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          
           
           ----------------------------------------------------------------- 
          |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    |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      11-6                                         
           
           -------------------------------- 
          |Ayes:|Fuentes, Blumenfield,     |
          |     |Bradford, Charles         |
          |     |Calderon, Campos, Davis,  |
          |     |Hall, Hill, Lara,         |
          |     |Mitchell, Solorio         |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Harkey, Donnelly, Gatto,  |
          |     |Nielsen, Norby, Wagner    |
          |     |                          |
           -------------------------------- 
           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