BILL ANALYSIS                                                                                                                                                                                                    



                                                                AB 794
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         REPLACE  - 06/23/2005

        CONCURRENCE IN SENATE AMENDMENTS
        AB 794 (Chu)
        As Amended June 9, 2005
        Majority vote
         
        
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        |ASSEMBLY: |     |(May 5, 2005)   |SENATE: |22-14|(June 16, 2005)      |
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             (vote not relevant)


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        |COMMITTEE VOTE:  |10-3 |(June 21, 2005)     |RECOMMENDATION: |Concur    |
        |                 |     |                    |                |          |
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        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  







                                                                AB 794
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          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 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, this bill and SB 88 (Ducheny), Chapter 17, Statutes of  
        2005, (if the federal government approves the state plan amendment  
        application before June 30, 2005), will result in a shift of 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  







                                                                AB 794
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        million annually.

         COMMENTS  :  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 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: 0011253