BILL ANALYSIS
AB 1863
Page 1
ASSEMBLY THIRD READING
AB 1863 (Gallegos)
As Amended May 30, 2000
Majority vote
HEALTH 9-3 APPROPRIATIONS 15-6
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|Ayes:|Gallegos, Corbett, |Ayes:|Migden, Alquist, Aroner, |
| |Firebaugh, Kuehl, Keeley, | |Cedillo, Corbett, Davis, |
| |Vincent, Wayne, Wesson, | |Kuehl, Maldonado, Papan, |
| |Wildman | |Romero, Shelley, Thomson, |
| | | |Wesson, Wiggins, |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Bates, Aanestad, Runner |Nays:|Campbell, Ackerman, |
| | | |Ashburn, Brewer, Runner, |
| | | |Zettel |
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SUMMARY : Expands eligibility in the Medi-Cal program without a
share of cost requirement for aged, blind and disabled people
and reduces the Medi-Cal share of cost requirements for
medically needy people and families with too much income to
qualify for no share of cost Medi-Cal. Specifically, this
bill :
1)Increases, beginning January 1, 2001, the income levels for
maintenance in effect August 22, 1996, by a percentage equal
to the intervening consumer price index increases but not more
than 10%, and by a percentage equal to the Consumer Price
Index on January 1 of each subsequent year for the next two
subsequent years, subject to federal financial participation.
Requires that the state is under no obligation to implement
with state funds. Authorizes the Attorney General to file
administrative and judicial proceedings to obtain federal
approval.
2)Requires, to the extent federal financial participation is
available, the Department of Health Services (DHS) to exercise
its federal option to implement a program for aged, blind and
disabled persons, as described, commencing April 1, 2001, with
the following financial eligibility conditions:
c) Countable income that does not exceed 133% of the
applicable federal poverty level; and,
AB 1863
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d) Countable resources that do not exceed the maximum
levels, as defined.
5)Implements #2 above, only to the extent funds are appropriated
in the annual Budget Act, and requires DHS to seek approvals
for federal financial participation.
EXISTING LAW :
1)Establishes the Medi-Cal program, administered by DHS, to
provide health services to qualified low-income, aged, blind
and disabled individuals.
2)Provides for the "medically needy" program, under which
low-income persons or families who are not categorically
eligible for Medi-Cal can obtain Medi-Cal benefits by paying a
share of cost.
3)Establishes "maintenance need income levels" for the purposes
of calculating an individual or family's share of cost.
FISCAL EFFECT : According to the Assembly Appropriation
Committee analysis:
1)$21.3 million General Fund (GF) in fiscal year (FY) 2000-2001
(half year) for all increases.
2)$65.3 million GF in FY 2001-2002 and thereafter for all
increases.
COMMENTS : The author indicates that this bill is necessary to
provide relief for low-income elderly and disabled individuals
and families who must pay expensive Medi-Cal deductibles before
Medi-Cal will cover health care expenses. For many, this
financial burden discourages early diagnosis and treatment, and
compliance with prescription medications and treatment
therapies, which can result in more expensive or catastrophic
outcomes. Under the current system an individual is expected to
support him/herself on $600 a month plus deductions. Any income
received over that amount is obligated as "share of cost" in any
month services are needed. According to the author, this $600
amount has not been adjusted since 1989, not even for inflation.
The author asserts that complaints about "share of cost" are
among the biggest criticisms of the Medi-Cal program even though
only about 6% of the 5 million people qualified for Medi-Cal are
AB 1863
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certified as "share of cost" eligibles. The author also points
out that seniors on Medicare who are also eligible for Medi-Cal
with a share of cost have access to prescription drug coverage
through Medi-Cal, but for expensive share of cost barriers.
The Governor's 2000-2001 Budget proposes to expand Medi-Cal
coverage for the elderly, blind and disabled in a manner that
would eliminate share of cost for 13,000 individuals who have
income up to the poverty level (monthly income of $696). This
bill would enhance the Governor's proposal by including couples
and expanding eligibility to individuals with monthly income of
about $914 and couples with monthly income of about $1,226
(based on 1999 federal poverty levels). Both the Assembly and
Senate budget proposals have approved funding for this proposal.
This bill also reduces the share of cost for those who would
not qualify for free Medi-Cal under the enhanced program by
raising the maintenance need income level to $660 for
individuals and $1027 for couples and adjusting this amount
annually for two years in an amount equal to the consumer price
index.
AB 2125 (Gallegos) of 1998 and AB 497 (Gallegos) of 1999 were
introduced to reduce share of cost requirements for the
medically needy. AB 2125 was stalled in the Senate
Appropriations Committee and AB 497 was amended in the Assembly
Appropriations Committee. AB 2500 (Ashburn), also pending in
the Assembly Health Committee, would establish an income
deduction in the Medi-Cal medically needy program of 150% of the
United States Department of Health and Human Services poverty
guidelines.
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097
FN: 0005187