BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1829
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          Date of Hearing:  April 22, 2014

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
                    AB 1829 (Conway) - As Amended:  April 21, 2014
           
          SUBJECT  :  California Health Benefit Exchange: employees and  
          contractors.

           SUMMARY  :  Prohibits the California Health Benefit Exchange  
          (Exchange, now known as Covered California) from hiring or  
          contracting with individuals who have been convicted of certain  
          felonies or violations if the person could have access to  
          specific personal information of enrollees.  Contains an urgency  
          clause to ensure that the provisions of this bill go into  
          immediate effect upon enactment.  Specifically,  this bill  :  

          1)Prohibits the Exchange from hiring or contracting with any  
            person whose duties would include facilitating enrollment in  
            qualified health plans offered through the Exchange or would  
            give the person access to the financial or medical information  
            of enrollees if the person has been convicted of:

             a)   A felony crime of dishonesty or breach of trust in a  
               state or federal jurisdiction;

             b)   Federal crimes related to the insurance business, as  
               specified; or,

             c)   A crime listed in current state regulations as  
               substantially related to the qualifications, functions, or  
               duties of an insurance licensee.  These crimes include any  
               felony conviction and specified misdemeanor convictions. 

          2)Requires employees and contractors to subsequently notify the  
            Exchange upon any misdemeanor or felony conviction or filing  
            of charges in state or federal court, any administrative  
            action regarding a professional or occupational license, or  
            any conviction listed in 1) above.

           EXISTING LAW  :  

          1)Requires, under the federal Patient Protection and Affordable  
            Care Act (ACA), each state, by January 1, 2014, to establish a  
            health benefit exchange that makes qualified health plans  








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            (QHPs) available to qualified individuals and qualified  
            employers, or, if a state chooses not to establish an  
            exchange, requires the federal government to establish one for  
            the state.  

          2)Establishes the Exchange as an independent public entity in  
            state government.  Requires the Exchange to compare and make  
            available through selective contracting health insurance for  
            individual and small business purchasers as authorized under  
            the ACA.

          3)Permits the Exchange to adopt rules and regulations, as  
            necessary, and permits the Exchange to adopt any necessary  
            rules and regulations as emergency regulations in accordance  
            with the Administrative Procedure Act, until January 1, 2016.

          4)Requires, under federal law, any person who receives  
            information provided by an applicant for coverage or receives  
            information from a federal agency, to use the information only  
            for the purposes of ensuring the efficient operation of the  
            Exchange, including verifying the eligibility of an individual  
            to enroll in the Exchange or to claim a premium tax credit or  
            cost-sharing reduction.  Prohibits the information from being  
            disclosed to any other person except as provided.

          5)Requires the Exchange to perform fingerprint-based background  
            checks of all employees, prospective employees, contractors,  
            subcontractors, employees of contractors, volunteers, or  
            vendors whose duties include access to confidential, personal,  
            or financial information, or any other information as required  
            by federal law or guidance.  

          6)Requires, under existing state regulations, the Exchange to  
            review any information from the criminal background check to  
            determine an individual's fitness to perform job duties, based  
            on a consideration of the nature of the job; the age, nature,  
            and gravity of the offense; and any evidence of  
            rehabilitation, including evidence provided by the individual.

          7)Allows the Insurance Commissioner to deny an application for  
            any license by an applicant who has been convicted of a  
            felony, certain misdemeanors, or a public offense that  
            involves a fraudulent act or an act of dishonesty, as  
            specified.  Allows, under state regulations, the Insurance  
            Commissioner to take into consideration the adverse effects of  








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            the crime, the recency or remoteness in time of the act, the  
            type of license involved, any extenuating or aggravating  
            circumstances, and related prior history.  Allows the  
            Insurance Commissioner to consider all of the evidence  
            presented, including evidence offered by the licensee or  
            applicant, to determine whether the licensee or applicant has  
            sufficiently rehabilitated from the prior act and is fit to  
            hold an insurance license.

           FISCAL EFFECT  :  This bill has not yet been analyzed by a fiscal  
          committee.

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  The author writes that millions of  
            Californians have started to enroll in the new state Exchange  
            and more than 20,000 individuals will be contracted to promote  
            the Exchange and enroll the public.  The author asserts that  
            these contractors will have access to enrollees' most  
            sensitive personal information, including home addresses,  
            Social Security numbers, state and federal tax information,  
            and personal health information.  

