Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified low-income recipients. Existing law also creates the Healthy Families Program, administered by the Managed Risk Medical Insurance Board (MRMIB), to arrange for the provision of health care services to children less than 19 years of age who meet certain eligibility requirements.

Existing law, the County Health Initiative Matching Fund, establishes a fund that is administered by MRMIB in collaboration with the department to accept intergovernmental transfers to be used to increase the state’s ability to use federal funds for programs to improve and expand access to health care. Under existing law, a county, a county agency, a local initiative, or a county organized health system that will provide an intergovernmental transfer may apply to MRMIB for funding to provide health care coverage to eligible children whose family income is at or below 300% of the federal poverty level or eligible adults whose family income does not exceed 200% of the federal poverty level. Existing law requires that persons receiving this coverage be ineligible for the Healthy Families Program and no share of cost Medi-Cal coverage.

This bill would allow a county, a county agency, a local initiative, or a county organized health system that will provide an intergovernmental transfer to apply to MRMIB for funding to provide health care coverage to eligible children whose family income is at or below 400% of the federal poverty level, as specified, and would require persons receiving this coverage be ineligible for no share of cost Medi-Cal coverage and either ineligible for the Healthy Families Program or unable to enroll in the program as a result of specified enrollment policies due to insufficient funds. The bill would specify that implementation of these provisions is conditioned on MRMIB obtaining necessary federal approval thereof.