BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1541
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          ASSEMBLY THIRD READING
          AB 1541 (Health Committee)
          As Amended May 13, 2009
          Majority vote 

           HEALTH              19-0        APPROPRIATIONS      15-0         
           
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          |Ayes:|Jones, Fletcher, Adams,   |Ayes:|De Leon, Nielsen, Ammiano,  |
          |     |Ammiano, Block, Carter,   |     |Charles Calderon, Davis,    |
          |     |Conway, De La Torre, De   |     |Duvall, Fuentes, Hall,      |
          |     |Leon, Emmerson, Gaines,   |     |Harkey, John A. Perez,      |
          |     |Hall, Hayashi, Hernandez, |     |Price, Skinner, Solorio,    |
          |     |Hill, Nava, V. Manuel     |     |Audra Strickland, Torlakson |
          |     |Perez, Salas,             |     |                            |
          |     |Audra Strickland          |     |                            |
          |-----+--------------------------+-----+----------------------------|
          |     |                          |     |                            |
           ------------------------------------------------------------------- 
           SUMMARY  :  Extends from 30 days to 60 days the time period an  
          individual or dependent who has lost or will lose Healthy Families  
          Program (HFP) coverage or no share-of-cost Medi-Cal coverage has  
          to request enrollment in group coverage without being considered a  
          late enrollee.  States legislative intent to enact legislation  
          that would implement a provision of the federal Children's Health  
          Insurance Program Reauthorization Act (CHIPRA) of 2009 (Public Law  
          111-3).

           EXISTING LAW :

          1)Provides for the regulation of health plans by the Department of  
            Managed Health Care (DMHC) under the Knox-Keene Health Care  
            Service Plan Act of 1975 (Knox-Keene) and for the regulation of  
            health insurers by the California Department of Insurance (CDI)  
            under the Insurance Code.

          2)Authorizes health plans and insurers to exclude "late  
            enrollees," as defined, from group health care coverage for no  
            more than twelve months from the date of the enrollee's  
            application for coverage.  

          3)Defines a "late enrollee" as an eligible employee or dependent  
            who has declined health coverage under a health benefit plan  
            offered through employment or sponsored by an employer at the  








                                                                  AB 1541
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            time of the initial enrollment period provided under the terms  
            of the health benefit plan and who subsequently requests  
            enrollment in that plan.  

          4)Excludes from the definition of a "late enrollee" an individual,  
            or his or her dependent, who has lost or will lose HFP coverage,  
            as specified, or no share-of-cost Medi-Cal coverage, and who  
            requests enrollment within 30 days after termination of  
            coverage.

          5)Requires, under federal law, a group health plan to permit an  
            eligible person to enroll for coverage under the plan if the  
            person's coverage under Medicaid (Medi-Cal in California) or  
            under a state child health plan (such as California's HFP) was  
            terminated, as specified, and the person applies for coverage  
            under the group health plan not later than 60 days after that  
            termination.

          6)Prohibits, under the California Constitution, a state  
            administrative agency from declaring a statute unenforceable, or  
            from refusing to enforce a statute on the basis that federal law  
            or federal regulations prohibit the enforcement of such statute,  
            unless an appellate court has made a determination that the  
            enforcement of such statute is prohibited by federal law or  
            federal regulations.

           FISCAL EFFECT  :   According to the Assembly Appropriations  
          Committee, no direct fiscal impact for the DMHC, CDI, the Managed  
          Risk Medical Insurance Board or Department of Health Care Services  
          to continue oversight of health coverage enrollment and  
          termination.

           COMMENTS  :   According to the author, this bill would conform  
          provisions of California law to one change made by the recently  
          enacted federal CHIPRA.  CHIPRA reauthorized the federal State  
          Children's Health Insurance Program (SCHIP, which is known as the  
          HFP in California), and made a number of changes to federal SCHIP  
          law.  

          One change made in Section 311 of CHPRA to the federal Internal  
          Revenue Code requires a group health plan to allow an employee who  
          is eligible for but not enrolled in coverage under the group  
          health plan to enroll in coverage if the employee or dependent is  
          covered under Medicaid (Medi-Cal in California) or a state child  








                                                                  AB 1541
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          health plan (HFP in California) and coverage is terminated because  
          of loss of eligibility for such coverage.  The federal law permits  
          an employee or dependent to enroll in coverage under the terms of  
          the group health plan not later than  60 days  after the date of  
          termination of SCHIP or Medicaid coverage.  California law  
          contains a similar provision, but the person must enroll within  30  
          days  after termination of coverage.  This bill would conform the  
          time frame in California health insurance law to the time frame in  
          federal tax law.

          United Ways of California and the 100% Campaign write in support  
          that this bill would align California law with federal law and  
          would assist California families in securing health insurance for  
          their children after the loss of public health insurance by  
          extending the time frame available to enroll in group coverage.  

           
          Analysis Prepared by  :    Scott Bain / HEALTH / (916) 319-2097 


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