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  








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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 








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