BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1580
AUTHOR: Bonilla
INTRODUCED: February 2, 2012
HEARING DATE: June 6, 2012
CONSULTANT: Bain
SUBJECT : Health care: eligibility: enrollment.
SUMMARY : Makes technical and clarifying changes to AB 1296
(Bonilla), Chapter 641, Statutes of 2011, the Health Care Reform
Eligibility, Enrollment, and Retention Planning Act (Act)
relating to applications for state health subsidy programs.
Existing law:
1.Establishes the Medi-Cal program, administered by the
Department of Health Care Services (DHCS), to provide health
care services and long-term care to pregnant women, children,
and people who are aged, blind, and disabled.
2.Requires, under the Act, a single, accessible, standardized
paper, electronic, and telephone application for state health
subsidy programs to be developed by DHCS in consultation with
the Managed Risk Medical Insurance Board (MRMIB) and the
California Health Benefit Exchange board as part of a
stakeholder process. Requires the application to be used by
all entities authorized to make an eligibility determination
for any of the state health subsidy programs and by their
agents.
3.Makes certain limited categories of individuals presumptively
eligible for Medi-Cal (children moving from Healthy Families
to Medi-Cal and vice versa, comatose or amnesia patients
arriving at a county health facility, individuals requiring
treatment for breast or cervical cancer, and pregnant women),
providing immediate and temporary Medi-Cal coverage.
4.Establishes, under the Act, requirements for the application
for state health subsidy programs, including a requirement
that an applicant be provided benefits in accordance with the
rules of the state health subsidy program, as implemented in
federal regulations and guidance for which he or she otherwise
qualifies until a determination is made that he or she is not
eligible and all applicable notices have been provided.
Continued---
AB 1580 | Page 2
This bill:
1.Clarifies that nothing in a provision of the Act is to be
interpreted to grant presumptive eligibility if it is not
otherwise required by state law and if so required, then only
to the extent permitted by federal law.
2.Narrows a provision of the Act that requires an individual
screened as ineligible for Medi-Cal on the basis of Modified
Adjusted Gross Income (MAGI) but who may be potentially
eligible for Medi-Cal on another basis to have his or her
application forwarded to the Medi-Cal program for an
eligibility determination. Instead of this requirement
applying to individuals who are potentially eligible on
another basis, this bill limits the requirement that the
application be forwarded to only those individuals who may be
Medi-Cal-eligible on the basis of being 65 years of age or
older or on the basis of blindness or disability.
3.Makes other technical and clarifying changes.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill has negligible direct state costs. The
clarifications it provides narrow the scope of two requirements
in current law related to the eligibility and enrollment system
for health programs. Without this bill, these requirements may
have been construed to compel some level of additional
administrative workload or state cost in state health programs
relative to that required under the provisions of this bill.
PRIOR VOTES :
Assembly Health: 13- 6
Assembly Appropriations:12- 5
Assembly Floor: 47- 24
COMMENTS :
1.Author's statement. According to the author, AB 1580 makes
technical changes, requested by the Administration, to ensure
successful implementation of AB 1296 to enroll consumers in
health coverage programs.
2.Background. AB 1296 was negotiated with Health and Human
Services Agency (Agency) staff, the sponsor and supporters,
and legislative staff. After AB 1296 passed the Legislature
and was in enrollment, Agency staff sought clarifying
amendments on two provisions. In response, the sponsor of AB
AB 1580 | Page
3
1296 (Western Center on Law & Poverty) indicated in a letter
dated September 21, 2011, a willingness to amend the language
in AB 1296 this year, and those changes are contained in this
bill.
3.Support. This bill is sponsored by Western Center on Law &
Poverty to fulfill the terms of an agreement made with Agency
staff to amend the language of AB 1296. The first
clarification relates to a provision of the bill that states
that an individual who is not eligible for Medi-Cal based on
MAGI but "who may be potentially eligible for Medi-Cal on
another basis shall have his or her application or case
forwarded to the Medi-Cal program for an eligibility
determination." Agency staff expressed a concern that this
could be a broad group of people who would have to have a full
Medi-Cal determination. Agency staff asked that the language
specify and limit these populations to individuals who may be
eligible on the basis of being age 65 or older or who are
blind or disabled. The second change sought by Agency staff
was that the bill language be clarified that one of its
provisions does not grant presumptive Medi-Cal eligibility to
any new populations. This bill contains both of these changes.
SUPPORT AND OPPOSITION :
Support: Western Center on Law & Poverty (sponsor)
American Federation of State, County and Municipal
Employees, AFL-CIO
California Immigrant Policy Center
Children Now
Children's Defense Fund-California
The Children's Partnership
Health Access California
National Health Law Program
United Ways of California
Oppose: None received.
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