Medi-Cal: continuous eligibility.

Existing law establishes the Medi-Cal program, which is 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. Under existing law, beginning no earlier than January 1, 2025, a child under 5 years of age is continuously eligible for Medi-Cal, including without regard to income, until the child reaches 5 years of age, subject to specified circumstances. Existing law makes this provision contingent on obtaining all necessary federal approvals, an appropriation, and a determination by the department that systems have been programmed to implement certain provisions. Existing law establishes the County Health Initiative Matching Fund, administered by the department, through which an applicant county, county agency, a local initiative, or a county organized health system that provides an intergovernmental transfer, as specified, is authorized to submit a proposal to the department for funding for the purpose of providing comprehensive health insurance coverage to certain children. For purposes of eligibility, existing law requires the child to meet specified citizenship and immigration status requirements, that their family income be at or below 317% of the federal poverty level or, at the option of the applicant, at or below 411% of the federal poverty level, and that the child not qualify for Medi-Cal with no share of cost or for other certain Medi-Cal programs. This bill would require, beginning no earlier than January 1, 2025, that the application also specify that the applicant will provide continuous eligibility for a child under the program until the child is 5 years of age if the child is not determined to be eligible for Medi-Cal during that time, except as specified. The bill would condition implementation of this provision on receipt of any necessary federal approvals, an appropriation, and a determination by the department, as described above. The bill would also remove the above-described reference to citizenship and immigration status requirements. Because counties are required to make Medi-Cal eligibility determinations, and to the extent that this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.