BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 43
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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  






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  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  






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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 






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