AB 1839, as introduced, Patterson. California Health Benefit Exchange: enrollment options.
Existing law establishes the California Health Benefit Exchange (Exchange) within state government, specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans through the Exchange by qualified individuals and small employers.
Existing law requires the board, among other things, to determine the criteria and process for eligibility, enrollment, and disenrollment of enrollees and potential enrollees in the Exchange and coordinate that process with state and local government entities administering other specified health care coverage programs, as specified. The board membership is required to possess acknowledged expertise in information technology system management, among other areas, and to hire a chief technology and information officer.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, the department exercises a specified federal option to extend continuous Medi-Cal eligibility to children 19 years of age and younger.
This bill would require the Exchange’s enrollment system to be upgraded so an enrollee whose family income qualifies him or her for subsidized coverage, but only qualifies children in the household 19 years of age or younger for Medi-Cal, would be presented with the option of either enrolling in a plan with subsidized coverage for himself or herself and enrolling the eligible child or children in Medi-Cal, or enrolling in a single plan for the family that preserves the enrollee’s subsidized coverage and purchasing unsubsidized coverage under the same plan for the child or children under 19 years of age. The bill would require the upgraded enrollment system to be operational no later than July 1, 2017, and would require the chief information and technology officer or his or her designee to oversee the upgrading process.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 100522 is added to the Government Code,
(a) (1) The enrollment system shall be upgraded so
4an enrollee whose family income qualifies him or her for subsidized
5coverage, but only qualifies children in the household under 19
6years of age for Medi-Cal, shall be presented with the choice to
7elect either of the following enrollment options:
8(A) To enroll in a plan with subsidized coverage for himself or
9herself and enroll the eligible child or children in Medi-Cal.
10(B) To enroll in a single plan for the family that preserves the
11enrollee’s subsidized coverage and purchase unsubsidized coverage
12under the same plan for the child or children under 19 years of
14(2) The upgrades to the enrollment system shall be operational
15no later than July 1, 2017.
16(b) The process of upgrading the enrollment system shall be
17overseen by the chief information and technology officer or his or