BILL ANALYSIS
AB 43
Page 1
ASSEMBLY THIRD READING
AB 43 (Villaraigosa)
As Amended May 28, 1999
Majority vote
HEALTH 9-3 APPROPRIATIONS 14-7
-----------------------------------------------------------------
|Ayes:|Gallegos, Corbett, |Ayes:|Migden, Cedillo, Davis, |
| |Firebaugh, Kuehl, | |Hertzberg, Kuehl, Papan, |
| |Steinberg, Thomson, | |Romero, Shelley, |
| |Vincent, Wayne, Wildman | |Steinberg, Thomson, |
| | | |Wesson, Wiggins, Wright, |
| | | |Aroner |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Granlund, Aanestad, |Nays:|Brewer, Ashburn, Battin, |
| |Strickland | |Pescetti, Maldonado, |
| | | |Runner, Zettel |
| | | | |
-----------------------------------------------------------------
SUMMARY : Revises the Healthy Families Program eligibility
requirements to allow children, their parents, and pregnant
women in families with income no more than 300% of the federal
poverty level (FPL) to enroll in the program, prevents
eligibility from being denied based on date of entry into the
United States, and establishes 12 months continuous eligibility
for children and six months continuous eligibility for adults in
managed care plans. Specifically, this bill :
1)Revises Healthy Families Program eligibility to be based on
the minimum requirements and maximum flexibility permitted
under the federal Medicaid and State Children's Health
Insurance Programs (SCHIP), as specified.
2)Prohibits, to the extent consistent with federal law,
eligibility from being denied, terminated, restricted or
limited based on any of family assets and resources, hours of
work, failure to apply in person, lack of documentation
proving income or residency, date of entry into the United
States, or more than an annual redetermination process.
3)Prohibits a person who is otherwise eligible for participation
from being denied eligibility based on his or her date of
entry into the United States (US), and states that a person
who is lawfully present
in the US who is otherwise eligible for participation is
AB 43
Page 2
eligible for this program.
4)Eliminates a requirement that subscribers continue to be
eligible for the program for a period of 12 months from the
month eligibility is established, and instead makes any
individual 19 or under who is determined to be eligible for
this program to remain eligible for those benefits for a
period no less than 12 months.
5)Makes any individual older than 19 years of age who is
determined to be eligible for this program, and is enrolled in
a managed care plan, eligible for those benefits for a period
of not less than six months.
6)Makes this bill inoperative in any fiscal year in which funds
have not been specifically designated in the Budget Act.
EXISTING LAW :
1)Provides for the Medi-Cal program, administered by DHS, to
provide comprehensive health care benefits to qualified
low-income, aged, blind and disabled individuals, and
authorizes contracts with public and private health plans for
the provision of services to Medi-Cal beneficiaries. Provides
for a variety of eligibility categories in Medi-Cal for
determining eligibility for children, pregnant women and
infants, and low-income families.
2)Establishes the Healthy Families Program, administered by
MRMIB, to provide low-cost, subsidized health, vision, and
dental insurance to uninsured children who are not eligible
for Medi-Cal.
3)Establishes the AIM program, administered by MRMIB, to provide
comprehensive subsidized, low cost, health insurance to women
throughout their pregnancy and for 60 days after their
pregnancy and coverage to infants for their first two years.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, 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% 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
AB 43
Page 3
state-offered benefit).
COMMENTS : This bill is one of a package of three bills that is
intended to create a comprehensive health care program with an
easy application and eligibility process to cover children and
their parents in families who earn no more than 300% of the
federal poverty level. 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. There are
seven milllion uninsured non-elderly in California including
over 1.8 million uninsured children. Recent efforts to expand
health care coverage for children through the newly established
Healthy Families Program and expanded Medi-Cal for children have
revealed that California's patchwork health care system for
low-income families is complex, confusing, uncoordinated, and in
many cases degrading and demeaning. In fact, according to a
recent UCLA report, over 1.1 million uninsured children are
currently eligible for Medi-Cal or Healthy Families. Newly
authorized federal eligibility programs intended to continue
health care coverage to families moving off welfare have been
confusing and difficult to implement, and families participating
in the workforce in low-paying jobs have limited access to
health insurance.
AB 93 (Cedillo) and AB 1015 (Gallegos) are the other two bills
that comprise this package. While this bill establishes the
eligibility requirements, AB 93 provides for the application
process, premium and copayment structure, and program benefits,
and AB 1015 focuses on outreach and maximizing federal funding.
In total, over 35 bills have been introduced in the Assembly and
Senate either expanding or simplifying eligibility, streamlining
administration, or consolidating existing health care programs.
This bill is supported by a number of organizations representing
health care providers and health care consumers including the
California Association of Public Hospitals and Health Systems
(CAPH), Los Angeles County and the Urban Counties Caucus (UCC).
UCC believes this bill will result in a healthier California by
enhancing the local safety net and simplifying and relaxing
Healthy Families and Medi-Cal eligibility rules.
Please see the policy committee analysis for a more
comprehensive discussion on this bill.
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097
AB 43
Page 4
FN: 0001463