverage for pregnancy-related services and  
          emergency services. An estimated 170,000 individuals under age  
          19 are eligible under this benefit expansion. To fund the  
          expansion, the Legislature augmented the 2015-16 Budget by $40  
          million General Fund. Ongoing annual costs are estimated at $132  
          million General Fund.

          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No

          Unknown with latest amendments.

          SUPPORT:   (Verified9/9/15)

           ACCESS Women's Health Justice
           ACT for Women and Girls
           Advancement Project
           Advancing Justice - Asian Law Caucus
           AltaMed Health Services Corporation
           American Academy of Pediatrics
           American Civil Liberties Union of California
           Asian Americans Advancing Justice Sacramento
           Asian Health Services 
           ASPIRE Los Angeles 
           California Alliance of Retired Americans
           California Asian Pacific Islander Budget Partnership
           California Association of Public Hospitals and Health Systems
           California Black Health Network
           California Chapter National Association of Social Workers
           California Chapter National Council of Jewish Women
           California Communities United Institute


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           California Coverage and Health Initiatives
           California Immigrant Policy Center
           California Family Health Council
           California Family Resource Association 
           California Labor Federation
           California Latinas for Reproductive Justice
           California Lesbian, Gay, Bisexual, and Transgender Health and  
            Human Services Network
           California Nurse-Midwife Association
           California Nurses Association
           California Pan-Ethnic Health Network
           California Partnership
           California Primary Care Association
           California Program of All-Inclusive Care for the Elderly
           California Rural Legal Assistance Foundation
           California School Employees Association
           California School-Based Health Alliance
           California State Council of the Service Employees International  
           California Teachers Association
           Cal-Islanders Humanitarian Association
           Campaign for a Healthy California
           Children's Defense Fund California
           Clínica Monseñor Oscar A. Romero
           Community Clinic Consortium
           Congregations Building Community
           Consumers Union
           Council of Mexican Federations
           Educators for Fair Consideration
           Equality California 
           Friends Committee on Legislation of California
           Gray Panthers of San Francisco
           Greenlining Institute
           Having Our Say Coalition
           Health Access 
           HOPE (Hispanas Organized for Political Equality)
           Insurance Commissioner Dave Jones
           Korean Resource Center 
           La Familia Family Counseling Center, Inc.
           Latino Coalition for a Healthy California
           Mexican American Legal Defense and Educational Fund
           March of Dimes Foundation


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           National Council of La Raza 
           National Health Law Program
           National Immigration Law Center
           Orange County Immigrant Youth United
           Planned Parenthood Affiliates of California
           Planned Parenthood Mar Monte
           Sacramento Covered
           St. Anthony Foundation
           St. John's Well Child & Family Center 
           San Francisco Bay Area Physicians for Social Responsibility
           SEIU California
           The Children's Partnership
           United Christian Centers of the Greater Sacramento Area, Inc.
           United Domestic Workers/AFSCME Local 3930
           United Way Silicon Valley 
           United Ways of California
           Western Center on Law & Poverty
           Young Invincibles

          OPPOSITION:   (Verified9/9/15)

          None received

          ARGUMENTS IN SUPPORT:   Supporters of this bill include  
          immigrant rights, consumer, labor and children's groups, who  
          argue that individuals and communities suffer when people are  
          uninsured. Supporters argue the uninsured are more likely to be  
          diagnosed with cancer at an advanced state, to die after a heart  
          attack or accident, and to suffer poor outcomes from a stroke,  
          and that Californians are better off when everyone has access to  
          health insurance.  

          Prepared by:Scott Bain / HEALTH / 
          9/11/15 21:00:13


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