BILL ANALYSIS Ó
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 1002|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: SB 1002
Author: De León (D), et al.
Amended: 3/28/14
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 3/26/14
AYES: Hernandez, Anderson, Beall, De León, DeSaulnier, Evans,
Monning, Wolk
NO VOTE RECORDED: Nielsen
SENATE HUMAN SERVICES COMMITTEE : 5-0, 4/8/14
AYES: Liu, Berryhill, DeSaulnier, Hancock, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-0, 5/23/14
AYES: De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg
SUBJECT : Medi-Cal: redetermination
SOURCE : California Food Policy Advocates
Western Center on Law and Poverty
DIGEST : This bill requires a county to begin a new 12-month
Medi-Cal eligibility period on a date that aligns that Medi-Cal
eligibility period with the beneficiary's household CalFresh
certification period, when a county determines or recertifies
CalFresh eligibility. Implements these provisions to the extent
permitted by federal law and to the extent that they do not
violate federal Medicaid maintenance of effort rules.
CONTINUED
SB 1002
Page
2
ANALYSIS :
Existing law:
1.Establishes the Medi-Cal program, administered by the
Department of Health Care Services (DHCS), under which
qualified low-income individuals receive health care services.
2.Establishes the federal Supplemental Nutrition Assistance
Program, under which each county distributes nutrition
assistance benefits provided by the federal government to
eligible households. In California, federal nutrition
assistance benefits are administered through CalFresh.
3.Requires counties to perform Medi-Cal eligibility
redeterminations every 12 months, and to promptly redetermine
Medi-Cal eligibility whenever the county receives information
about changes in a beneficiary's circumstances (such as the
birth of a child, change in family size, or change in income)
that may affect eligibility for benefits.
4.Requires a county to begin a new 12-month Medi-Cal eligibility
period in a redetermination due to a change in circumstances,
if a county determines that the beneficiary remains eligible
for Medi-Cal benefits.
This bill:
1.Requires a county, when a Medi-Cal redetermination due to a
change of circumstance is required, to begin a new 12-month
Medi-Cal eligibility period on a date that aligns that
eligibility period with the beneficiary's household CalFresh
certification period if the county receives information about
the change in circumstances in a CalFresh application or
during a CalFresh recertification, and the Medi-Cal
beneficiary is determined eligible to receive CalFresh
benefits.
2.Requires a county, when a Medi-Cal redetermination is not
required, to begin a new 12-month Medi-Cal eligibility period
that aligns the beneficiary's
Medi-Cal eligibility period with his/her CalFresh household
certification period, if a county receives an application or
recertification for CalFresh benefits from a Medi-Cal
CONTINUED
SB 1002
Page
3
beneficiary who is not receiving CalWORKs benefits, and who is
determined eligible to receive CalFresh benefits.
3.Prohibits (2) above, from applying if doing so would either
increase the Medi-Cal beneficiary's share of cost or reduce
the benefits for any member of the beneficiary's CalFresh
family budget unit. Requires the Medi-Cal beneficiary's
eligibility period and CalFresh certification period to remain
unaligned in such a situation.
4.Prohibits (2) above, from being construed to permit a CalFresh
recipient who is otherwise ineligible for Medi-Cal benefits to
receive Medi-Cal benefits.
5.Implements the provisions of this bill and a specified
provision of existing law to the extent permitted by federal
law and to the extent that this action does not violate
federal maintenance of effort rules.
6.Names this bill "The Aligning Opportunities for Health Act of
2014."
Background
Counties perform Medi-Cal, CalWORKS and CalFresh eligibility
determinations for the state. Individuals can apply for all
three programs at one time using a joint application, but
individuals may apply for each program at different times using
separate applications. While an individual who is enrolled in
CalWORKS is automatically categorically eligible for Medi-Cal,
when individuals apply for CalFresh and Medi-Cal at different
times, they can have different deadlines to renew eligibility
for each program. According to state data from the last quarter
of 2012, 66% of Medi-Cal households received CalFresh and 77% of
CalFresh households received Medi-Cal.
Prior Legislation
SB 970 (De León, 2012) would have allowed an individual, at
initial application or renewal of health care coverage using the
single state application, to have his/her health care
application information used to initiate a simultaneous
application for CalWORKs or CalFresh programs to be transmitted
to the applicable county human services department to initiate
CONTINUED
SB 1002
Page
4
the application, if the individual granted consent. The bill
was vetoed by Governor Brown.
SB X1 1 (Hernandez and Steinberg, Chapter 4, Statutes of 2013),
among other provisions, requires DHCS to seek any federal
waivers necessary to use the eligibility information of
individuals who have been determined eligible for the CalFresh
who are under 65 years of age and are not disabled, to determine
their Medi-Cal eligibility.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Minor administrative costs to counties (General Fund and
federal funds). Counties are not likely to experience
significant administrative costs, because resetting the
Medi-Cal eligibility period would occur during a
redetermination of eligibility for the CalFresh program.
Potentially significant costs to the Medi-Cal program due to
increased enrollment, potentially in the millions to low tens
of millions per year (General Fund and federal funds). Under
existing law, Medi-Cal beneficiaries must have their
eligibility redetermined every 12 months. Every year a small
but significant number of Medi-Cal beneficiaries lose their
eligibility temporarily due to administrative issues, for
example, not returning required forms or delays in locating
needed documents. Short term lapses in eligibility are
referred to as "churn." By resetting a beneficiary's Medi-Cal
eligibility when performing CalFresh eligibility
determinations, this bill is likely to reduce churn among this
population of beneficiaries. The reduction in churn will, in
turn, increase Medi-Cal costs, particularly the per-member
per-month payments made to managed care plans.
SUPPORT : (Verified 5/23/14)
California Food Policy Advocates (co-source)
Western Center on Law and Poverty (co-source)
Alameda County Community Food Bank
American Federation of State, County and Municipal Employees
Asian Law Alliance
CONTINUED
SB 1002
Page
5
California Association of Food Banks
California Coverage and Health Initiatives
California Center for Public Health Advocacy
California Hunger Advocacy Coalition
California Partnership
Children Now
Children's Defense Fund-California
Coalition of California Welfare Rights Organization
Community Food and Justice Coalition
Congress of California Seniors
CSUC Center for Nutrition and Activity Promotion
Greenlining Institute
Hunger Advocacy Network
Los Angeles Regional Food Bank
National Health Law Program
PICO California
Redwood Empire Food Bank
San Diego Hunger Coalition
San Francisco Living Wage Coalition
SF-Marin Food Bank
St. Anthony Foundation
The Children's Partnership
United Ways of California
ARGUMENTS IN SUPPORT : This bill is jointly sponsored by
California Food Policy Advocates and the Western Center on Law
and Poverty to improve alignment between Medi-Cal and CalFresh
reporting periods. In order to maintain benefits, individuals
and families must meet ongoing reporting requirements for both
programs, including the submission of paperwork with necessary
information for the annual renewal of benefits. If a
household's reporting periods are aligned, a beneficiary will
have a common due date for renewal paperwork, thus reducing the
administrative burden for program administrators and
facilitating joint reporting and renewal for beneficiaries.
Additionally, individuals and families are less likely to
confuse reporting requirements if the paperwork for both
programs is due concurrently. Doing so would encourage benefit
retention and promote Medi-Cal and CalFresh dual enrollment.
JL:e 5/25/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
CONTINUED
SB 1002
Page
6
**** END ****
CONTINUED