BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2477
                                                                  Page  1

          Date of Hearing:   April 21, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                 AB 2477 (Jones) - As Introduced:  February 19, 2010 

          Policy Committee:                              Health Vote:15-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill eliminates mid-year status reporting for children on  
          Medi-Cal to conform to requirements of the federal Patient  
          Protection and Affordable Care Act (PL 111-148). The federal  
          health reform law requires California to maintain current  
          specified eligibility standards for children until September 30,  
          2019. Failure to comply with maintenance-of-effort (MOE)  
          requirements will likely result in the loss of major Medi-Cal  
          funding. 

           FISCAL EFFECT  

          1)An annual increase of $10 million (50% GF) to maintain 7,300  
            children on Medi-Cal who may otherwise lose coverage due to  
            failure to comply with a semi-annual reporting period. 

          The Governor's 2010-11 budget contains a proposal to move  
            children from a 12-month eligibility period to a six-month  
            eligibility period effective January 1, 2011. The savings  
            associated with this proposal implemented for a half-year are  
            $4.9 million (50% GF). The governor's budget proposal is  
            consistent with legislative actions taken in 2008, discussed  
            below. 

          2)The cost generated by this bill is eclipsed by the possible  
            loss of federal funding in the range of $25 billion if  
            California violates the federal MOE requirements for children  
            in effect through September 2019. 

          3)According to some quantitative analysis and advocates, annual  
            reporting may be cost-beneficial by providing continuous  
            coverage to children and reducing Medi-Cal administrative  








                                                                 AB 2477
                                                                  Page  2

            workload.
           
          COMMENTS  

           1)Rationale . This bill is sponsored by the 100% Campaign and  
            supported by a wide variety of children's groups, providers,  
            and insurers. This bill increases the continuity of coverage  
            for children on Medi-Cal and allows California to continue to  
            draw billions of dollars in federal Medi-Cal support. 

           2)Recent Legislative Actions on Status Reporting for Children  .  
            The frequency of status reporting for children on Medi-Cal has  
            been addressed several times in recent years. A semi-annual  
            status reporting period for children, effective until July  
            2012, was enacted in Assembly Bill 1183 (Committee on Budget)  
            Chapter 758, Statutes of 2008. 

          The federal American Recovery and Reinvestment Act (ARRA),  
            enacted in February 2009, established an MOE for eligibility  
            through December 2010 while an enhanced Federal Medical  
            Matching Percentage (FMAP) is available to states. SB 3X 24  
            (Alquist), Chapter 24, Statutes of 2009, restored annual  
            reporting for children in Medi-Cal to ensure the receipt of  
            $10 billion in enhanced FMAP.

           3)Related Legislation . SB 711 (Alquist), pending in the Assembly  
            Health Committee, addresses annual status reporting for  
            children on Medi-Cal in order to conform to federal law  
            regarding a pending federal extension of the enhanced FMAP and  
            to ensure California qualifies for additional federal funding.  
             

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081