Medi-Cal program costs: large employer responsibility.

Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, to afford to qualifying individuals health care and related remedial or preventive services. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law, the federal Patient Protection and Affordable Care Act, requires applicable large employers, as defined, who offer full-time employees and their dependents the opportunity to enroll in minimum essential coverage and for whom one full-time employee has been certified as having enrolled in a qualified health plan for which a premium tax credit or cost-sharing reduction is allowed or paid, to pay a specified fee. This bill would, commencing January 1, 2015, require a large employer, as defined, to pay the Employment Development Department an employer responsibility penalty for each covered employee, as defined, enrolled in Medi-Cal based on the average cost of employee-only coverage provided by large employers to their employees, including both the employer's and employee's share of the premiums, as specified. The bill would assess interest of 10% per annum on employer responsibility penalties not paid on or before the date payment is due, as specified, and would require a large employer subject to an employer responsibility penalty to pay a penalty, as specified, for any employer responsibility penalty payment that is more than 60 days overdue. The bill would establish the Employer Responsibility for Medi-Cal Trust Fund, which would consist of the penalty amounts and interest collected pursuant to these provisions and would require that, upon appropriation, the moneys in the fund be used by the State Department of Health Care Services to provide payment for the nonfederal share of Medi-Cal costs for covered employees, to increase reimbursement to providers of care by providing supplemental Medi-Cal payments for specified benefits and providers, to provide reimbursement to county health systems, community clinics, and other safety net providers, as defined, that provide care without expectation of compensation to those Californians who do not have minimum essential coverage, as defined, to fund medical residency programs that meet certain criteria developed by the Office of Statewide Health Planning and Development, and for all costs to implement the penalty provisions, as specified. This bill would, commencing January 1, 2015, prohibit a large employer from discharging or taking other action, as specified, against an employee who enrolls in a public health benefit program or advance premium tax credits through the California Health Benefit Exchange, and would provide that an employee is entitled to reinstatement and reimbursement of lost wages and work benefits if a large employer discharges or takes other action against an employee for those reasons. The bill would authorize an employee to file a complaint with the Division of Labor Standards Enforcement of the Department of Industrial Relations if the employee is discharged, threatened with discharge, demoted, suspended, or in any other manner discriminated or retaliated against in the terms and conditions of employment by his or her employer in violation of these provisions. Existing law requires employers to file specified information with the Employment Development Department, upon hiring an employee, that may be used by specified state departments, exchanges, and boards, and county departments and agencies for specified purposes, including verifying or determining the eligibility of an applicant for, or a recipient of, state health subsidy programs, as specified, if the verification or determination is directly connected with, and limited to, the administration of the referenced state health subsidy programs. This bill would expand these provisions to allow the information to be used if the verification or determination is directly connected with, and limited to, the administration or funding of the referenced state health subsidy programs. Existing law authorizes the Director of the Employment Development Department to permit the use of information in his or her possession for specified purposes and to require reimbursement for all direct costs incurred in providing that information. Existing law provides that this information includes information provided to enable federal, state, or local government departments or agencies, subject to federal law, to verify or determine the eligibility or entitlement of an applicant for, or a recipient of, public social services if the verification or determination is directly connected with, and limited to, the administration of public social services. This bill would expand these provisions to allow the information to be used if the verification or determination is directly connected with, and limited to, the administration or funding of the public social services. Existing law also authorizes the director to permit the use of information in his or her possession and to require reimbursement for all direct costs incurred in providing that information to enable specified state departments, exchanges, and boards, and county departments and agencies, to obtain information regarding employee wages, California employer names and account numbers, employer reports of wages and number of employees, and disability insurance and unemployment insurance claim information, for specified purposes. This bill would authorize the director to provide information to enable these entities to obtain information regarding state employer identification numbers. The bill would also authorize the director to provide to the State Department of Health Care Services employer information and employee wage information on individuals who are enrolled in the Medi-Cal program to determine the employer responsibility penalties that would owed by large employers. Existing law requires the State Department of Social Services and the State Department of Health Care Services to make use of the records of the Franchise Tax Board to match unearned income against reported income of applicants for, and recipients of, aid or public social services. This bill would also require each department to use these records to match social security numbers of applicants for, and recipients of, aid or public services with their employer's state employer identification number, which shall then be forwarded to the appropriate county welfare department or other appropriate state departments for use, as specified. This bill would declare that it is to take effect immediately as an urgency statute.