BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                   AB 794|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 445-6614         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 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





                                                                AB 794
                                                                Page  
          2

           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  







                                                                AB 794
                                                                Page  
          3

          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  







                                                                AB 794
                                                                Page  
          4

          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

                                ****  END  ****