            The author notes that, although the Exchange performs  
            background checks, an article in the National Review recently  
            indicated that Covered California has certified a number of  
            individuals with criminal convictions, including those who  
            have committed significant financial crimes such as forgery,  
            burglary, and welfare fraud.  The author suggests that this  
            bill, by excluding individuals with certain convictions from  
            working for the Exchange, would provide a much needed  
            safeguard for the public and restore confidence in the state  
            Exchange.  The author concedes that individuals who have paid  
            their debt to society deserve a second chance, but argues that  
            felons convicted of financial crimes should be disqualified  
            from being hired by the Exchange or contracted as enrollment  
            counselors.  

           2)BACKGROUND  .  

             a)   Certified enrollment counselors.  Certified enrollment  
               counselors are certified by the Exchange to provide  
               culturally and linguistically appropriate one-on-one  
               counseling and assistance to consumers in need of help with  
               applying for Covered California programs. Certified  








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               enrollment counselors must be registered with either the  
               In-Person Assistance Program or the Navigator Program and  
               are often referred to as in-person asstisters or  
               navigators.  Counselors work for certified enrollment  
               entities, which are community-based organizations that  
               conduct outreach and enrollment activities, and are not  
               employees of the Exchange.

             b)   Exchange data on criminal background clearances.  In  
               January 2014, an article in the National Review reported on  
               documents provided by the Exchange on criminal background  
               clearances for certified enrollment counselors.  The  
               article called particular attention to one counselor with  
               forgery convictions in 1982 and 1994, and another counselor  
               with two forgery convictions in 1988.  Other convictions  
               disclosed by the Exchange include the sale and possession  
               of drugs, petty theft, perjury, driving under the  
               influence, shoplifting, and battery.

             According to information provided by the Exchange, of over  
               3,000 enrollment counselor applicants, 35 individuals, or  
               about 1%, had potentially disqualifying convictions.  Of  
               these 35, four applicants have been disqualified based on  
               background checks.  One disqualified individual had a  
               commercial burglary conviction in 2005; another had a  
               robbery conviction from 1992 and a spousal abuse conviction  
               in 2002.  The Exchange indicates that its current  
               background check process, which is based on state law and  
               federal guidance, requires an individualized assessment of  
               each application, considering factors that include the age  
               and nature of the offense, the applicant's age at the time  
               of the offense, the relation of the offense to job duties,  
               the performance of similar duties in other jobs, and  
               evidence of rehabilitation.

             c)   Current fingerprinting requirement.  The federal Minimum  
               Acceptable Risk Standards for Exchanges Personnel Screening  
               Requirements, developed by the federal Centers for Medicare  
               and Medicaid Services, require exchanges to perform a  
               criminal history check prior to employment and require  
               appropriate personnel to obtain and hold a moderate-risk  
               security clearance, as defined in federal personnel  
               security guidelines.  In 2013, the Legislature enacted this  
               requirement through SB 509 (DeSaulnier and Emmerson),  
               Chapter 10, Statutes of 2013, which required  








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               fingerprint-based background checks for all employees and  
               contractors of the Exchange.

             d)   Federal civil rights guidance.  In April 2012, the U.S.  
               Equal Employment Opportunity Commission (EEOC) published  
               guidance regarding the use of arrest or conviction records  
               in employment decisions under Title VII of the Civil Rights  
               Act of 1964 (Title VII).  The guidance notes that in the  
               last twenty years, there has been a significant increase in  
               the number of Americans who have had contact with the  
               criminal justice system: in 1991, only 1.8% of the adult  
               population had served time in prison; by the end of 2007,  
               3.2% of all adults in the U.S. (one in every 31) were under  
               some form of correctional control involving probation,  
               parole, prison, or jail.  Arrest and incarceration rates  
               are particularly high for African American and Hispanic  
               men, who are arrested at two to three times the rate of the  
               general population.  Given current incarceration rates,  
               about one in 17 white men are expected to serve time in  
               prison during their lifetime, compared to one in six for  
               Hispanic men and one in three for African American men.

             Given these disparities in the criminal justice system, the  
               EEOC guidance states that an employer's use of an  
               individual's criminal history in making employment  
               decisions, may, in some instances, violate the prohibition  
               against employment discrimination under Title VII.  An  
               employer is liable for violating Title VII if its policy  
               disproportionately screens out a protected group and the  
               employer cannot demonstrate that the policy is job related  
               for the position in question and consistent with business  
               necessity.  The guidance suggests that, because there are  
               few social science studies that assess whether convictions  
               are linked to future conduct with workplace ramifications,  
               it is unlikely that an employer would have a sufficient  
               basis to validate particular employment exclusions.  The  
               guidance therefore recommends against blanket exclusions,  
               and instead recommends that employers should develop a  
               detailed policy for individualized screening of  
               applications that requires consideration of the nature and  
               gravity of the offense; the time that has passed since the  
               offense; and the nature of the job.  This is the approach  
               taken by the Exchange in regulations implementing SB 509.  

