BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 792 (Bonilla)
Hearing Date: August 16, 2012 Amended: August 17, 2011
Consultant: Katie Johnson / Brendan McCarthyPolicy Vote: Health
5-3 Judic 3-2
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BILL SUMMARY: AB 792 would require courts, health care service
plans, health insurers, and employers to provide a notice of the
availability of coverage in the California Health Benefit
Exchange (Exchange), effective January 1, 2014.
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Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
Potential state potentially significant, depending
onGeneral/
cost avoidance actual take up of coverage Federal/
or cost Other
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SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
This bill would require on various effective dates commencing
January 1, 2012, and ongoing, as specified, the courts, health
care service plans, health insurers, and employers, to provide a
notice of the availability of coverage in the California Health
Benefit Exchange (Exchange), effective January 1, 2014. Any
costs to the courts would be minor and absorbable.
This bill would require health plans, health insurers, and
employers, for employees or dependents who have experienced a
death, loss of employment or a reduction in hours, divorce or
the loss of dependent status that results in a loss of health
insurance, to transfer information to the Exchange to initiate
an application for enrollment in the Exchange if the individual
consents. This bill would require an individual electing to
decline coverage from the Exchange to do so in writing.
There could be cost avoidance to the extent that individuals who
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would have otherwise enrolled in state programs such as the
Major Risk Medical Insurance Program (MRMIP), Access for Infants
and Mothers program (AIM), the Preexisting Condition Insurance
Program (PCIP), and the AIDS Drug Assistance Program (ADAP),
purchase health care coverage through the Exchange. However, to
the extent that individuals, upon application to the Exchange,
are found eligible for state programs such as those listed above
or Medi-Cal or the Healthy Families Program, there could be
significant state health care coverage costs.
ADAP and other publicly funded programs administered by the
California Department of Public Health costs would be shared
amongst a variety of state and federal funds; Medi-Cal costs
would be shared 50 percent General Fund and 50 percent federal
funds, except that newly eligible Medi-Cal individuals' coverage
would be paid by 100 percent federal funds until 2016; Healthy
Families Program costs would be shared 35 percent General Fund
and 65 percent federal funds; AIM would be shared 35 percent
state Proposition 99 funds and 65 percent federal funds; MRMIP
would be shared state Proposition 99 funds and subscriber
premiums; PCIP would be funded 100 percent federal funds and
shares of enrollee premiums; Family Planning, Access, Care, and
Treatment program costs would be shared 10 percent General Fund
and 90 percent federal funds. Exchange costs would consist of
enrollee premiums and potentially federal subsidies.
Federal Exchange Funding
On August 12, 2011, California was awarded a Level One Exchange
establishment grant by the federal Department of Health and
Human Services in the amount of $39,421,383 for the purposes of
developing policy goals, securing consultants and experts, and
engaging stakeholders in the Exchange planning process. It is
unclear whether or not these funds could be utilized to
implement this bill. The state previously received a $1 million
Exchange Planning Grant to start up the Exchange on September
29, 2010.
The August 17 amendments remove the requirement on EDD to
furnish notices and reduce the costs of the bill accordingly.
There would continue to be cost avoidance to the extent that
individuals who would have otherwise enrolled in state programs
such as MRMIP, AIM, PCIP, and ADAP, purchase health care
coverage through the Exchange. Additionally, there would
continue to be significant costs to the extent that individuals,
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upon application to the Exchange, are found eligible for state
programs such as those listed above or Medi-Cal or the Healthy
Families Program.
The proposed author's amendments eliminate any requirements on
EDD and further narrow the required notice requirements for
employers.