BILL ANALYSIS
AB 794
Page 1
REPLACE - 06/23/2005
CONCURRENCE IN SENATE AMENDMENTS
AB 794 (Chu)
As Amended June 9, 2005
Majority vote
-----------------------------------------------------------------
|ASSEMBLY: | |(May 5, 2005) |SENATE: |22-14|(June 16, |
| | | | | |2005) |
-----------------------------------------------------------------
(vote not relevant)
Original Committee Reference: G.O.
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 Access for Infants and Mothers Program
(AIM) programs.
The Senate amendments delete the Assembly version of this bill,
and instead:
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.
AB 794
Page 2
5)Specifies that this bill is a declaration of existing law.
EXISTING FEDERAL LAW prohibits:
1)Under the federal Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, 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.
2)A state from providing defined state public benefits to
certain aliens, unless state legislation is enacted subsequent
to the effective date of the act.
EXISTING LAW establishes:
1)AIM, 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 infant's life.
2)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.
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 (GF) and Proposition 99
revenues] from state to federal funds in the current and future
budget years. Of this amount, the GF would shift about $192
million for the two-year period. In the future, state savings
would be approximately $165 million annually.
COMMENTS : According to the author, recent federal regulations
permit states to use S-CHIP funds (a 65% federal match) for
AB 794
Page 3
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 privacy.
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% of the federal poverty level 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.
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.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097 FN: 0011252