20250AB__101299INT INTRODUCED 2025-02-20 2025 AB INT Introduced by Assembly Member Essayli LEAD_AUTHOR ASSEMBLY Essayli

An act to amend

Section 14007.2 of, to add

Article 6 (commencing with

Section 15210) to

Chapter of Part of Division of, and to repeal

Section 14007.8 of, the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor. Medi-Cal, and making an appropriation therefor Medi-Cal: immigration status. Existing federal law provides for the Medicare Program, which is a public health insurance program for persons years of age and older and specified persons with disabilities who are under years of age. Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services.

The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. The federal Medicaid program prohibits payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law. Existing state law extends Medi-Cal eligibility for the full scope of Medi-Cal benefits to an individual who does not have satisfactory immigrant status if they are otherwise eligible for those benefits, as specified.

This bill would create the Serving Our Seniors Fund, would make an individual who does not have satisfactory immigrant status ineligible for Medi-Cal benefits, and would transfer funds previously appropriated for the provision of Medi-Cal benefits to those individuals to that fund. The bill would appropriate the moneys in that fund to the State Department of Health Care Services to restore and maintain payments for Medicare Part B premiums for eligible individuals. By making the moneys available without regard to fiscal years, the bill would create a continuous appropriation.

TWO_THIRDS YES YES NO NO NO NO NO NO NO NO The people of the State of California do enact as follows:

SECTION

Section 14007.2 of the Welfare and Institutions Code is amended to read: 14007.2. (

a) Any individual who is otherwise eligible for Medi-Cal services, but who does not meet the documentation requirements described in subdivision (

e) of

Section 14011.2, shall be eligible only for the scope of services made available to persons who are not citizens or nationals of the United States under subdivision (

d) of

Section 14007.5 and Sections 14007.65 and 14007.7. (

b) To the extent that federal financial participation is available to fund services described under subdivision (a), the department shall file all necessary state plan amendments or waivers to obtain that funding.

SEC.

Section 14007.8 of the Welfare and Institutions Code is repealed. <caml:Num>14007.8.</caml:Num><caml:LawSectionVersion id="id_6C9336D8-13A2-4C6C-AD7A-B58733CBDB71"><caml:Content><xhtml:p>(a)<xhtml:span class="EnSpace"/>(1)<xhtml:span class="EnSpace"/>An individual who is years of age or younger, and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status as required by

Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, if they are otherwise eligible for benefits under this chapter.</xhtml:p><xhtml:p>(2)<xhtml:span class="EnSpace"/>(A)<xhtml:span class="EnSpace"/>After the director determines, and communicates that determination in writing to the Department of Finance, that systems have been programmed for implementation of this subparagraph, but no sooner than May 1, 2022, an individual who is years of age or older, and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status as required by

Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, if they are otherwise eligible for benefits under this chapter.</xhtml:p><xhtml:p>(B)<xhtml:span class="EnSpace"/>After the director determines, and communicates that determination in writing to the Department of Finance, that systems have been programmed for implementation of this subparagraph, but no later than January 1, 2024, an individual who is to years of age, inclusive, and who does not have satisfactory immigration status as required by

Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, if they are otherwise eligible for benefits under this chapter.</xhtml:p><xhtml:p>(C)<xhtml:span class="EnSpace"/>The effective date of enrollment into the Medi-Cal program for an individual described in this paragraph, and enrolled in the Medi-Cal program pursuant to subdivision (

d) of

Section 14007.5, shall be on the same day on which the systems are operational to begin processing new applications pursuant to the director’s determination described in either subparagraph (

A) or (B), as applicable.</xhtml:p><xhtml:p>(3)<xhtml:span class="EnSpace"/>(A)<xhtml:span class="EnSpace"/>An individual enrolled in the Medi-Cal program pursuant to this

section and subdivision (

d) of

Section 14007.5 shall not be required to file a new application for the Medi-Cal program.</xhtml:p><xhtml:p>(B)<xhtml:span class="EnSpace"/>The enrollment specified in subparagraph (

A) shall be conducted pursuant to an eligibility and enrollment plan, and shall include outreach strategies developed by the department in consultation with interested stakeholders, including, but not limited to, counties, health care service plans, health care providers, consumer advocates, and the Legislature.</xhtml:p><xhtml:p>(C)<xhtml:span class="EnSpace"/>(i)<xhtml:span class="EnSpace"/>For individuals described in subparagraph (

B) of paragraph (2), the eligibility and enrollment plan shall enable, to the maximum extent the department determines possible, an individual to maintain their primary care provider or medical home as their assigned primary care provider in the Medi-Cal managed care health plan provider network without disruption, if the provider is a contracted network provider with that Medi-Cal managed care health plan.

