BILL ANALYSIS �
AB 714
Page
1
ASSEMBLY THIRD READING
AB 714 (Atkins)
As Amended May 27, 2011
Majority vote
HEALTH 13-6 APPROPRIATIONS 12-5
-----------------------------------------------------------------
|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hern�ndez, Bonnie | |Gatto, Hall, Hill, Lara, |
| |Lowenthal, Mitchell, Pan, | |Mitchell, Solorio |
| |V. Manuel P�rez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, |Nays:|Harkey, Donnelly, |
| |Nestande, Silva, Smyth | |Nielsen, Norby, Wagner |
| | | | |
-----------------------------------------------------------------
SUMMARY : Establishes notification requirements to be included in
materials otherwise provided to individuals enrolled in or ceasing
to be enrolled in specified public programs about potential
eligibility for health care coverage through the California Health
Benefit Exchange (Exchange). Requires the disclosure of enrollee
information to the Exchange, requires the initiation of an
application for enrollment in coverage through the Exchange and
permits individuals to have the opportunity to decline coverage by
notifying the Exchange in writing. Specifically, this bill :
1)Requires individuals who have ceased to be enrolled in the
Healthy Families Program (HFP), the Access for Infants and
Mothers program, the California Major Risk Medical Insurance
Program, the federal temporary high risk pool also known as the
Preexisting Condition Insurance Plan (PCIP), and Medi-Cal, after
January 1, 2012, to be provided with a notice included in
materials otherwise provided regarding potential eligibility for
health care coverage through the Exchange. Specifies the exact
language to be used in the notice for each program.
2)Requires the notice in 1) above to be provided to persons
receiving services under the AIDS Drug Assistance Program
(ADAP), the federal Ryan White HIV/AIDS Treatment Extension Act
AB 714
Page
2
of 2009 (Ryan White program), FamilyPACT program, and the breast
and cervical cancer treatment program (BCCP). Requires entities
that provide services under those programs, after January 1,
2013, to provide to the Department of Public Health (DPH) �for
ADAP and Ryan White program] and the Department of Health Care
Services (DHCS) �for FamilyPACT and BCCP] the name, address, and
other information of each enrollee, as specified. Requires DPH
and DHCS to provide the information to the Exchange and to the
Medi-Cal program so that eligibility may be determined and
enrollment completed.
3)Requires for each Medi-Cal enrollee, DHCS, after January 1,
2013, to provide to the Exchange, the name, address, and other
information that is in the possession of DHCS, that the Exchange
may require, in a manner to be prescribed by the Exchange in
order to determine eligibility and complete enrollment.
Requires the information to be kept confidential in a manner
consistent with the Patient Protection and Affordable Care Act.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Minor, absorbable costs to include a notification about coverage
availability in the exchange. Some costs could likely be offset
by federal funding for outreach through HFP, Medi-Cal, or the
PCIP program.
2)Potential significant state screening and enrollment costs to
the Exchange and/or Medi-Cal that would otherwise not occur, in
the range of millions to tens of millions of dollars.
3)Unknown, potentially significant state information technology
costs to transfer data from several different enrollment systems
to the Exchange.
4)Potentially significant state savings to the extent that this
bill speeds the transition of individuals from General Fund
(GF)-funded services to the Exchange or new eligibility
categories of Medi-Cal covered by 100% federal funds.
AB 714
Page
3
5)Potentially significant state Medi-Cal costs (50% GF) if
individuals are found to be eligible for Medi-Cal under existing
eligibility rules, to the extent that this bill causes more
individuals to become enrolled in Medi-Cal more quickly than
would otherwise occur.
6)Federal funding is available for Exchange-related activities
through federal Exchange implementation grants. Subject to
federal approval, some of the activities mandated in this bill
may be eligible for funding through these grants.
7)Reduced cost pressure to counties to fund otherwise
uncompensated care, to the extent this bill results in more
individuals enrolled more quickly into comprehensive health care
coverage.
COMMENTS : According to the author, 7 million Californians were
estimated to be uninsured in 2009, and of those, as many as 5
million are eligible for coverage through the Exchange or
Medi-Cal. The author states that initial enrollment in public
programs including HFP and the new high risk pool has been slow.
Additionally, the author states that existing law is silent with
respect to notifying and pre-enrolling those who are likely to be
eligible for the Exchange or newly eligible for Medi-Cal who are
already enrolled in other public programs or who seek charity care
or discounted care from hospitals. The author states that in
order to accelerate enrollment of those likely to be eligible for
Exchange coverage or Medi-Cal in 2014, takes two steps: in 2012
and 2013, those likely to be eligible are given notice of the
availability of low-cost or no-cost coverage through the Exchange
or Medi-Cal effective in 2014; and, second, in 2013, those already
enrolled in an existing public program with limited benefits or
covered by Medi-Cal and HFP but about to lose coverage will be
pre-screened and pre-enrolled in coverage through the Exchange or
Medi-Cal.
California was the first state in the nation to enact legislation
creating a health benefit exchange under the federal Patient
Protection and Affordable Care Act. AB 1602 (John A. P�rez),
Chapter 655, Statutes of 2010, and SB 900 (Alquist), Chapter 659,
Statutes of 2010, establishes the Exchange as an independent
public entity governed by a five-member executive board. This
bill is supported by a number of consumer advocacy and provider
AB 714
Page
4
organizations who believe that it will jump-start enrollment of
individuals newly eligible for Medi-Cal and the Exchange.
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097
FN: 0001125