BILL ANALYSIS
AB 1541
Page 1
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 | | |
|-----+--------------------------+-----+----------------------------|
| | | | |
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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
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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
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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
FN: 0000856