BILL ANALYSIS
AB 43
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Date of Hearing: May 12, 1999
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Carole Migden, Chairwoman
AB 43 (Villaraigosa) - As Amended: April 15, 1999
Policy Committee: HealthVote:9 - 3
Urgency: No State Mandated Local
Program:YesReimbursable: Yes
SUMMARY
This bill expands eligibility for the Healthy Families program,
which provides health insurance coverage to children in
low-income families. Among its provisions, the bill:
1)Expands eligibility to cover children in families with incomes
less than 300 percent of the federal poverty level (or $49,000
for a family of four). The income limit in current law is 200
percent of the poverty level.
2)Makes the parents in families with incomes less than 300
percent of poverty eligible for the program.
3)Provides one year of guaranteed eligibility for children
enrolled in the program and six months for parents.
4)Moves certain low-income children, pregnant women, and infant
eligibility groups from the Medi-Cal program to the Healthy
Families program, and subsumes the AIM (Access for Infants and
Mothers) program within the Healthy Families program.
5)Eliminates provisions in current law that limit the amount of
savings or other assets a family may have to qualify for the
Healthy Families program.
6)Prohibits requiring documentation of income, residency, or
date of entry into the United States to the extent permissible
under federal law.
7)Requires the Healthy Families program to develop a simplified
application and authorizes program application by mail.
AB 43
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8)Requires eligibility to be presumed for up to 45 days while an
application is being processed.
9)Makes any child enrolled in the following federal programs
also eligible for Healthy Families, to the extent permitted by
federal law:
Food Stamps.
Special Supplemental Food Program for Women, Infants,
and Children (WIC).
Head Start Program.
School Lunch Program.
FISCAL EFFECT
The bill is intended to be considered as part of a "package,"
also including AB 93 (Cedillo) and AB 1015 (Gallegos), which
make additional changes to the Healthy Families and Medi-Cal
programs.
In March of this year, the Legislative Analyst's Office
estimated a package with similar elements would result in annual
state costs of $250 million to $500 million, depending on the
proportion of individuals eligible for the program that choose
to enroll. Costs could exceed this range if the assumed 50
percent federal funding is not forthcoming, or if businesses
that currently offer coverage to individuals in these income
groups elect not to provide it (due to the availability of the
state-offered benefit).
COMMENTS
1)Purpose of the Bill . According to the author, this bill is
part of a package intended to create a comprehensive health
care program with an easy application and eligibility process
to cover children and their parents in families that earn up
to 300 percent of the federal poverty level. The author
believes the proposed program would effectively reduce the
number of low-income uninsured Californians by integrating and
expanding eligibility for Medi-Cal for children and families,
AIM, and the Healthy Families Program. The author argues
recent efforts to expand health care coverage for children
have revealed that California's patchwork health care system
for low-income families is complex, uncoordinated, and in many
cases degrading. The author notes a recent UCLA report, which
indicates over 1.1 million children are currently eligible for
Medi-Cal or Healthy Families but are not enrolled.
AB 43
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2)The Uninsured in California . Extensive research has
documented increasing numbers of uninsured in California, in
part due to the concentration of certain industries that tend
not to provide job-based health insurance. The UCLA Center
for Health Policy Research reports that in 1997, over 7
million Californians were uninsured - nearly one quarter of
the state's non-elderly population. (The federal Medicare
program covers all elderly adults.) The author also notes the
following statistics:
The proportion of uninsured Californians is one-third
higher than the average for the rest of the United States,
largely because fewer Californians have job-based health
insurance.
Eight of ten uninsured Californians are in families
headed by a working adult, including nearly half who are in
families headed by at least one full-time worker.
Nearly three-quarters of the uninsured have incomes
below 200 percent of the federal poverty level ($33,000 for
a family of four in 1998).
1)Healthy Families and Medi-Cal Expansion Legislation . In
addition to this measure, AB 93 (Cedillo), AB 100 (Thomson),
and AB 1015 (Gallegos), all on calendar before the committee
today, would expand the Medi-Cal and Healthy Families
programs. Among other provisions, these bills make additional
children eligible for the programs, cover the parents of
enrolled children, allow mail-in application and require less
documentation to demonstrate eligibility, reduce or eliminate
existing co-payments and premiums, and guarantee one year of
continuous eligibility for enrollees.
Analysis Prepared by : William Wehrle / APPR. / (916) 319-2081