           3)SUPPORT  .  Independent Insurance Agents and Brokers of  








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            California (IIAB), in support, argues that while most  
            individuals seeking employment or contract with Covered  
            California are doing so with the best intentions to help  
            consumers, sadly there may be some out there who see  
            involvement in the program as a way to scheme, manipulate,  
            steal, or financially abuse consumers looking to purchase  
            health care.  Insurance agents and brokers must pass rigorous  
            background checks to obtain a license in California.  IIAB  
            suggests this bill will help protect consumers from potential  
            abuses, preventing the creation of mistrust among consumers,  
            which can affect the industry as a whole.  

          4)OPPOSITION  .  The National Employment Law Project, in  
            opposition, states that this bill's blanket ban on certain  
            felonies and many misdemeanors will exclude and unfairly  
            discriminate against many otherwise eligible candidates, in  
            violation of Title VII.  The American Civil Liberties Union  
            (ACLU) of California, in opposition, writes that this bill is  
            overly restrictive without furthering consumer protection and  
            will disproportionately impact applicants from communities of  
            color.  ACLU writes that, by creating a lifetime ban from  
            certain government jobs and contracts, this bill could limit  
            the Exchange's ability to hire a diverse workforce that can  
            adequately respond to consumers' linguistic and cultural  
            needs.  Health Access California, in opposition, writes that  
            75% of the uninsured and two-thirds of those eligible for  
            either Medi-Cal or subsidies under the Exchange are from  
            communities of color.  Young Invincibles, also in opposition,  
            argues young people of color are more likely to be uninsured  
            than most other groups, making it particularly essential that  
            the outreach and enrollment workforce represents these  
            communities.  

           5)RELATED LEGISLATION  .  

             a)   AB 1428 (Conway), Chapter 561, Statutes of 2013, inserts  
               a reference to a specific federal document relating to  
               health exchange privacy and security to clarify criminal  
               background check requirements for employees, contractors,  
               and vendors who facilitate enrollment in the Exchange.

             b)   AB 1560 (Gorell) prohibits the Exchange from disclosing  
               an individual's personal information to third parties for  
               the purpose of eligibility or enrollment in health care  
               coverage unless the individual confirms specified  








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               information and provides prior written consent.  AB 1560 is  
               pending in this Committee and is set for hearing April 22,  
               2014.

             c)   AB 1830 (Conway) prohibits the Exchange and its  
               employees from using or disclosing personal information  
               except as necessary to carry out specified functions under  
               the ACA and creates a civil penalty of up to $25,000 per  
               individual or entity, per use or disclosure.  AB 1830 is  
               pending in this Committee and is set for hearing April 22,  
               2014.

             d)   AB 2301 (Mansoor) requires the Exchange to report on a  
               quarterly basis on enrollments and disenrollments under  
               QHPs purchased through the Exchange by specified  
               categories.  AB 2301 is pending in this Committee and is  
               set for hearing April 22, 2014.

             e)   SB 509 (DeSaulnier and Emmerson), Chapter 10, Statutes  
               of 2013, requires fingerprint-based background checks for  
               all Exchange employees, contractors, volunteers, or vendors  
               with access to enrollees' personal information.  

             f)   SB 974 (Anderson) prohibits the Exchange from disclosing  
               an individual's personal information to any other person or  
               entity without explicit permission and requires the  
               Exchange to report a disclosure in violation of this  
               provision within five business days.  SB 974 is pending in  
               the Senate Appropriations Committee.

           6)PREVIOUS LEGISLATION  .  AB 1602 (John A.  P�rez), Chapter 655,  
            Statutes of 2010, and SB 900 (Alquist), Chapter 659, Statutes  
            of 2010, establish the Exchange and its powers and duties.

           REGISTERED SUPPORT / OPPOSITION  :  

           Support 
           
          Independent Insurance Agents and Brokers of California

           Opposition 
           
          American Civil Liberties Union of California
          American Federation of State, County and Municipal Employees,  
          AFL-CIO








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          American Friends Service Committee, Pacific Mountain Region
          Californians United for a Responsible Budget
          California Pan-Ethnic Health Network
          Drug Policy Alliance
          Greenlining Institute
          Health Access California
          Legal Services for Prisoners with Children
          Los Angeles Regional Reentry Partnership
          National Employment Law Project
          Service Employees International Union, California State Council
          Service Employees International Union Local 1000
          Young Invincibles
           
          Analysis Prepared by  :    Ben Russell / HEALTH / (916) 319-2097