BILL ANALYSIS
SB 771
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Date of Hearing: August 4, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 771 (Alquist) - As Amended: August 2, 2010
Policy Committee: Health Vote:15-4
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill requires the Department of Health Care Services (DHCS)
to extend Medi-Cal, including Early Periodic Screening Diagnosis
and Treatment (EPSDT), eligibility to emancipated former foster
youth who are under 26 years of age to the extent federal
financial participation is available, and per requirements of
federal health reform, the Patient Protection and Affordable
Care Act (PL-111-148). Authorizes initial implementation by
all-county letter or similar instructions without the
requirement of regulatory action.
FISCAL EFFECT
Increased annual Medi-Cal costs starting January 1, 2014 of $25
million (zero to 50% GF) to $50 million (zero to 50% GF). This
estimate assumes extended coverage is provided to between 5,000
and 10,000 former foster youth, from 21 years of age until their
26th birthday.
The actual funding sharing ratio will depend on what federal
matching rate is applied to this group of Medi-Cal recipients.
For example, 100% federal funding will be provided to specified
groups of newly eligible Medi-Cal beneficiaries in 2014, 2015,
and 2016 under health reform. Federal matching then drops over
the next few years to 90% of total costs. Other groups of
Medi-Cal recipient costs will be shared 50%-50% by federal and
state government.
Other requirements of federal health reform, not addressed in
this bill, but that would apply to many of these young adults,
include a major expansion of Medi-Cal to low-income adults up to
133% of the federal poverty level. This expansion includes the
SB 771
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100% federal support discussed above.
COMMENTS
1)Rationale . This bill conforms state law to a requirement of
federal health reform to extend Medicaid coverage to former
foster youth until age 26. This federal requirement for foster
youth coverage establishes symmetry to expanded access for
young adults via another expansion in federal health reform,
the increase in the limiting age for dependent health coverage
to age 26. More than 4,000 youth each year leave foster care
in California at the age of 18. According to the author, is
bill provides key support to young adults who face significant
barriers to healthy stable living.
2)Medi-Cal Eligibility . Foster youth have automatic eligibility
for Medi-Cal because they are in foster care. California has
adopted the state option to provide Medi-Cal coverage for
former foster youth between the ages of 18 and 21 that was
made available under the federal Foster Care Independence Act
of 1999. A simplified application is required and there is no
income or asset test for eligibility.
3)Foster Youth . There are more than 75,000 children in foster
care in California. Many will spend only a short time in
foster care and then be reunified with their family of origin
or be adopted. Others may spend several years in foster care
and emancipate or age-out of the foster care system when they
turn 18. Substantial evidence over the past 20 years
indicates children enter the child welfare system in a poor
state of health. In addition to a history of abuse or neglect
that results in out-of-home placement, foster youth often have
poor health due to poverty, poor prenatal care, maternal
substance abuse, family and neighborhood violence, and
parental mental illness.
4)Related Legislation . SB 1188 (Price), also being heard in this
committee today, prohibits the limiting age of dependent
health coverage from being less than 26 years of age, with
specified exceptions.
AB 1602 (J. Perez), pending in the Senate, enacts a series of
changes related to health reform including establishing the
California Health Benefits Exchange and allowing young adults
to stay on their parents' health coverage until age 26
SB 771
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Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081