BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          SB 997 (Lara) - Health care coverage:  immigration status
          
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          |Version: April 20, 2016         |Policy Vote: HEALTH 7 - 1       |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: May 27, 2016      |Consultant: Brendan McCarthy    |
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          Bill  
          Summary:  SB 997 requires undocumented children who are eligible  
          for full-scope Medi-Cal coverage and who are enrolled in  
          low-cost coverage provided by Kaiser Permanente or another  
          Medi-Cal managed care plan to be enrolled in full-scope Medi-Cal  
          with the same health plan.


          *********** ANALYSIS ADDENDUM - SUSPENSE FILE ***********
             The following information is revised to reflect amendments 
                      adopted by the committee on May 27, 2016




          Fiscal  
          Impact:  
           Likely one-time administrative costs of about $1 million for  
            the Department of Health Care Services to coordinate with  
            health plans and determine Medi-Cal eligibility for current  
            low-cost coverage enrollees (General Fund). The Department  
            will need to collect information from health plans about their  
            current low-cost coverage enrollees who are likely to gain  







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            full-scope Medi-Cal eligibility, determine eligibility for  
            those individuals, and set up a special process for those  
            individuals to be directly enrolled with the same health plan  
            under full scope Medi-Cal. Because this is not the normal  
            process for determining Medi-Cal eligibility and assigning  
            enrollees to a Medi-Cal managed health plan, there will be  
            additional workload for the Department. (Because undocumented  
            immigrants are generally not eligible for federal financial  
            participation, all costs will be General Fund costs.)

           Likely increased Medi-Cal costs in the millions per year due  
            to increased enrollment in Medi-Cal under the bill (General  
            Fund). Under current law, undocumented immigrants under 19  
            years of age will be eligible for full-scope Medi-Cal on or  
            after May 1, 2016. The undocumented children who are the  
            subject of this bill will soon become eligible for full scope  
            Medi-Cal. However, without the bill, those children's' parents  
            will need to enroll them in Medi-Cal through the normal  
            application process. Given that these children are already  
            enrolled in health care coverage (often with a modest monthly  
            fee per child), it is likely that a high percentage of these  
            children's' parents will enroll them in Medi-Cal. However,  
            there is likely to be a small share of the current population  
            that will not enroll in Medi-Cal through the normal enrollment  
            process. Under the bill, the streamlined enrollment into  
            Medi-Cal is likely to reduce the number of individuals who  
            would lose coverage during the transition. For example, if 10%  
            of current program participants would not have transitioned to  
            Medi-Cal coverage without the bill and the bill reduces that  
            share to 5% losing coverage, the state cost for that  
            additional Medi-Cal coverage would be about $7 million per  
            year.


          Author  
          Amendments:  Clarify how information would be provided to the  
          families of enrollees, authorize the Department to implement the  
          bill without taking regulatory action, and require a report from  
          the Department. 


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