BILL ANALYSIS
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THIRD READING
Bill No: AB 794
Author: Chu (D)
Amended: 6/9/05 in Senate
Vote: 21
SENATE JUDICIARY COMMITTEE : 5-2, 06/14/05
AYES: Dunn, Cedillo, Escutia, Figueroa, Kuehl
NOES: Morrow, Ackerman
SENATE APPROPRIATIONS COMMITTEE : Not available
ASSEMBLY FLOOR : Not relevant
SUBJECT : Health care funding: Access for Infants and
Mothers
Program
SOURCE : California Health and Human Services Agency
DIGEST : This bill authorizes the Department of Health
Services to accept or use funds allocated to the state
under the federal State Childrens Health Insurance Program
to fund the medically necessary pregnancy-related services
provided to immigrants under the Medi-Cal program, and to
accept and use these funds for women in the Access for
Infants and Mothers Program only when, during the period of
coverage, the woman is the beneficiary. The bill affirms
the State Supreme Court's holding in People v. Belous and
state that the bill is declaratory of existing law.
CONTINUED
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ANALYSIS : Existing California case law has consistently
recognized, in a variety of contexts, such as prosecutions
for homicide and for "prenatal child abuse," that the fetus
is not a human being until birth. [ People v. Belous (1969)
71 Cal. 2d 954, 968.] Belous stands for the principle that
women have a fundamental right to make childbearing
decisions, including abortion.
Existing federal case law, Roe v. Wade (1973) 410 US. 113,
held that the word "person" as used in the Fourteenth
Amendment does not include the unborn. Since Roe v. Wade ,
the Supreme Court has reaffirmed in many cases a woman's
right of reproductive choice, which is based upon the
principle that the fetus is not a person with rights
separate from and equivalent to those of the pregnant
woman.
This bill states that California protects a woman's right
to reproductive privacy through its Constitution, the
courts, and statutes and that California reaffirms these
protections specifically as stated in People v. Belous ,
supra.
Existing federal law requires the state to adopt a plan for
the provision of health services to low-income children and
pre-natal services to low-income women, for the purpose of
receiving and using funds allocated to the state under the
State Children's Health Insurance Program (SCHIP) program.
Recent amendments to the federal regulations define "child"
for purposes of the SCHIP funds to mean an "individual
under the age of 19 years including the period from
conception to birth."
This bill authorizes the Department of Heath Services and
the Managed Risk Medical Insurance Board to accept and use
moneys under the SCHIP, as interpreted under the federal
regulations, only when, during the period of coverage, the
woman is the beneficiary. The bill requires the state's
SCHIP plan and any amendments submitted to be consistent
with this limitation.
This bill provides that the scope of services provided to
low-income children and low-income pregnant women would not
be altered by the bill or the state plan or any amendments
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made to the state SCHIP plan.
Background
Congress created the SCHIP federal health coverage program
in 1997 to provide health care services for low-income
children. [42 CFR 457.10.] Under 42 U.S.C. Section
1397jj(b)(1) and (c)(1), the SCHIP service population is
"targeted low-income children," defined as minors who are
"individual(s) under 19 years of age." However, a recent
amendment to the SCHIP regulations regarding the target
population redefines "child" to read: "'Child' means an
individual under the age of 19 including the period from
conception to birth."
In light of this expanded definition of "child" in the
SCHIP regulations, the state's acceptance of federal SCHIP
funds may result in potential legal implications relating
to reproductive rights, religious liberty, and potential
medical liability.
The amendments to this bill were drafted in consultation
with the Department of Health Services and groups concerned
about the impact of the new regulation on a woman's right
of reproductive privacy in California. Thus, it reflects a
delicate balance that would allow the state to continue to
receive federal funds under the SCHIP program while
avoiding any potential erosion of a woman's reproductive
rights in California. The language is not mandatory; the
state may accept and use the potentially restricted funds
only when the woman is the beneficiary. However, no
reduction in pregnancy-related services to low-income
pregnant women is expected, because the two programs that
provide such services, the Access for Infants and Mothers
and Medi-Cal's pre-natal care programs, are borne solely by
state funds [General Fund and Proposition 99 (tobacco
funds)].
According to the Health and Human Services Agency, this
bill provides the framework for California to access $288
million in new federal funds to support critical health
services. "This legislation clarifies that California will
accept and utilize the Federal funds for comprehensive
pregnancy-related services for women in a manner that is
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consistent with its Constitution, case law and statutes
that protect a woman's right to reproductive privacy."
(Letter from Health and Human Services Agency, dated June
9, 2005.)
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 6/15/05)
California Health and Human Services Agency (source)
American Association of University Women, California
American Civil Liberties Union
California Family Health Council
Maternal and Child Health Access
Maternal, Child, and Adolescent Health Action
Planned Parenthood Affiliates of California Inc.
ARGUMENTS IN SUPPORT : The recent change in the federal
regulation governing the allocation of SCHIP moneys has
become a concern to reproductive rights advocates, who see
the redefinition of "child" to include, in the 19 year age
limit, the period from conception to birth, as an effort to
promote the concept that fetuses are persons. In light of
this state's history relating to a woman's right of
reproductive choice, as established by both People v.
Belous and Roe v. Wade , the author's office and the
proponents believe it is important to ensure that no matter
what limitation the federal government places on the
federal funds that are to be allocated to the state, or
expansion into pre-natal care all the way back to
conception, such limitation or expansion does not erode a
woman's right of reproductive choice.
RJG:nl 6/15/05 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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