The department shall work with counties, Medi-Cal managed care health plans, health care providers, consumer advocates, and other interested stakeholders, to identify and maintain that linkage, to the maximum extent the department determines possible.</xhtml:p><xhtml:p>(ii)<xhtml:span class="EnSpace"/>This subparagraph does not limit the ability of an individual enrolled in Medi-Cal pursuant to subparagraph (

B) of paragraph (2) to select either, or both, a different primary care provider or, if there is more than one Medi-Cal managed care health plan available in the county where they reside, a different Medi-Cal managed care health plan, consistent with subdivision (

g) of

Section 14087.305 and paragraph (7) of subdivision (

d) of

Section 14089.</xhtml:p><xhtml:p>(D)<xhtml:span class="EnSpace"/>The department shall provide monthly updates to the appropriate policy and fiscal committees of the Legislature on the status of the implementation of this section.</xhtml:p><xhtml:p>(b)<xhtml:span class="EnSpace"/>To the extent permitted by state and federal law, an individual eligible under this

section shall be required to enroll in a Medi-Cal managed care health plan. Enrollment in a Medi-Cal managed care health plan shall not preclude a beneficiary from being enrolled in any other children’s Medi-Cal specialty program that they would otherwise be eligible for.</xhtml:p><xhtml:p>(c)<xhtml:span class="EnSpace"/>(1)<xhtml:span class="EnSpace"/>The department shall maximize federal financial participation in implementing this

section to the extent allowable. For purposes of implementing this section, the department shall claim federal financial participation to the extent that the department determines it is available.</xhtml:p><xhtml:p>(2)<xhtml:span class="EnSpace"/>To the extent that federal financial participation is unavailable, the department shall implement this

section using state funds appropriated for this purpose.</xhtml:p><xhtml:p>(d)<xhtml:span class="EnSpace"/>This

section shall be implemented only to the extent it is in compliance with

Section 1621(

d) of Title of the United States Code.</xhtml:p><xhtml:p>(e)<xhtml:span class="EnSpace"/>(1)<xhtml:span class="EnSpace"/>Notwithstanding

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this

section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt regulations in accordance with the requirements of

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code.</xhtml:p><xhtml:p>(2)<xhtml:span class="EnSpace"/>Notwithstanding

Section 10231.5 of the Government Code, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with

Section of the Government Code, until regulations have been adopted.</xhtml:p><xhtml:p>(f)<xhtml:span class="EnSpace"/>In implementing this section, the department may contract, as necessary, on a bid or nonbid basis. This subdivision establishes an accelerated process for issuing contracts pursuant to this section. Those contracts, and any other contracts entered into pursuant to this subdivision, may be on a noncompetitive bid basis and shall be exempt from both of the following:</xhtml:p><xhtml:p>(1)<xhtml:span class="EnSpace"/>Part 2 (commencing with

Section 10100) of Division of the Public Contract Code and any policies, procedures, or regulations authorized by that part.</xhtml:p><xhtml:p>(2)<xhtml:span class="EnSpace"/>Review or approval of contracts by the Department of General Services.</xhtml:p></caml:Content></caml:LawSectionVersion></caml:LawSection>"?>

SEC.

Article 6 (commencing with

Section 15210) is added to

Chapter of Part of Division of the Welfare and Institutions Code , to read: 6. Serving Our Seniors Fund 15210. (

a) The Serving Our Seniors Fund is hereby created in the State Treasury. (

b) Notwithstanding

Section of the Government Code, funds deposited and maintained under this

section are continuously appropriated, without regard to fiscal years, to the State Department of Health Care Services to restore and maintain payments for Medicare Part B premiums for eligible individuals.

SEC. 4. All funds previously appropriated for the purpose of providing Medi-Cal benefits pursuant to former

Section 14007.8 of the Welfare and Institutions Code, and not encumbered on or before January 1, 2026, shall transfer to the Serving Our Seniors Fund.