BILL ANALYSIS Ó
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CONSENT
Bill No: AB 1869
Author: John A. Pérez (D), et al.
Amended: As introduced
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 6/20/12
AYES: Hernandez, Harman, Alquist, Anderson, Blakeslee, De
León, DeSaulnier, Rubio, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 74-0, 4/26/12 (Consent) - See last page
for vote
SUBJECT : Office of Patient Advocate: federal veterans
health benefits
SOURCE : Author
DIGEST : This bill 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.
ANALYSIS :
Existing law:
1. Transfers OPA from the Department of Managed Health
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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 requires OPA, commencing January 1, 2013, to
provide and assist in the provision of outreach and
education about federal veterans health benefits.
Background
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.
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 Veterans Affairs health
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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's office 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.
Public Assistance Reporting Information System
(PARIS)-Veterans data match . According to an April 2012
report to the Legislature on the 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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
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Local: No
SUPPORT : (Verified 7/2/12)
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
ARGUMENTS IN 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.
ASSEMBLY FLOOR : 74-0, 4/26/12
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Charles Calderon, Campos,
Carter, Chesbro, Conway, Cook, Davis, Dickinson,
Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Beth
Gaines, Galgiani, Garrick, Gatto, Gordon, Gorell, Grove,
Hagman, Hall, Hayashi, Roger Hernández, Hill, Huber,
Hueso, Huffman, Jeffries, Knight, Lara, Logue, Bonnie
Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell,
Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan,
Perea, V. Manuel Pérez, Portantino, Silva, Skinner,
Solorio, Swanson, Torres, Valadao, Wagner, Wieckowski,
Williams, Yamada, John A. Pérez
NO VOTE RECORDED: Cedillo, Furutani, Halderman, Harkey,
Jones, Smyth
CTW:d1 7/3/12 Senate Floor Analyses
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SUPPORT/OPPOSITION: SEE ABOVE
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