Governor Signs SB4, Capping Year of Progress Toward #Health4All

Today Governor Brown signed a bill, SB4(Lara), to make it easier for all income-eligible children to get enrolled in Medi-Cal, following up on the state budget’s expansion of Medi-Cal coverage to children regardless of immigration status.

SB4 (Lara) takes a modest but critical step to implement the decision in the 2015-16 state budget to expand Medi-Cal to all income-eligible children regardless of immigration status. That expansion, adopted in June but slated to start as early as May 2016, is projected to eventually cover as many as 170,000 undocumented children who are up to 266% of the federal poverty level, around $50,000 for a family of three.

BUILDING ON BUDGET VICTORY: Specifically, SB 4 includes important reforms to ensure successful implementation of the “#Health4All Kids” effort and the seamless enrollment of eligible children:

·       It clarifies that kids currently enrolled in Restricted Scope/Emergency Medi-Cal will not be required to submit a new application when they transition to full-scope coverage, no sooner than May of 2016;

·       It ensures that kids currently enrolled in restricted scope emergency Medi-Cal will be transferred to full scope services immediately, as soon the program is operational;

·       It ensures that kids with serious medical conditions who require specialty care will be properly evaluated and referred to the appropriate Medi-Cal managed care plan in their area when they enroll.

We thank the Governor for taking the historic step in June to ensure all California children have access to coverage, and this additional step to ensure they actually get enrolled. These actions to expand coverage will not just help specific California families, but also help improve the health system on which we all rely. Californians increasingly recognize it is more efficient and effective to offer primary, preventive and specialty care on the front end rather than just expensive emergency and episodic care when it may be too late. We are pleased with the progress made this year and are excited by the momentum to take additional steps next year toward a fully inclusive, more efficient and effective health system.

Authored by Senator Ricardo Lara, SB4 got bipartisan votes in both the California Senate and Assembly, with unanimous Democratic support but also key Republican votes as well, from Senators Cannella and Vidak and Assemblyman Chavez.

ONE OF MANY STEPS to #HEALTH4ALL THIS YEAR: The signing of SB4 is an important step politically and policy-wise in the statewide #Health4All effort that has racked up several victories this year, at the state and county levels, and provides the momentum to do more. Beyond the expansion to all children in Medi-Cal, the state budget also reaffirmed the inclusion of income-eligible California adults with “deferred action” immigration status, such as those who would benefit under President Obama’s administrative relief.

COUNTY ACTIONS: We are pleased that both the state and many counties recognize the benefit in extending health services to the entire community, including immigrants. At the beginning of this year, less than ten counties served the undocumented outside of the emergency room; by next year, nearly 50 counties will be doing something, however limited. We hope these county efforts can be bridges to a statewide solution of covering all Californians.

Earlier this year, Sacramento, Contra Costa, and Monterey counties, along with the County Medical Services Program serving 35 small and rural counties, all started new pilot programs to provide limited health benefits to the remaining uninsured regardless of immigration status.

MOMENTUM FOR NEXT YEAR: Our health system and our economy is stronger when everyone is included. While California has implemented and improved upon the Affordable Care Act to make historic reductions in the uninsured rate, we still need to take additional steps to get everyone insured. Earlier this year Health Access released a report earlier in the year detailing the safety-net programs of each of California’s 58 counties, while also advocating for statewide solutions. Statewide, health, immigrant, and community advocates are focusing next year the advancement and passage of SB10(Lara), pending legislation to cover all income-eligible adults in Medi-Cal, and to seek a federal waiver to allow all to buy insurance in Covered California.