BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1869
AUTHOR: John A. Pérez
INTRODUCED: February 22, 2012
HEARING DATE: June 20, 2012
CONSULTANT: Rubin
SUBJECT : Office of Patient Advocate: federal veterans health
benefits.
SUMMARY : Adds federal veterans health benefits to the list of
public programs that the Office of Patient Advocate (OPA) will
be required to include, commencing January 1, 2013, in its
efforts to provide outreach and education about health care
coverage options.
Existing law:
1.Transfers OPA from the Department of Managed Health Care
(DMHC) to the California Health and Human Services Agency
(CHSSA), effective July 1, 2012.
2.Defines OPA's goal to help individuals secure health care
services to which they are entitled or for which they are
eligible.
3.Requires OPA, commencing January 1, 2013, to provide and
assist in the provision of outreach and education about health
care coverage options, including public programs such as
Medi-Cal, Healthy Families, and Medicare.
This bill:
1.Requires OPA, commencing January 1, 2013, to provide and
assist in the provision of outreach and education about
federal veterans health benefits.
FISCAL EFFECT : The Assembly Appropriations analysis indicates
that:
1.This bill is not likely to result in additional workload or
increased state costs. It simply adds specificity to a
requirement in current law that OPA provide information on a
variety of public health care programs.
2.Potential cost savings related to this bill are uncertain, but
are likely negligible. Based on OPA's broad mandate to provide
Continued---
AB 1869 | Page 2
a variety of information to individuals about health care
coverage programs, it seems likely that information about the
U.S. Department of Veterans Affairs (VA) benefits would be
provided to individuals potentially eligible for such benefits
even in the absence of this bill.
PRIOR VOTES :
Assembly Health: 19- 0
Assembly Appropriations:17- 0
Assembly Floor: 74- 0
COMMENTS :
1.Author's statement. AB 1869 simply directs OPA to include
information regarding federal veteran health care benefits as
part of the information and assistance it provides to the
public. California has almost 2 million residents that are
veterans, many of whom are unaware of their eligibility to
collect federal veteran benefits, including pension and health
care benefits. In some instances, the health care benefits a
veteran may be eligible for provide a more attractive health
care service option than state programs. The bill would simply
require that a duty of OPA is to provide information regarding
VA health benefits so that veterans who contact the office are
better informed about their options.
2.OPA. OPA is an independent state office that was established
in July 2000 in conjunction with DMHC to represent the
interests of enrollees served by health care service plans
regulated by DMHC. AB 922 (Monning), Chapter 552, Statutes of
2011, transfers OPA and DMHC to CHHSA, effective July 1, 2012,
requires that existing duties and responsibilities apply to
CDI-regulated health insurers in addition to DMHC-regulated
health plans, and adds new duties and responsibilities with
respect to providing outreach and education about health care
coverage to consumers. AB 922 states that the Legislature
recognizes that, because of the enactment of the Patient
Protection and Affordable Care Act (ACA) on March 23, 2010,
and the implementation of various provisions by January 1,
2014, it is appropriate to transfer OPA and to confer new
responsibilities on OPA, including assisting consumers in
obtaining health care coverage and obtaining health care
through health coverage that is regulated by multiple
regulators, both state and federal.
AB 1869 | Page
3
3.Veterans health benefits. UCLA's California Health Interview
Survey 2009 data reveal approximately 130,000 persons in
California who had served in the U.S. Armed Forces were
uninsured despite some of these individuals possibly being
eligible for federal VA health care benefits. On January 1,
2014, individuals - including veterans - will be required to
maintain health coverage under the ACA. The UCLA data
additionally indicate that 174,000 individuals who had served
in the armed forces were covered by Medi-Cal. The author
argues that since Medi-Cal is supposed to be the payer of last
resort, a veteran who is eligible to be covered under VA
health benefits should be enrolled in the VA health care
program rather than Medi-Cal, a shift which would save the
state money since the state pays half the cost for Medi-Cal
services while the federal government pays the entire cost for
VA health benefits. In addition, the medical benefits offered
through the VA health care system are often greater than the
benefits offered through Medi-Cal.
4.PARIS-Veterans data match. According to an April 2012 report
to the Legislature on the Public Assistance Reporting
Information System (PARIS) -Veterans Match, a two-year pilot
program to improve the identification of Medi-Cal
beneficiaries who are veterans (or dependents or survivors)
using PARIS was conducted to potentially improve veterans
access to enhanced health benefits by using VA health benefits
and improve the cost-effectiveness of Medi-Cal. The
PARIS-Veterans data match is one of three different data
matches operated by the U.S. Department of Health and Human
Services' Administration for Children and Families and allows
states to compare their beneficiary information with the VA.
The report describes how the pilot project, operating from
July 2009 to June 2011, started with three counties (Fresno,
San Bernardino, and San Diego) and expanded to seven
additional counties (Alameda, Orange, Sacramento, San Mateo,
San Francisco, Santa Clara, and Solano), where the Department
of Health Care Services (DHCS) found 16,000 positive data
matches, or identifications of veterans enrolled in Medi-Cal.
To maximize resources, DHCS focused on redirecting to VA
health benefits those beneficiaries who may have had high
Medi-Cal expenditures, those who could have had benefits
restored, and survivors who appeared eligible for VA's
Civilian Health and Medical Program, resulting in an estimated
$1.634 million in cost avoidance and savings for the Medi-Cal
program.
AB 1869 | Page 4
5.Related legislation. AB 1223 (Committee on Veterans Affairs)
would make PARIS, which requires DHCS to identify veterans and
their dependents enrolled in Medi-Cal and assist them in
obtaining federal veteran health care benefits, a permanent
statewide program and would eliminate the requirement that
PARIS be implemented in three consenting counties on a pilot
program basis. AB 1223 is pending in the Senate Health
Committee.
AB 2315 (Monning) would amend the list of officers appointed
by the Governor that are subject to confirmation by the Senate
to reflect the transfer of OPA from DMHC to CHHSA, as
specified by AB. AB 2315 is pending in the Senate Health
Committee.
6.Support. Health Access California argues that research has
identified returning veterans as one of the populations that
faces a life transition where loss of coverage is a common
problem. Since military veterans have a greater need for
health coverage, particularly the broader benefits for mental
health and substance abuse treatment that will be available
the ACA, this bill can provide a great service to veterans
without impact to the state general fund. The Western Center
on Law and Poverty adds that this bill will ensure that
veterans are adequately served by OPA and receive the
information and assistance that they deserve.
SUPPORT AND OPPOSITION :
Support: American Federation of State, County and Municipal
Employees
California School Employees Association
Health Access California
National Association of Social Workers, California
Chapter
Western Center on Law and Poverty
Oppose: None received.
-- END --