BILL ANALYSIS
AB 158
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Date of Hearing: January 24, 2008
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mark Leno, Chair
AB 158 ( Ma) - As Amended: January 16, 2008
Policy Committee: Health Vote:15-2
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill expands Medi-Cal eligibility to Californians with
Chronic Hepatitis B Viral (CHBV) infections who are not
currently disabled, but who would qualify for benefits once
disabled.
FISCAL EFFECT
1)Increased annual costs of at least $1 million (50% GF) if 200
individuals with CHBV become eligible for Medi-Cal pursuant to
this bill. This estimate reflects CHBV infection rates, family
and size, and take-up rates when public program coverage is
offered to new beneficiaries.
2)Unknown offsetting savings to the extent newly eligible or
current enrollees elect Medi-Cal managed care, which is only
available in certain counties. This bill requires the
Department of Health Care Services (DHCS) to meet federal
revenue neutrality requirements through savings generated by
voluntary enrollment of CHBV beneficiaries into Medi-Cal
Managed Care from existing fee-for-service or when
beneficiaries newly enroll.
3)The Medi-Cal benefit created by this bill, as well as the
revenue neutrality provision is modeled on AB 2197 (Koretz),
Chapter 687, Statutes of 2002. AB 2197 requires Medi-Cal
eligibility to be extended to HIV-positive individuals who are
not disabled by the infection, but who would qualify for
benefits once disabled. AB 2197 has not been funded or
implemented and is now the subject of litigation brought by
the AIDS Healthcare Foundation, one of the country's largest
AB 158
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providers of HIV/AIDS medical care.
COMMENTS
1)Rationale . This bill increases health care provided to
low-income Californians infected with CHBV. HBV is a highly
contagious disease and creates a significant health threat if
chronic. HBV may be vaccinated against and reflects a much
higher rate of infection among Asian Americans. Although
anyone can be infected with HBV, people of Asian descent are
more likely to be infected because of higher rates of
infection in Asian counties and corresponding transmission
pregnant women to their children. Under current law, those
infected with CHBV must be disabled to qualify for Medi-Cal.
Without Medi-Cal, those with non-disabling CHBV may be unable
to access health services to reduce long-term health
consequences such as illness and death.
2)Hepatitis B . A person may be infected with HBV for several
weeks before symptoms show. More than 90% of adults infected
with HBV experience no ill effects and clear the infection
within six months. Others, who continue to carry the virus,
are chronically infected. Approximately 1.25 million people
nationally have chronic Hepatitis B, which causes inflammation
of the liver and sometimes liver failure. Based on
California's population, at least 125,000 people have HBV.
Acute symptoms include liver inflammation, vomiting, jaundice,
and sometimes death. Hepatitis B is responsible for 80%of
liver cancers in Asian and Pacific Islander groups. The Asian
Liver Center at Stanford University estimates that up to 10%of
Asian Americans have Hepatitis B and do not know it. Despite
the availability of a Hepatitis B vaccine, immunization rates
are low.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081