BILL NUMBER: AB 43 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Villaraigosa
DECEMBER 7, 1998
An act to amend Section 12693.70 of, and to add Section 12693.705
to, the Insurance Code, and to amend Section 14012 of, and to add
Section 14005.235 to, the Welfare and Institutions Code, relating to
children, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
AB 43, as introduced, Villaraigosa. Children: Healthy Families
Program: eligibility.
(1) Existing law establishes the Healthy Families Program to
arrange for the provision of health services to eligible children.
Under existing law, in order to be eligible, an applicant must be
applying on behalf of a child, who meets certain requirements,
including being in a family having a gross annual household income
equal to or less than 200% of the federal poverty level, and meeting
the citizenship and immigration status requirements established by
federal law.
This bill would require that a child's family have a gross annual
household income equal to or less than 250% of the federal poverty
level for purposes of eligibility, and would provide that a child who
is otherwise eligible for participation shall not be denied
eligibility based on the child's date of entry into the United
States.
Existing law continuously appropriates money from the Healthy
Families Fund for purposes of implementation of the Healthy Families
Program.
This bill, by liberalizing an eligibility criterion for
participation within this program and thereby covering a new pool of
participants, would make the moneys in this continuously appropriated
fund available for a new or expanded purpose, and would thereby
result in an appropriation.
(2) Existing law provides for the Medi-Cal program, through which
health care benefits are provided to eligible individuals. Existing
law requires reaffirmation of eligibility for Medi-Cal benefits for
persons, whose eligibility is not determined on the basis of
eligibility for CalWORKs program benefit recipients and supplemental
security income benefit recipients, on an annual basis or at other
times as required by the State Department of Health Services.
This bill would revise Medi-Cal income eligibility standards for
otherwise eligible individuals to include any child under 19 years of
age whose family income does not exceed 133% of the federal poverty
level. This bill would revise the reaffirmation of eligibility
requirement to limit reaffirmations of eligibility for Medi-Cal
benefits on any basis other than annually to apply only to persons
who are 19 years of age or older.
Existing law requires local governments to determine Medi-Cal
eligibility. This bill by changing the eligibility standards may
increase the number of persons for whom there would have to be an
eligibility determination, thus creating a state-mandated local
program.
(3) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement, including the creation of a State Mandates Claims Fund
to pay the costs of mandates that do not exceed $1,000,000 statewide
and other procedures for claims whose statewide costs exceed
$1,000,000.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs so mandated by the state,
reimbursement for those costs shall be made pursuant to the statutory
provisions noted above.
Vote: 2/3. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 12693.70 of the Insurance Code is amended to
read:
12693.70. To be eligible to participate in the program, an
applicant shall meet all of the following requirements:
(a) Be an applicant applying on behalf of an eligible child, which
means a child who is all of the following:
(1) Greater than 12 months of age and less than 19 years of age.
An application may be made on behalf of a child less than 12 months
of age for coverage to begin as early as the child's first birthday.
(2) Not eligible for no-cost full-scope Medi-Cal or Medicare at
the time of application.
(3) In compliance with Sections 12693.71 and 12693.72.
(4) A child who meets citizenship and immigration status
requirements that are applicable to persons participating in the
program established by Title XXI of the Social Security Act.
(5) A resident of the State of California pursuant to Section 244
of the Government Code.
(6) In a family with a gross annual household income equal to or
less than 200 250 percent of the federal
poverty level.
(b) If the applicant is applying for the purchasing pool, the
applicant shall pay the first month's family contribution and agree
to remain in the program for six months, unless other coverage is
obtained and proof of the coverage is provided to the program.
(c) An applicant shall enroll all of the applicant's eligible
children in the program.
SEC. 2. Section 12693.705 is added to the Insurance Code, to read:
12693.705. A child who is otherwise eligible for participation
shall not be denied eligibility based on his or her date of entry
into the United States.
This section does not constitute a change in, but is declaratory
of, existing law.
SEC. 3. Section 14012 of the Welfare and Institutions Code is
amended to read:
14012. Reaffirmation shall be filed annually and
. With respect to the determination of eligibility
for any person 19 years of age or older, reaffirmation may be
required at other times in accordance with general standards
established by the department.
SEC. 4. Section 14005.235 is added to the Welfare and Institutions
Code, to read:
14005.235. To the extent federal participation is available, any
child under 19 years of age who meets all the other applicable
eligibility requirements shall be eligible for benefits under this
chapter if his or her family income does not exceed 133 percent of
the federal poverty level.
SEC. 5. Notwithstanding Section 17610 of the Government Code, if
the Commission on State Mandates determines that this act contains
costs mandated by the state, reimbursement to local agencies and
school districts for those costs shall be made pursuant to Part 7
(commencing with Section 17500) of Division 4 of Title 2 of the
Government Code. If the statewide cost of the claim for
reimbursement does not exceed one million dollars ($1,000,000),
reimbursement shall be made from the State Mandates Claims Fund.
Notwithstanding Section 17580 of the Government Code, unless
otherwise specified, the provisions of this act shall become
operative on the same date that the act takes effect pursuant to the
California Constitution.