BILL ANALYSIS                                                                                                                                                                                                    



                                                          SB 92
                                                          Page  1

Date of Hearing:  July 13, 1999

                  ASSEMBLY COMMITTEE ON HEALTH 
                     Martin Gallegos, Chair
           SB 92 (Hayden) - As Amended:  May 28, 1999

  SENATE VOTE  :  25-13
  
SUBJECT  :  Healthy Families Program.

  SUMMARY  :  Ensures Healthy Families eligibility for otherwise  
qualified children who legally immigrate to the United States  
(U.S.) after August 22, 1996, and expands the program's  
definition of resident to include children whose parents moved  
to the state for a job commitment or to seek employment.   
Specifically,  this bill  :  

1)Revises the definition of resident to include an applicant who  
  is physically present and living in California and entered the  
  state with a job commitment or to seek employment, whether or  
  not he or she is currently employed.  (Existing law defines an  
  applicant as a specified person applying on behalf of a child  
  or a person over 18 who is applying on his or her own behalf.)

2)Prevents a child from being denied eligibility based on his or  
  her date of entry into the U.S.

3)Makes the above provisions contingent upon funding in the  
  Budget Act.

  EXISTING LAW  : 

1)Establishes the Healthy Families Program, administered by the  
  Managed Risk Medical Insurance Board (MRMIB), to provide  
  comprehensive subsidized health, vision, and dental insurance  
  to qualified children in low-income families.

2)Restricts, pursuant to federal law, certain federal  
  means-tested public benefits for certain qualified aliens who  
  enter the U.S. after August 22, 1996, for their first five  
  years.

  FISCAL EFFECT  :  According to the Senate Appropriations Committee  
analysis, the General Fund cost to include new immigrant  
children would be $4.9 million in fiscal year 1999-2000 and $15  








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million in 2000-01, and the cost associated with revising the  
residency definition is unknown.  Federal funding for recent  
immigrants is not now permitted although President Clinton's  
budget proposes to allow it.

  COMMENTS  :   

  1)PURPOSE OF THIS BILL  .  The author believes it is unfair to  
  deny health care to a child who would otherwise qualify for  
  Healthy Families, based on an arbitrary date of entry into the  
  U.S.  The author states that providing access to children of  
  recent immigrants to preventive and primary care is sound  
  health policy and is far more cost-efficient than treating  
  children in emergency rooms.  The program also protects the  
  health of all Californians by screening for communicable  
  diseases, and it helps children remain healthy in their  
  crucial years of development.  The author points out that  
  California has already recognized the wisdom of such a policy  
  by allowing new immigrant children to receive Medi-Cal  
  coverage if they meet certain income and age requirements.   
  Excluding kids from Healthy Families based on when they  
  entered the country has the perverse effect of leaving many  
  families with one child covered and another left out.

Additionally, the author describes the current residency  
  definition as "antiquated" and believes that it fails to  
  address the unique circumstances of children of migrant  
  workers.  The author cites a federal study indicating that  
  migrant farmworkers and their families are among the most  
  medically underserved groups in the U.S.  The author maintains  
  that California should not deny farmworkers the opportunity to  
  purchase Healthy Families coverage for their children when  
  they are in the state.  The proposed change would align the  
  residency definition in Healthy Families with that of Medi-Cal  
  and ensure that migrant workers can apply on behalf of their  
  children.

  2)SUPPORT  .  This bill is supported by many health care provider  
  organizations and consumer and immigrant health advocates.   
  The California Nurses Association believes that it is in the  
  best interest of public health that all efforts to advertise  
  and enroll all children be made and that there should be no  
  restrictions on children who reside in our state to  
  participate in the program.  The Coalition for Humane  
  Immigrant Rights of Los Angeles believes this bill would  








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  ensure and promote basic health care for the most vulnerable  
  population, children.  The National Health Law Program, Inc.,  
  indicates this bill contains very important improvements to  
  extend access to thousands of currently uninsured children.

  3)BACKGROUND  .  The Healthy Families Program is a low-cost  
  subsidized health insurance program for uninsured children who  
  do not meet the eligibility requirements for free health care  
  through the Medi-Cal program.  Monthly premium payments range  
  from $4 to $27.  Dental and vision services are also included.  
   A 1998 report issued jointly by UC Berkeley and UCLA  
  indicates that by 2001, California will have 40,000 uninsured  
  legal immigrant children who came to the U.S. after the  
  welfare reform cut-off date (August 22, 1996).  
  
  4)BUDGET ACTION .  The 1999-2000 proposed budget provides state  
  funding for one year to cover the full expense of including  
  legal immigrant children arriving after August 22, 1996.   
  After a child's 12-month eligibility period expires,  
  eligibility will be contingent upon receipt of federal  
  matching funds for this purpose.  In addition, the health  
  budget trailer bill contains a revision of the residency  
  definition similar to the relevant provision in this bill.

  5)SUGGESTED AMENDMENT  .  The author may wish to amend this bill  
  to conform it to the health budget trailer bill to avoid  
  chaptering out problems.  
  
  6)PRIOR LEGISLATION  .  SB 1398 (Hayden) contained provisions  
  similar to this bill and was held last year in the Assembly  
  Appropriations Committee.

  REGISTERED SUPPORT / OPPOSITION  :

  Support  

100% Campaign
American Federation of State, County and Municipal Employees
Asian and Pacific Islander American Health Forum
Children's Advocacy Institute
Children's Network Council of Solano County
California Association of Catholic Hospitals
California Immigrant Welfare Collaborative
   Asian Pacific American Legal Center of Southern California 
   Coalition for Humane Immigrant Rights of Los Angeles








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   National Immigration Law Center
   Northern California Coalition for Immigrant Rights
California Nurses Association
Center for Public Interest Law
Coalition for Humane Immigrant Rights of Los Angeles
County of Santa Barbara KIDS Network
Friends Committee on Legislation of California
Health Access California
Interfaith Coalition for Immigrant Rights
Jericho:  A Voice for Justice
Mexican American Legal Defense and Education Fund
National Health Law Program, Inc.
Private Essential Access Community Hospitals, Inc.
Solano County Board of Supervisors
Western Center on Law and Poverty

  Opposition  

None on file

  Analysis Prepared by  :  Teri Boughton / HEALTH / (916) 319-2097