BILL ANALYSIS
AB 115
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Date of Hearing: April 22, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 115 (Beall) - As Amended: April 13, 2009
Policy Committee: HealthVote:19-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill expands the Adult Health Coverage Expansion Program
(AHCEP) in Santa Clara County established by AB 12 (Beall),
Chapter 677, Statutes of 2007. This program serves low-income,
uninsured workers in small businesses in that county.
Specifically, this bill:
1)Defines "complementary product" to include coverage provided
to an employee's spouse, domestic partner, or children.
Authorizes the use of complementary products in the AHCEP and
authorizes the use of complementary products that differ from
employee health coverage in terms of benefits and eligibility.
2)Exempts complementary products from current law provisions
governing the regulation of the small group (firms of two to
50 employees) health insurance market.
3)Reduces the AHCEP firm eligibility threshold from 35% to 25%
of employees who must be earning less than 350% of the federal
poverty level ($38,000 for an individual in 2009).
4)Prohibits the use of GF for AHCEP or any complementary
products.
FISCAL EFFECT
No direct fiscal impact on the Department of Managed Health Care
(DMHC) to continue oversight of the AHCEP and health plan laws
and regulations.
COMMENTS
AB 115
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1)Rationale . This bill expands the AHCEP, a health coverage
expansion pilot program in Santa Clara County. This bill
provides greater access to health coverage for low-income,
uninsured workers in small businesses in that county. SB 1448
(Kuehl), Chapter 76, Statutes of 2006 established California's
Coverage Initiative (CI) to administer funding through
California's federal Medi-Cal hospital financing waiver to
increase health access for low-income uninsured individuals
who are not currently eligible for the Medi-Cal, Healthy
Families, or Access for Infants of Mothers (AIM) programs. The
program addressed in this bill is a part of Santa Clara
County's CI.
2)California's Working Uninsured . According to estimates, there
are more than 6 million Californians who are uninsured.
Approximately 90% of workers statewide are employed by
businesses that offer health insurance. However, only 70% of
workers in firms that offer health insurance accept that offer
of coverage. Many are unable to afford the employee share of
premium cost. The proportion of working Californians who have
employer-sponsored coverage has also declined due to firms
being unable to afford premiums. Barriers to coverage at
smalls firms, such as those addressed in this bill, are even
greater. Only seven percent of workers at firms with fewer
than 10 employees have employer-sponsored health coverage and
only 17% of employees at firms with 10-49 workers have health
insurance through their job. This compares to almost half of
workers accessing health coverage at firms with more than
1,000 employees.
Many low-income Californians have Medi-Cal coverage for
themselves and their families. Medi-Cal provides no-cost
full-scope health coverage to almost seven million
Californians, including low-income workers and their families
and persons who are elderly or who have disabilities.
3)Related Legislation . AB 1057 (Beall) in 2008 was similar to
this bill and vetoed. The veto message expressed concerns
about a piecemeal approach to the larger problem of health
reform that needs to be addressed comprehensively.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081
AB 115
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