BILL ANALYSIS                                                                                                                                                                                                    




                    Appropriations Committee Fiscal Summary
          
                                           794 (Chu)
          
          Hearing Date:   6/16/05         Amended:  6/9/05       
          Consultant:  John Decker            Policy Vote: Jud 5-2
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          BILL SUMMARY: AB 794 would authorize the state to receive  
          additional federal matching funds for financing prenatal  
          health care.  To achieve full current- and budget-year  
          savings, the state must take additional statutory,  
          administrative and budgetary actions prior to July 1, 2005.  
           The federal government must also grant a waiver.
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                          Fiscal Impact (in thousands)

           Major Provisions                       2005-06             
           2006-07              2007-08            Fund
           State AIM* Savings           $50,376            $61,880      
                 $65,000        Prop. 99**
          State Medi-Cal Savings    $94,440            $97,288         
            $100,000        General**

          Federal Matching Funds $144,815          $159,169           
          $165,000        Federal**

          * Access for Infants and Mothers (AIM)
          ** Assuming the federal government approves the entire  
          waiver request to be submitted by the Administration and  
          that the Governor signs SB 88 (Ducheny) before June 30,  
          2005.
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          STAFF COMMENTS: This bill is consistent with the Governor's  
          January budget proposal and was recommended by the Senate  
          budget subcommittee's staff (c.f., hearing agenda on April  
          4, 2005).
          
          In 2002, the federal government issued regulations  
          authorizing states to apply for federal funds to finance  
          prenatal care under the State Children's Health Insurance  
          Program (SCHIP). According to the Legislative Analyst's  
          Office, seven states (Arkansas, Illinois, Massachusetts  










          Michigan, Minnesota, Rhode Island and Washington) received  
          subsequent federal approval.  They have used the federal  
          funds to offset the cost of services provided to  
          undocumented immigrants, incarcerated pregnant women, and  
          other low-income pregnant women.  Two of the state's  
          prenatal health programs are almost exclusively financed  
          with state funds:

                 Access for Infants and Mothers (AIM) extends  
               comprehensive health care (during the pregnancy and 60  
               days after delivery) to low- to moderate-income women.  
                The program is financed with tobacco tax revenue  
               generated under the provisions of Proposition 99.   
               Under current law, these revenues cannot be used to  
               meet federal match requirements.  (SB 88 (Ducheny),  
               enrolled on June 8, 2005 and pending action by the  
               Governor, would authorize the state to leverage  
               Proposition 99 allocations against federal match  
               requirements.)


                                   Continued


          Page 2


          AB 794 (Chu)


                 Medi-Cal provides prenatal, delivery and  
               post-partum services to undocumented immigrants. The  
               prenatal and post partum services are entirely  
               supported with General Fund. 


          The Governor's budget assumes that the Legislature will  
          adopt the fiscal changes included in this bill.  If both AB  
          794 and SB 88 (Ducheny) are signed and the federal  
          government approves the state's waiver application before  
          June 30, 2005, then the state could shift over $300 million  
          (General Fund and Proposition 99 revenues) from state to  
          federal funds in the current and budget years.  Of this  
          amount, the General Fund costs would fall by about $192  
          million for the two-year period.  In the future, the  
          savings would be around $100 million annually.












          The Legislative Analyst notes (c.f., Analysis of the  
          2005-06 Governor's Budget) that the state may not be able  
          to successfully claim a federal match for the post-partum  
          services currently provided by AIM and Medi-Cal.  As such,  
          the savings may be less than the full $300 million listed  
          in the fiscal impact.