BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 970|
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UNFINISHED BUSINESS
Bill No: SB 970
Author: De León (D), et al.
Amended: 8/20/12
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 4/11/12
AYES: Hernandez, Harman, Alquist, Anderson, De León,
DeSaulnier, Rubio, Wolk
NO VOTE RECORDED: Blakeslee
SENATE APPROPRIATIONS COMMITTEE : 5-2, 5/24/12
AYES: Kehoe, Alquist, Lieu, Price, Steinberg
NOES: Walters, Dutton
SENATE FLOOR : 31-5, 5/31/12
AYES: Alquist, Anderson, Berryhill, Calderon, Cannella,
Corbett, Correa, De León, DeSaulnier, Emmerson, Evans,
Fuller, Harman, Hernandez, Huff, Kehoe, Leno, Lieu, Liu,
Lowenthal, Negrete McLeod, Padilla, Pavley, Price, Rubio,
Simitian, Vargas, Wolk, Wright, Wyland, Yee
NOES: Blakeslee, Dutton, Gaines, La Malfa, Walters
NO VOTE RECORDED: Hancock, Runner, Steinberg, Strickland
ASSEMBLY FLOOR : 53-26, 8/22/12 - See last page for vote
SUBJECT : Health Care Reform Eligibility, Enrollment, and
Retention
Planning Act: coordination with other programs
SOURCE : Western Center on Law and Poverty
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DIGEST : Authorizes, upon consent of the applicant,
information provided for the single state application for
health subsidy programs to be used to initiate a
simultaneous application for the California Work
Opportunity and Responsibility to Kids (CalWORKs) or the
CalFresh programs.
Assembly Amendments provide that at the time a person
applies for or renews health coverage using the single
state application, the person may also consent to have the
application information used by the county human services
department to initiate an application for CalWORKs and
CalFresh programs and requires the information to be
transmitted to the applicable county human services
department, and make other clarifying changes.
ANALYSIS :
Existing law:
1. Requires the California Health Benefit Exchange
(Exchange) to inform individuals of eligibility
requirements for the Medi-Cal program, the Healthy
Families Program, or any applicable state or local
public program. Requires, through screening of the
application for coverage by the Exchange, if the
Exchange determines that an individual is eligible for
any such program, the Exchange to enroll that individual
in the program.
2. Requires, under the Health Care Reform Eligibility,
Enrollment, and Retention Planning Act, the California
Health and Human Services Agency (CHHSA), in
consultation with the Department of Health Care Services
(DHCS), the Managed Risk Medical Insurance Board
(MRMIB), the Exchange, the California Office of Systems
Integration, counties, health plans, consumer advocates,
and other stakeholders to undertake a planning and
development process regarding the federal Patient
Protection and Affordable Care Act (ACA) related to
eligibility for, and enrollment and retention in, state
health subsidy programs.
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3. Requires DHCS, in consultation with MRMIB and the
Exchange, to develop a single, accessible, standardized
paper, electronic, and telephone application for state
health subsidy programs as part of the stakeholder
process in #2 above. 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.
This bill:
1. Provides that at the time a person applies for or renews
health coverage using the single state application, the
person may also consent to have the application
information used by the county human services department
to initiate an application for CalWORKs and CalFresh
programs and requires the information to be transmitted
to the applicable county human services department.
2. Requires the California Health and Human Services Agency
(CHHSA) to convene a work group of stakeholders, as
specified, including advocates, legislative staff, and
staff from state and county departments and agencies to
consider the feasibility, costs and benefits of
integrating application and renewal process for
additional human services and work support programs with
the single state application for health subsidy programs
and requires CHHSA to provide information regarding the
workgroup to the appropriate fiscal and policy
committees of the Legislature by July 1, 2013.
3. Requires the functionality needed to implement 1) above
to be achieved no later than the expiration of a
specified federal waiver requiring states to evenly
allocate the development costs for systems that are
federally funded and will be used to determine
eligibility for multiple programs.
4. Authorizes the Secretary of CHHSA to phase in
implementation or to entirely cease implementation, upon
reporting a recommendation to the Legislature, holding a
public hearing, and filing a declaration, if it is
determined that implementation of this bill would
prevent timely implementation of the single standardized
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application for state health subsidy programs.
5. Provides for this bill to become inoperative upon the
filing of the declaration pursuant to #4) above.
Background
The ACA, enrollment application process, and this bill
proposes changes. The ACA makes numerous changes to
increase the number of individuals with health coverage.
These changes include requiring a single streamlined form
for state health subsidy programs, and by allowing
individuals to be able to apply in person, by mail, through
the internet, or by telephone.
