California Progress Report, February 20, 2013
Yesterday, the state Assembly Health Committee held its first hearing of the Special Session on health reform. Tuesday's hearing focused only on the proposed legislation related to Medi-Cal expansion.
The Committee heard a presentation from Ken Jacobs of the UC Berkeley Labor Center on the impact that Medi-Cal expansion will have on the state. Jacobs presented data about the up to 1.4 million Californians who are likely to enroll in Medi-Cal by 2019. Some of these individuals will be newly eligible for the program due to expansions from the Affordable Care Act, while others are already eligible for the program but are not currently enrolled.
The majority of those likely to sign up are in the former category, and will be 100% federally funded for the first two years of the expansion. UC Berkeley's data suggests that the Medi-Cal expansion will benefit the state by stimulating the economy (along with other components of the ACA, it will bring 100,000 new jobs to California) and improving health outcomes.
Speaker Perez presented the legislation he authored, ABX1 1, calling it a crucial component of the implementation of health reform that will bring billions of federal dollars in to California. ABX1 1 expands Medi-Cal eligibility to 1.4 million Californians, including former foster youth up to age 26, and streamline eligibility and enrollment processes.
Advocates pointed out that it is crucial for the new Medi-Cal program to adopt modern rules to match the modern systems that will allow for real-time electronic determinations of eligibility, so that purchasing health insurance, even if that means signing up for Medi-Cal, can be as easy as purchasing a book online. Part of the promise of the Affordable Care Act was to create a consumer-friendly no-wrong-door approach to buying health insurance, and the state is already engaged in creating an electronic eligibility, enrollment and retention system.
Dozens of advocates provided testimony in strong support of the bill, and though some asked for amendments to the bill, no one stood in opposition. Representatives of the California Pan-Ethnic Health Network and the California Immigrant Policy Center asked that the Speaker consider including legal permanent residents to the expansion, rather than asking them to purchase insurance on the state's health benefit exchange, which will likely be cost-prohibitive.
Republican Committee members resurrected concerns that the Affordable Care Act may be rolled back and suggested limiting this program in anticipation of that unlikely outcome. Speaker Perez asserted that the Legislature should and would respond if Congress changed the funding formula, but was unwilling to adopt a defeatist attitude that might limit the state's ability to fully implement reform as currently written in federal law.
AB X1 1 passed out of committee on a 13-6 party-line vote.