BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:                    SB 1477             
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          |AUTHOR:        |Committee on Health                            |
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          |VERSION:       |March 9, 2016                                  |
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          |HEARING DATE:  |April 13, 2016 |               |               |
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          |CONSULTANT:    |Vince Marchand                                 |
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           SUBJECT  :  Health

           SUMMARY  :  Requires the California Health Benefit Exchange to also be  
          known as Covered California, replaces references from the  
          now-repealed Healthy Families Program to the Medi-Cal program,  
          and from the repealed AIM-Linked Infants Program to the Medi-Cal  
          Access Program, and makes a technical change to ensure that  
          trade associations remain eligible for federal emergency  
          preparedness funds.
          
          Existing federal law:
          1)Requires, under the Patient Protection and Affordable Care Act  
            (ACA, Public Law 111-148), as amended by the Health Care  
            Education and Reconciliation Act of 2010 (Public Law 111-152),  
            each state, by January 1, 2014, to establish an American  
            Health Benefit Exchange that makes qualified health plans  
            available to qualified individuals and qualified employers.  
            Requires, if a state does not establish an Exchange, the  
            federal government to administer the Exchange. 

          Existing state law:
          1)Establishes the California Health Benefit Exchange (known as  
            Covered California) in state government, and specifies its  
            duties and authority. Requires Covered California to be  
            governed by a board that includes the Secretary of the  
            California Health and Human Services Agency and four members  
            with specified expertise who are appointed by the Governor and  
            the Legislature. 

          2)Establishes the Medi-Cal Program, administered by the  
            Department of Health Care Services (DHCS), which provides  
            comprehensive health benefits to low-income children up to 266  
            % of the federal poverty level (FPL), parents and adults up to  







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            138 % of the FPL, pregnant women, and elderly, blind or  
            disabled persons, who meet specified eligibility criteria.

          3)Establishes the Medi-Cal Access Program, which was formerly  
            known as the Access for Infants and Mothers Program or AIM) as  
            a low-cost health coverage program for pregnant women and  
            infants. The Medi-Cal Access Program provides coverage to  
            pregnant women with a household income between 208% and 317%  
            of the federal poverty.
          
          4)Establishes provisions of law to govern those instances when  
            federal funding is allocated and expended for public health  
            preparedness and response by local health jurisdictions,  
            hospitals, long-term health care facilities, clinics,  
            emergency medical systems, and poison control centers for the  
            prevention of, and response to, bioterrorist attacks and other  
            public health emergencies.

          5)Requires federal funding received by the Department of Public  
            Health (DPH) for bioterrorism preparedness and emergency  
            response to be subject to appropriation in the annual Budget  
            Act or other statute. Requires that that funds appropriated  
            for these purposes are to be allocated through the use of  
            agreements that are not subject to the State Contract Act, as  
            specified.
          
          This bill:
          1)Requires the California Health Benefit Exchange to also be  
            known as Covered California, and deems any reference to the  
            California Health Benefit Exchange or the Exchange to refer to  
            Covered California.

          2)Replaces references from the now-repealed Healthy Families  
            Program to the Medi-Cal program, and from the repealed  
            AIM-Linked Infants Program to the Medi-Cal Access Program. 

          3)Clarifies that trade associations are eligible for federal  
            emergency preparedness funds by including trade associations  
            in the list of eligible entities that may receive funds  
            through the use of agreements that are not subject to the  
            State Contract Act.

           FISCAL  
          EFFECT  :  None








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           COMMENTS  :
          1)Author's statement.  According to the author, this is an  
            omnibus committee bill intended to make technical, clarifying,  
            or noncontroversial changes to various provisions of law  
            relating to health care. This bill revises law in three areas:  
            formally recognizing Covered California as the name of the  
            California Health Benefit Exchange as Covered California while  
            retaining the ability to continue using the full California  
            Health Benefit Exchange if necessary for legal purposes;  
            correcting outdated terminology by replacing references to the  
            now-repealed Healthy Familes Program and the AIM-Linked  
            Infants Program to the Medi-Cal program and the Medi-Cal  
            Access Program, respectively; and, clarifying a bill from last  
            year that allowed trade associations to be eligible for  
            federal emergency preparedness funds by also adding trade  
            associations to a related provision of law governing how these  
            funds are allocated.
            
          2)Prior legislation.
               a)     AB 1149 (Wood, Chapter 93, Statutes of 2015) added  
                 trade associations to the list of entities that are  
                 eligible to receive federal funding, that has been  
                 allocated to DPH for public health preparedness and  
                 response; 
               b)     SB 900 (Alquist, Chapter 659, Statutes of 2010),  
                 established Covered California as an independent public  
                 entity within state government, and requires Covered  
                 California to be governed by a board composed of the  
                 Secretary of the Agency, or his or her designee, and four  
                 other members appointed by the Governor and the  
                 Legislature who meet specified criteria; 
               c)     AB 1494 (Committee on Budget, Chapter 28, Statutes  
                 of 2012), transitioned children enrolled in the Healthy  
                 Families Program to the Medi-Cal Program beginning  
                 January 1, 2013, in four Phases throughout 2013; and, 
               d)     SB 857 (Committee on Budget, Chapter 31, Statutes of  
                 2014), transferred the coverage of pregnant women through  
                 AIM to DHCS and renamed AIM as the
                  Medi-Cal Access Program.

          1)Support. This bill is supported by the California Association  
            of Health Facilities (CAHF), which states that recently, DPH  
            has stated that statutory clean-up to AB 1149 (Wood) of 2015  








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            is needed to continue the status quo of who is eligible to  
            receive funding through the Hospital Preparedness Program for  
            strengthening public health emergency preparedness. This bill  
            will assure that trade associations, such as CAHF, can  
            continue to participate in the program, as it has for years.

           SUPPORT AND OPPOSITION  :
          Support:  California Association of Health Facilities
          
          Oppose:   None received
          
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