BILL ANALYSIS Ó
AB 2706
Page 1
Date of Hearing: April 29, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
AB 2706 (Roger Hernández) - As Amended: April 24, 2014
SUBJECT : Schools: health care coverage.
SUMMARY : Requires public schools to ensure their enrollment
forms include a section that offers the parent or legal guardian
of a pupil the option of being referred to an entity that can
provide information regarding health care coverage options and
enrollment assistance. Specifically, this bill :
1)Requires public schools, including charter schools, to add an
additional enrollment form, or amend an existing enrollment
form to provide the parent or guardian of a pupil the option
of being referred to any of the following:
a) A Certified Enrollment Counselor;
b) School personnel who conduct health care coverage
enrollment; or,
c) A local nonprofit organization qualified to assist with
health care coverage enrollment.
2)Requires the form or amendment to request the parent or
guardian's contact information, consent to share that
information with the entities described in 1) above and to be
signed and dated by the parent or guardian.
3)Requires the form or amendment to include a notice that the
information will only be shared with individuals or entities
who assist with health care coverage enrollment.
4)Requires that when a parent or guardian checks the box and
provides the requested information, that a school provide the
information to one of the individuals or entities described in
1) above.
5)Specifies that the information provided on the form or
amendment be considered a pupil record and the information
shall not be disclosed to any person other than as required by
these provisions.
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6)Allows a school to include a fact sheet with its enrollment
forms explaining basic information about affordable health
care coverage options for children and families.
7)Allows the California Department of Education (CDE) to develop
standardized templates for the following: a) the form or
amendments to be provided to parents or guardians; and, b) the
optional fact sheet.
8)Requires CDE to make any templates developed available on its
Internet Website and, upon request, provide written copies of
the template to a school district.
9)Prohibits a school district from discriminating against a
pupil who does not have health care coverage or using any
information relating to a pupil's health care coverage or
interest in learning about health care coverage in any manner
that would bring harm to the pupil or the pupil's family.
EXISTING LAW :
1)Requires, effective January 1, 2014, under the federal Patient
Protection and Affordable Care Act (ACA), an individual to
have the option to apply for state subsidy programs, which
include the state Medicaid program, the state's Children's
Health Insurance Program, enrollment in a qualified health
plan through a state exchange, and a Basic Health Plan, if
there is one, either in person, by mail, online, by telephone,
or through other commonly available electronic means.
2)Requires, under the ACA, each state, by January 1, 2014, to
establish a health benefit exchange that makes qualified
health plans (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.
3)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
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disclosed to any other person except as provided.
4)Requires, under the ACA, individuals to maintain health
insurance or pay a penalty, with exceptions for financial
hardship, religion, incarceration, and immigration status.
5)Permits school districts or county superintendents of schools
to incorporate into the School Lunch Program application
packet or notification of eligibility for the School Lunch
Program a notification that the child may qualify for free or
reduced-cost health coverage under the California Health
Benefit Exchange.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, the expansion
of health care coverage options under the ACA generated
approximately 7 million newly eligible Californians as of
January 1, 2014. Of those 7 million, nearly 1 million
children under the age 18 are uninsured and 67% of these
qualify for Medi-Cal. The author states that there is great
opportunity in 2014 to enroll these eligible children, however
currently notable barriers exist for eligible populations to
enrollment in Medi-Cal including lack of awareness about the
programs, difficult application or re-enrollment processes,
and stigmas associated with enrolling into low-income health
insurance and other public programs. Finally, the author
notes that while the ACA will dramatically reduce the number
of uninsured Californians, a significant number of eligible
children will be left behind in the absence of proactive and
practical solutions.
2)BACKGROUND . The concept of using schools to reach out to
families regarding health care coverage is not a new one. AB
59 (Cedillo), Chapter 894, Statutes of 2001, established a
statewide pilot project to expedite enrollment, referred to as
"EE," into Medi-Cal for children receiving free lunches
through the National School Lunch Program. Five school
districts implemented EE in 73 schools for the 2003-04 school
year. The process was structured to expedite Medi-Cal
enrollment for children who qualified for free school lunches.
