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.
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          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 




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            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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