BILL ANALYSIS �
SB 18
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SENATE THIRD READING
SB 18 (Leno and Ed Hernandez)
As Amended August 18, 2014
Majority vote
SENATE VOTE :Vote not relevant
HEALTH 13-5 APPROPRIATIONS 12-0
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|Ayes:|Pan, Ammiano, Bonilla, |Ayes:|Gatto, Bocanegra, |
| |Bonta, Chesbro, Gomez, | |Bradford, |
| |Gonzalez, | |Ian Calderon, Campos, |
| |Roger Hern�ndez, | |Eggman, Gomez, Holden, |
| |Lowenthal, Nazarian, | |Pan, Quirk, |
| |Ridley-Thomas, Rodriguez, | |Ridley-Thomas, Weber |
| |Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Maienschein, Ch�vez, | | |
| |Mansoor, Patterson, | | |
| |Wagner | | |
| | | | |
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SUMMARY : Requires the Department of Health Care Services (DHCS)
to accept contributions by private foundations in the amount of
at least $6 million for the purposes of providing Medi-Cal
renewal assistance payments, starting January 1, 2015.
EXISTING LAW : Authorizes DHCS to accept contributions by
private foundations in the amount of at least $26.5 million, and
to obtain an equal amount of federal matching funds, to support
and fund Medi-Cal outreach and enrollment activities, as well as
payments for in-person Medi-Cal enrollment assistance.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Expenditures of $12 million beginning in January 2015
(assuming costs are shared 50% private foundation funding, 50%
federal funds) on grants to community-based organizations to
assist with Medi-Cal renewal. This bill appropriates $6
million from the specified special fund (the Healthcare
Outreach and Medi-Cal Enrollment Account, which was created
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through an uncodified trailer bill section, Section 5 of SB
101 (Budget and Fiscal Review Committee), Chapter 361,
Statutes of 2013) and $6 million in federal matching funds.
2)Costs for Medi-Cal benefits in 2015 likely in the tens of
millions of dollars (GF/federal). This estimate assumes the
renewal assistance effort results in significant numbers of
enrollees who otherwise would not have renewed their Medi-Cal
eligibility. The GF share of costs could be in excess of $10
million to the low tens of millions in the first year for
additional Medi-Cal benefits. Actual GF costs would depend on
how many new renewals are generated for individual who
otherwise may not have renewed, and the corresponding federal
share of cost. The one-time renewal assistance will likely
result in higher ongoing costs as well, since a greater number
of beneficiaries will likely maintain enrollment in the
program in future years.
3)To the extent greater continuous Medi-Cal enrollment results
in more beneficiaries receiving regular care for chronic
conditions, increased up-front benefits costs could
potentially be offset somewhat by fewer expensive
complications from uncontrolled chronic conditions. Such
costs offsets would be nebulous, but could be reflected in
lower managed care payments in future years.
COMMENTS : According to the author, this bill provides the
mechanism necessary to obtain federal matching dollars for $6
million. The California Endowment (The Endowment), a private
health foundation that provides grants to community-based
organizations throughout California, is willing to contribute to
help individuals renew their Medi-Cal coverage. The author
states, as part of its work in leading the nation on the
implementation of the ACA, California has developed an outreach
and enrollment infrastructure of community-based organizations
and county employees who have assisted millions of Californians
to enroll in Covered California and Medi-Cal. The author adds
that these Californians will need to renew their coverage in
order to keep it for the year 2015, and that renewal assistance
will be particularly important in 2014-15 as existing Medi-Cal
enrollees move from welfare-based income and household
eligibility rules to modified adjusted gross income (MAGI)-based
eligibility rules.
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In 2013, The Endowment committed $26.5 million to the state in
an effort to help increase and enhance outreach and enrollment
efforts in Medi-Cal, and support enrollment for up to 450,000
Medi-Cal applicants. AB 82 (Budget Committee), Chapter 23,
Statutes of 2013, authorizes DHCS to accept the private
foundation funds, and to secure an equal amount in federal
matching funds, to be used for Medi-Cal in-person enrollment
assistance payments and local Medi-Cal outreach and enrollment
efforts. A portion is also used to supplement counties'
existing funding for Medi-Cal outreach and enrollment efforts
associated with implementation of Patient Protection and
Affordable Care Act (ACA).
The Western Center on Law and Poverty (WCLP), a cosponsor of
this bill, states that the role of community-based organizations
in assisting consumers with enrollment into Medi-Cal has been
critical to the progress California has made in expanding the
program and streamlining eligibility rules. WCLP states it is
similarly important to have community-based organizations assist
beneficiaries in renewing their Medi-Cal coverage, particularly
given the shift under the ACA to MAGI eligibility rules. WCLP
asserts that the new Medi-Cal renewal application is confusing,
and that while there should be many improvements to the renewal
process in 2015, due to the implementation of ex parte review
and the use of prepopulated forms, this will be a different type
of renewal process for which beneficiaries must adapt.
Health Access California, also a cosponsor of this bill, states
that The Endowment has generously offered $6 million to assist
consumers who are enrolled in Medi-Cal to renew that their
coverage, and that this bill would allow a federal match for
those dollars. Health Access states that keeping eligible
beneficiaries enrolled in coverage assures ongoing access to
medically necessary care and reduces administrative overhead due
to avoidable churning of enrollment.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097
FN: 0005046
SB 18
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