BILL ANALYSIS
AB 794
Page 1
Date of Hearing: June 21, 2005
ASSEMBLY COMMITTEE ON HEALTH
Wilma Chan, Chair
AB 794 (Chu) - As Amended: June 9, 2005
SUBJECT : Health care funding: aliens: Access for Infants and
Mothers Program (AIM).
SUMMARY : Permits the Department of Health Services (DHS) and
the Managed Risk Medical Insurance Board (MRMIB) to accept or
use federal moneys allocated under the State Children's Health
Insurance Program (S-CHIP) to fund specified services to women
under the Medi-Cal and AIM programs. Specifically, this bill :
1)States that through its courts, statutes, and under its
Constitution, California protects a woman's right to
reproductive privacy and that California reaffirms these
protections and specifically its Supreme Court decision in
People v. Belous (1969) 71 Cal.2d 954, 966-68.
2)Permits DHS and MRMIB to accept or use moneys under S-CHIP, as
specified, to fund medically necessary pregnancy-related
services for alien women under Medi-Cal and services under AIM
only when, during the period of coverage, the woman is the
beneficiary.
3)Prohibits the scope of services covered under Medi-Cal and
AIM, as defined in statutes, regulations, and state plans,
from being altered by this bill or the state plan amendment
submitted pursuant to this bill.
4)Requires California's S-CHIP plan and any amendments submitted
and implemented pursuant to this bill to be consistent with
#1) and #2) above.
5)Specifies that this bill is a declaration of existing law.
EXISTING LAW :
1)Establishes the AIM program, administered by MRMIB, to provide
health coverage, at a minimum, to subscribers during one
pregnancy, and for 60 days thereafter. Requires any infant
born to a woman covered under AIM to be automatically enrolled
in the Healthy Families Program for first 12 months of the
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infant's life.
2)Establishes the Medi-Cal program, administered by DHS, under
which qualified low-income persons receive health care
benefits. Provides that any alien who is otherwise eligible
for Medi-Cal services, but who does not meet certain federal
residency requirements, is only eligible for care and services
that are necessary for the treatment of an emergency medical
condition and medical care directly related to the emergency
and for medically necessary pregnancy-related services.
3)Under the federal Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, prohibits any alien who is not a
qualified alien, as defined, from being eligible for federal
public benefits, including under Medicaid (Medi-Cal in
California) except for care and services necessary for the
treatment of an emergency medical condition. Prohibits a
state from providing defined state public benefits to certain
aliens, unless state legislation is enacted subsequent to the
effective date of the act.
FISCAL EFFECT : According to the Senate Appropriations
Committee analysis, if this bill and SB 88 (Ducheny) are signed
by the Governor and the federal government approves the state
plan amendment application before June 30, 2005, 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 would shift about $192
million for the two year period. In the future, state savings
would be approximately $165 million annually.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, recent federal
regulations permit states to use S-CHIP funds (a 65% federal
match) for health benefits coverage, including prenatal care
and delivery. To capture these funds for the current and
future budget years, California must submit an S-CHIP State
Plan Amendment to the Centers for Medicare and Medicaid
Services (CMS) by June 30, 2005. This bill provides the
framework for California to access S-CHIP funds for prenatal
care services while assuring that receipt of these federal
funds does not erode or jeopardize existing California law
regarding the provision of prenatal care services to women, or
existing Supreme Court rulings regarding a woman's right to
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privacy.
2)S-CHIP FUNDS . According to CMS, as part of the Balanced
Budget Act of 1997, Congress created Title XXI (S-CHIP) as a
federal/state partnership, with the goal of expanding health
insurance to children whose families earn too much money to be
eligible for Medicaid, but not enough money to purchase
private insurance. S-CHIP was the single largest expansion of
health insurance coverage for children since the initiation of
Medicaid in the mid-1960s. Some states have expanded
eligibility beyond the income limit of 200% FPL originally
established under S-CHIP, including California. The amount of
federal S-CHIP funds is limited for each fiscal year both
nationally and on a state-by-state basis, based on a statutory
formula established every three years. In October 2002, the
federal Health and Human Services Agency released regulations
permitting states to use S-CHIP funds to provide health
coverage for prenatal care and delivery to women with the goal
of helping to ensure that low-income mothers have healthy
pregnancies and that their babies are born healthy and strong.
3)RELATED LEGISLATION . SB 88 (Ducheny) is a companion bill and
amends the California Tobacco Tax and Health Promotion Act of
1988 (Proposition 99) to permit funds in specified accounts to
be used as a federal match for health care treatment programs.
This bill is awaiting action by the Governor.
4)SUPPORT . Maternal and Child Health Access, Planned Parenthood
Affiliates of California, and the American Civil Liberties
Union write that this legislation clarifies that California is
accepting and utilizing the federal funds for comprehensive
pregnancy-related services for women in a manner that is
consistent with its Constitution, case law, and statues that
protect a woman's right to reproductive privacy.
REGISTERED SUPPORT / OPPOSITION :
Support
American Civil Liberties Union
California Family Health Council
Maternal and Child Health Access
Planned Parenthood Affiliates of California
AB 794
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Opposition
None on file
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097