Under the program, if a child was determined ineligible for
Medi-Cal due to income but was potentially eligible for the
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Healthy Families Program (HFP), the county sent a HFP
application to the child's parents, who completed the
application process for that program separately.
SB 1196 ( Cedillo), Chapter 729, Statutes of 2004, revised the
process to permit the information from the School Lunch
Program to be used to determine eligibility for HFP and any
other county- or local-sponsored programs, if the parent had
granted consent. SB 1196 also required a county to forward a
School Lunch Program application and any specified
supplemental forms to the HFP or a county or local-sponsored
health insurance program. An example of how this has been
implemented is the Los Angeles Unified School District (LAUSD)
Parent Handbook that includes information about student health
insurance, entitled the LAUSD Children's Health Access and
Medi-Cal Program (CHAMP), and informs parents that it can
assist them with enrolling their children into no-fee or
low-cost health insurance programs, provides a toll-free CHAMP
HELPLINE for enrollment assistance, a Website, and other
referrals to information.
AB 422 (Nazarian), Chapter 440, Statutes of 2013, adds
information regarding health care coverage available through
the California Health Benefit Exchange (Exchange), to
notifications on applications for the School Lunch Program,
effective January 1, 2014.
3)SUPPORT . The California Coverage & Health Initiatives is the
sponsor of this bill and writes that research shows that
California children who newly enroll in a health coverage
program experience a nearly 63% improvement in performance and
paying attention in class and are better prepared to succeed
in a learning environment and in life. Children Now, United
Way, PICO California, and Children's Partnership support the
bill for similar reasons.
The California Pan-Ethnic Health Network supports this bill,
stating that while the ACA will dramatically reduce the number
of uninsured Californians, a significant number of eligible
children including a majority from communities of color will
be left behind in the absence of solutions, and that this bill
will decrease that number by encouraging schools to offer
families the option to be connected to qualified community
enrollment entities when enrolling their child in school.
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4)DOUBLE REFERRAL . This bill has been double referred. It
passed the Assembly Committee on Education with a vote of 5-1
on April 23, 2014.
5)SUGGESTED AMENDMENTS .
a) Because one of the exceptions to the ACA's requirement
for health insurance coverage is a person's immigration
status, asking the parent or guardian of an undocumented
child to effectively disclose that they do not have health
insurance could discourage them from enrolling their child
in school. The bill should be amended to more clearly
state that the form or amendment shall request, but may not
require , the parent or guardian's contact information and
consent to share that information with an enrollment
counselor.
b) In order to ensure that parent, guardians and pupil
information remains confidential the Committee may wish to
amend the bill as follows:
i) To clarify that a school may not amend an existing
form, such as an emergency contact form, if that form is
intended to be shared with other persons that would not
otherwise have access to the pupil's records or personal
information.
ii) To clarify that if the form used by the school is
only for the notification purposes of this bill, upon
providing the parent or guardian's contact information to
the enrollment entity, the school shall immediately
destroy the form.
c) In order to ensure that schools are not penalized if an
enrollment entity fails to follow up with a parent or
guardian who request's assistance the Committee may wish to
amend the bill to clarify that a school is only required to
deliver the contact information provided on the form or
amendment to the specified enrollment entities, and upon
delivery of the information, the school district or
employee shall not be liable for any civil damages
resulting from any act or omission that may arise from
health care coverage or the lack thereof.
d) As a condition of passage in the Assembly Education
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Committee, the author agreed to amend a sunset date into
this bill. Committee staff suggests amending the bill to
sunset on December 31, 2018.
REGISTERED SUPPORT / OPPOSITION :
Support
California Coverage & Health Initiatives (sponsor)
California Immigrant Policy Center
California Pan-Ethnic Health Network
California School-Based Health Alliance
Children Now
Children's Defense Fund, California
Children's Partnership
El Monte Union High School District
El Rancho Unified School District
Lynwood Unified School District
PICO California
United Ways of California
Opposition
None on file.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097