BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
SB 280 (Lieu and Lara) - Insurance affordability programs:
application form.
Amended: January 6, 2014 Policy Vote: Health 7-0
Urgency: No Mandate: No
Hearing Date: January 23, 2014
Consultant: Brendan McCarthy
SUSPENSE FILE.
Bill Summary: SB 280 would permit the application form for
insurance affordability programs (including Medi-Cal and health
care coverage through the California Health Benefit Exchange) to
include questions on sexual orientation and gender identity.
After January 1, 2016, the bill would require the application
form to include such questions.
Fiscal Impact:
One-time costs of $100,000 to $150,000 to modify
information technology systems to allow the health care
coverage application system for Medi-Cal and the California
Health Benefit Exchange to include required demographic
questions in the application (federal funds or special
funds).
Unknown potential costs, possibly in the millions, to
update county welfare department information technology
systems and to reprint paper applications, if necessary. The
Department of Health Care Services has indicated that there
could be significant costs to update county welfare
department information technology systems (referred to as
SAWS) to collect the required data when performing Medi-Cal
eligibility determinations. In addition, if the requirement
to add new questions to the Medi-Cal application requires
existing paper applications for Medi-Cal and other social
service programs to be reprinted, there could be substantial
costs.
Background: Under state and federal law, the Department of
Health Care Services operates the Medi-Cal program, which
SB 280 (Lieu and Lara)
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provides health care coverage to pregnant women, children and
their parents with incomes below 100% of the federal poverty
level, as well as blind, disabled, and certain other
populations.
The federal Affordable Care Act allows states to expand Medicaid
(Medi-Cal in California) eligibility to persons under 65 years
of age, who are not pregnant, not entitled to Medicare Part A or
enrolled in Medicare Part B, and whose income does not exceed
133% of the federal poverty level (effectively 138% of the
federal poverty level as calculated under the Affordable Care
Act). California has opted to expand eligibility for Medi-Cal up
to 138% of the federal poverty level.
AB X1 1 (J. Perez, Statutes of 2013) and SB X1 1 (Hernandez and
Steinberg, Statutes of 2013) implement the expansion of Medi-Cal
and include a number of changes to the eligibility and
enrollment process for the Medi-Cal program. AB X1 1 and SB X1 1
require a single paper, electronic, or telephone application for
Medi-Cal and health care coverage through the California Health
Benefit Exchange. Current law authorizes the single application
to include questions about the applicant's demographic
characteristics. Those questions are voluntary for the applicant
to answer.
Proposed Law: SB 280 would permit the application form for
insurance affordability programs (including Medi-Cal and health
care coverage purchased through the California Health Benefit
Exchange) to include questions on sexual orientation and gender
identity.
After January 1, 2016, the bill would require the application
form to include specified
demographic questions - including questions regarding the
applicant's race, ethnicity, primary language, disability
status, sexual orientation, gender identity or expression.
Applicants would not be required to answer those demographic
questions to complete the application.
Related Legislation:
AB 50 (Pan) formerly included language similar to this
bill. Those provisions were amended out of that bill. That
bill was vetoed by Governor Brown.
SB 280 (Lieu and Lara)
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AB 1208 (Pan) was identical to this bill, except that the
requirement for additional questions would have gone into
effect on January 1, 2015. That bill was vetoed by Governor
Brown.