BILL ANALYSIS
AB 794
Page 1
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
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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
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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