BILL ANALYSIS �
AB 792
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ASSEMBLY THIRD READING
AB 792 (Bonilla)
As Amended May 27, 2011
Majority vote
HEALTH 13-6 JUDICIARY 7-2
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|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Feuer, Atkins, Dickinson, |
| |Bonilla, Eng, Gordon, | |Huber, Huffman, Monning, |
| |Hayashi, | |Wieckowski |
| |Roger Hern�ndez, Bonnie | | |
| |Lowenthal, Mitchell, Pan, | | |
| |V. Manuel P�rez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, |Nays:|Wagner, Jones |
| |Nestande, Silva, Smyth | | |
| | | | |
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APPROPRIATIONS 11-6
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|Ayes:|Fuentes, Blumenfield, |
| |Bradford, Charles |
| |Calderon, Campos, Davis, |
| |Hall, Hill, Lara, |
| |Mitchell, Solorio |
| | |
|-----+--------------------------|
|Nays:|Harkey, Donnelly, Gatto, |
| |Nielsen, Norby, Wagner |
| | |
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SUMMARY : Establishes notification requirements about the
availability of coverage through the California Health Benefit
Exchange (Exchange) for individuals who are experiencing certain
life transitions such as divorce, adoption, loss of employment or
loss of health insurance, and initiates an application for
enrollment in the Exchange if the individual consents.
Specifically, this bill :
1)Requires a number of entities to send notifications to
individuals regarding health care coverage through the Exchange.
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The entities and circumstances include:
a) Family courts, upon the filing of a petition for
dissolution of marriage, nullity of marriage, or legal
separation, must notify the petitioner and the respondent;
b) Family courts, upon the filing of a petition for adoption,
must notify the petitioner;
c) Health plans and insurers, upon an individual ceasing to
be enrolled in a group or individual health plan, must notify
former employees or former dependents of an employee; and,
d) The Employment Development Department (EDD), upon
receiving claims for unemployment or disability, must notify
the claimant.
2)Requires health plans and insurers to obtain the consent of
enrollees to transmit their information to the Exchange in the
event that the enrollee ceases to be enrolled in coverage.
3)Requires health plans, insurers, and the EDD, under certain
circumstances, to transmit information about individuals
receiving the notifications to the Exchange, and requires the
provision of this information to initiate an application for
health care coverage through the Exchange.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Estimated costs in the range of $800,000 to $3 million annually
(special fund) to EDD to provide notifications, depending upon
the number of individuals seeking employment benefits. Unknown,
potentially significant state information technology costs to
transfer data from EDD (special fund) to the Exchange. It is
unknown whether federal grant funding available for Exchange
activities would be available for this purpose.
2)Minor, absorbable costs to the family court system to provide
notifications.
3)If screening and enrollment is conducted upon provision of
information about potential enrollees, there could be
significant state screening and enrollment costs to the Exchange
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and/or Medi-Cal that would otherwise not occur, in the range of
millions to tens of millions of dollars. Potentially
significant state Medi-Cal costs, if more individuals enroll in
Medi-Cal more quickly than would otherwise occur. If
individuals are found to be eligible for Medi-Cal under existing
eligibility rules, the cost associated with these individuals
will be funded 50% through the General Fund. Medi-Cal costs for
newly eligible individuals are 100% federally funded through
2016.
4)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, in 2014 and thereafter, a
component of the federal Patient Protection and Affordable Care
Act (PPACA) institutes an individual mandate provision, which
requires everyone to have insurance and this bill helps ensure
that Californians comply with the individual mandate even when
they are faced with life changing situations such as filing for
unemployment, divorce, adoption, and loss of employment-based
coverage. The author also states that this bill ensures the
design of the Exchange and redesign of Medi-Cal take into account
the need to serve short-term uninsured as well as provide
long-term coverage; and, that it will help ensure Californians are
provided notices and that they are automatically enrolled into
either the Exchange or Medi-Cal. The author contends that the
auto-enrollment process and notices are essential to ensure that
when life changing situations occur, people are aware of their
health care options. The author states that this auto-enrollment
process is not final until the individual accepts the coverage.
The individual maintains the discretion to decline coverage.
California was the first state in the nation to enact legislation
creating a health benefit exchange under PPACA. 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 to enhance competition and provide the same advantages
available to large employer groups by organizing the private
insurance market, including a more stable risk pool, greater
purchasing power, more competition among insurers and detailed
information about the price, quality, and service of health
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coverage.
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097
FN: 0001101