California, through the Exchange, has issued a request for
proposal (RFP) to implement a new information technology
system known as CalHEERS (California Healthcare
Eligibility, Enrollment and Retention System). CalHEERS
will provide a "one-stop-shop" to determine eligibility for
non-subsidized health coverage for individuals in the
Exchange, and subsidized coverage for individuals eligible
for state health subsidy programs. The Exchange RFP for
CalHEERS calls for vendors to provide the ability to notify
the applicant that he or she may be eligible for other
state programs (for example, CalWORKs and CalFresh), that
would direct the individual to the appropriate links, and
collect and send the basic application data (along with any
documents provided by the applicant) to the system of
record for that program to complete the application
process. The Exchange asked vendors to have the ability to
provide this expanded system by December 31, 2015, but the
Exchange has a not made a decision on whether it wishes to
purchase these additional services (known as a "state
option to buy"). Vendor submissions to the Exchange were
submitted earlier this year, and the bids are not public
information. Vendor selection is anticipated for late
April or early May 2012. Once the contract has been
awarded, the contract and the dollar amounts will be made
public.
The current application process for Medi-Cal is primarily
through county human services departments, where
individuals can apply either in person, through the mail,
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or online. In addition, individuals can also apply
(through the county) for enrollment in human services
programs such as CalWORKs or CalFresh (previously known as
Food Stamps) using the same application, but those programs
have additional requirements that Medi-Cal does not.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee, unknown
costs to convene a workgroup and develop a plan to
integrate social service program eligibility and enrollment
systems into the single application (mostly federal funds).
SUPPORT : (Verified 5/29/12) (Per Senate Health Comm.
analysis, prior version of the bill)
Western Center on Law and Poverty (source)
ACCESS Women's Health Justice
Alameda County Community Food Bank
American Federation of State, County and Municipal
Employees, AFL-CIO
California Association of Food Banks
California Black Health Network
California Catholic Conference, Inc.
California Children's Health Coverage Coalition
California Commission on Aging
California Communities United Institute
California Coverage & Health Initiatives
California Family Resource Association
California Food Policy Advocates
California Hunger Action Coalition
California Pan Ethnic Health Network
California Partnership to End Domestic Violence
California Rural Legal Assistance Foundation
California School Nutrition Association
California WIC Association
Catholic Charities of California United
Children Now
Children's Defense Fund
Coalition of California Welfare Rights Organizations, Inc.
Community Clinic Association of Los Angeles County
Consumer Federation of California
County Welfare Directors Association of California
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George M. Shirakawa, President, Santa Clara County Board of
Supervisors
Greenlining Institute
Having Our Say
Health Access California
Hunger Action Los Angeles
Jericho: A Voice for Justice
La Cooperativa Campesina de California
Latino Coalition for a Healthy California
LifeLong Medical Care
Los Angeles Regional Food Bank
Madera Coalition for Community Justice
National Association of Social Workers
National Health Law Program
River City Food Bank
San Francisco Food Security Task Force
Service Employees International Union
The Children's Partnership
United Way CA
ARGUMENTS IN SUPPORT : According to the author's office,
this bill has two goals: (1) to allow consumers applying
for health coverage through the new streamlined California
Healthcare Eligibility, Enrollment and Retention System
(CalHEERS is an information technology system) to also
apply for human services programs, so they can receive
needed public benefits; and (2) to maximize enrollment in
health coverage by 2014 by identifying CalFresh recipients
who are uninsured and, with their consent, using their
CalFresh information to apply for health coverage.
Integrating human services programs into CalHEERS increases
administrative efficiency and streamlines the application
and renewal processes for consumers. The benefits of
maximizing health coverage enrollment are several.
Californians will be required by law to have health
coverage in 2014 and coverage for the newly eligible will
be paid for with 100 percent federal funds from 2014-2016,
going to a still-high 90 percent federal match by 2020.
Multiple strategies are needed to maximize health coverage
enrollment including "pre-enrollment" of eligible
populations such as CalFresh recipients. Additional
strategies to reach those eligible for CalFresh benefits (a
100 percent federally financed benefit) are also needed
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given California's low participation level.
ASSEMBLY FLOOR : 53-26, 8/22/12
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Davis, Dickinson, Eng, Feuer, Fletcher, Fong,
Fuentes, Furutani, Galgiani, Gatto, Gordon, Hall,
Hayashi, Hill, Huber, Hueso, Huffman, Lara, Bonnie
Lowenthal, Ma, Mendoza, Mitchell, Monning, Olsen, Pan,
Perea, V. Manuel Pérez, Portantino, Skinner, Solorio,
Swanson, Torres, Wieckowski, Williams, Yamada, John A.
Pérez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Beth Gaines, Garrick, Gorell, Grove, Hagman, Halderman,
Harkey, Jeffries, Jones, Knight, Logue, Mansoor, Miller,
Morrell, Nestande, Nielsen, Norby, Silva, Smyth, Valadao,
Wagner
NO VOTE RECORDED: Roger Hernández
CTW:d 8/22/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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