BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 43
                                                          Page  1

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. 








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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