The Assembly and Senate Health Committees passed AB X 1 1 (Perez) and SB X 1 1 (Hernandez), the Medi-Cal expansion bills, this week. This is a major step forward although there are still some details that will need to be worked out as part of the ongoing budget and bill negotiations.
An estimated 1.4 million uninsured Californians will be eligible for coverage. Projections by UC Berkeley Labor Center and UCLA Center for Health Policy Research are that between 750,000 and 910,000 will enroll depending on the effectiveness of outreach and enrollment simplification.
Some of the major features are:
- Coverage of the MIAs (individuals without dependent children living at home) and parents with incomes up to 133% of federal poverty level ($15,292 for an individual, $31,322 for a family of four),
- Federal approval will be sought for full scope Medi-Cal coverage rather than the Essential Health Benefits delineated under the Affordable Care Act – the major difference involves coverage of long term care, which is available in traditional Medi-Cal (Medicaid)
- Coverage for children in foster care at age 18 extended up to age 26,
- Premium assistance to cover new legal immigrant MIAs through Covered California, rather than Medi-Cal,
- Expanded full scope coverage under the Medi-Cal pregnancy only program,
- Conversion to MAGI (Modified Adjusted Gross Income pursuant to the federal tax code) eligibility rules and the 5% income disregard for all families and individuals (other than the disabled and elderly),
- Simplification of eligibility categories and of eligibility processing by moving to the CalHEERS system of computerized verifications of eligibility processing, and
- Conformity to the new federal rules on streamlined applications, eligibility and redeterminations.
Lucien Wulsin, ITUP, June 13, 2013