Health care: maintenance and expansion.

Plain English Breakdown

The official source does not provide details on specific services that will be covered or expanded without federal support, leaving this as an open question.

Health Care Maintenance and Expansion

This law requires California to develop or expand health programs if federal funding for certain services under Medi-Cal is reduced, focusing on beneficiaries of the State-Only Family Planning Program.

What This Bill Does

• Requires the State Department of Health Care Services to develop new programs or expand existing ones to provide services that are covered under Medi-Cal but may not be funded due to changes in federal financial support for Medi-Cal beneficiaries.
• Allows the California Health and Human Services Agency to create new programs or expand existing state-funded health programs to provide certain services, including abortion and gender-affirming care, if there is a lack of federal funding.
• Creates the Health Care Maintenance and Expansion Fund to distribute money for these services, which can include private donations.
• Expands the State-Only Family Planning Program to help with implementation of new or expanded health care services.

Who It Names or Affects

• People who receive Medi-Cal benefits
• California residents who might need family planning, abortion, and gender-affirming care services

Terms To Know

Medi-Cal

A health insurance program for low-income Californians funded partly by the federal government.

Family PACT Program

A state-funded family planning program in California.

Limits and Unknowns

• The bill needs funding to be effective.
• It is not clear which specific services will be covered or expanded without federal support.

Official Summary Text

SB 528, as amended, Weber Pierson.
Health care: maintenance and expansion.
(1) Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, 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.
Existing law establishes, under the Medi-Cal program, the Family Planning, Access, Care, and Treatment (Family PACT) Program. If Family PACT becomes inoperative, existing law requires all persons who have received, or are eligible to receive, comprehensive clinical family planning services pursuant to Family PACT to receive family planning services under other specified provisions of the Medi-Cal program or under the State-Only Family Planning Program, which is also established within the department for purposes of family planning
services.
This bill would require the department, subject to an appropriation,
to develop a new program or
to expand any existing state-only-funded health programs,
including, but not limited to, the State-Only Family Planning Program,
in order
to provide to Medi-Cal beneficiaries certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation.
For purposes of the expansion above, the bill would require the department to determine the services or benefits, which may include, but are not limited to, abortion and
gender-affirming care, based on the levels of federal financial participation, as specified.
(2) This bill would, subject to an appropriation, require the California Health and Human Services Agency to develop a new program, or to expand an existing state program, as applicable, to provide certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation. Under the bill, these services or benefits would not be limited to the population of Medi-Cal beneficiaries.
The bill would require the agency to determine the services or benefits, which may include, but are not limited to, abortion, family planning, and gender-affirming care, based on the needs of target populations and the levels of federal financial participation, as specified.
The bill
would create the Health Care Maintenance and Expansion Fund for purposes of distributing funding, if appropriated, for these services or benefits. The bill would authorize the agency to receive private donations, for deposit into the fund, to support implementation.
(3) The bill would authorize
modification and
expansion of the State-Only Family Planning Program, subject to an appropriation, to facilitate implementation of the provisions described in paragraphs (1) and (2), as specified.

Current Bill Text

Download Bill PDF