CA health care budget bill expected to pass legislature

SACRAMENTO — AB 94, the omnibus health trailer bill, awaits a vote on the Senate floor. The health care budget bill provides for a number of different health care policy and funding changes, including:

  • Providing Medi-Cal coverage for undocumented children
  • Extending Covered California’s rule-making authority while expanding board meeting transparency
  • Allocating $50 million for the implementation of the Health Home Program
  • Hepatitis C demonstration project
  • Coverage requirements for genetic tests
  • Increased licensure fees for skilled nursing facilities

The bill is on the Senate’s third reading calendar, meaning it could be voted on at any time. The bill analysis provides an overview of the over two-dozen changes proposed by AB 94. Below are explanations for a few key reforms.

Medi-Cal for undocumented children: AB 94 would extend full Medi-Cal benefits to those under age 19 who do not have “satisfactory immigration status.” The bill instructs the Department of Health Care Services (DHCS) to seek out potential federal waivers or grants what would allow for federal funds to be used for this expansion. It authorizes state-only funding only in the event that federal funds cannot be obtained.

Covered California: The state’s exchange is authorized to implement emergency regulations until January 1, 2017. Any emergency regulations established until then may be readopted until January 1, 2020. In addition, AB 94 would require Covered California’s Board of Directors to discuss any new product standardized by the board during at least one public meeting prior to the meeting in which the standardized product is adopted. The board would also be required to adopt a Health Benefit Exchange Contracting Manual that incorporates the Exchange’s procurement and contracting policies and procedures.

Health Home Program: AB 94 authorizes a $50 million appropriation for the implementation of the Health Home Program. The bill would also authorize DHCS to seek private grant funds or other non-general fund dollars for the account. The Health Home Program provides additional supports for Medi-Cal enrollees with chronic conditions.

Hepatitis C: A Hepatitis C linkage to care demonstration project would be established, authorizing funding for select counties and community organizations to provide outreach, screenings and linkage to health care for underserved individuals living with or at risk of contracting Hepatitis C.

Coverage of genetic testing services: The bill would prohibit health care service plans and health insurers from implementing any form of cost sharing for Alpha Feto Protein (AFP) genetic testing. This would include copays, coinsurance, and deductibles. 

Licensure fees for skilled nursing facilities: Licensing fees paid by skilled nursing facilities would be increased in order to fund increased investigative authority provided to the Long Term Care Ombudsman Program within the California Department of Aging.

AB 94 passed the Assembly in March on a 51 to 27 vote. Once passed, amendments made by the Senate will have to be confirmed by the Assembly before heading to the Governor’s desk for signature.