Healthy FamiliesEligibility
Section § 12693.70
This section explains who can participate in a health program for children in California. To be eligible, an applicant must apply on behalf of a child under 19, who is not eligible for no-cost full Medi-Cal or Medicare, and who meets immigration and residency requirements. The child must be in a family with income at or below 200% of the federal poverty level. Newborns from mothers in a specific maternity program have special eligibility rules. After initial coverage, families must provide income updates to continue eligibility. Applicants must agree to remain in the program for six months unless they acquire other coverage, and must enroll all eligible children in the program. Any past dues for family contributions must be settled, and income can sometimes be self-reported if documentation is not available.
Section § 12693.71
This law is about keeping track of applications for a state health program to ensure people aren't leaving employer-sponsored dependent health coverage to join this program. If children were covered by their parent's work insurance within the last three months, the board managing the program can reject their application. However, there are exceptions if the previous insurance ended for reasons like job loss, switching jobs to a place without dependent coverage, moving where no employer coverage is offered, the employer stopping health benefits, COBRA coverage ending, or special exemptions. If funds for the program mainly cover kids who dropped employer insurance to join, or if required by federal rules, the board might extend this waiting period to up to six months.
Section § 12693.72
This law lets a board decline a health insurance application if the children were already covered by a private plan before applying, but only if federal rules require it. The waiting period can't be longer than what the federal government mandates.
If a waiting period is enforced, there must be exceptions. These exceptions apply when the previous coverage ended for reasons unrelated to the availability of this program, like if the old plan was under a certain legal exemption.
Section § 12693.73
In simple terms, this law states that children who are not covered under Title XXI of the Social Security Act cannot get coverage from this particular program. However, there are some exceptions detailed in specific parts of other related sections.
Section § 12693.74
Subscribers remain eligible for the program for 12 months from when they first qualify. If voters approve a specific addition to the Welfare and Institutions Code in the November 2024 election, this section of the law will stop being effective on January 1, 2025, or when the State Department of Health Care Services certifies it, whichever is later, and will be repealed the following January 1. If the voters do not approve the addition, this section becomes inoperative on January 1, 2026, or when certified by the department, whichever is later, and will be repealed the following January 1.
Section § 12693.74
This law ensures that children remain eligible for a health program until they turn five, as long as the federal government helps pay. The state must get approval from the federal government and confirm that funds are available to support this program continuously from the 2024-25 fiscal year onwards. Certain systems must also be ready for implementation.
If these conditions are met, the department will make a public declaration and share it with various state officials. The department can change eligibility rules if federal funding is at risk and can make these changes without extra regulatory steps.
The program will only start with federal approvals and if federal funding is secured. If voters pass a specific law in November 2024, the program becomes active in January 2025. If not, this section of the law will be canceled as of January 2025.
Section § 12693.75
This law mandates that the program must use a straightforward mail-in application system. When determining children's eligibility, the program can use information from school lunch applications and only request extra details if necessary. The Managed Risk Medical Insurance Board can issue emergency regulations to implement related sections, ensuring quick and necessary actions to protect public health and welfare. These regulations can skip usual review processes but remain effective for up to 180 days unless reissued.
Section § 12693.76
This California insurance law states that children and parents who qualify under certain immigration categories won't be denied eligibility for insurance programs just because of when they entered the U.S. However, this rule can only be applied if there's money set aside for it in the state's annual budget.
Section § 12693.755
This law says that once federal approval is granted, California will expand its health insurance coverage to include uninsured parents or responsible adults of children who are already enrolled in certain health coverages. The income of these parents cannot exceed 250 percent of the federal poverty line. This expansion is part of a program that relies on federal support and will only be implemented if certain conditions and resources are available.
Section § 12693.765
This law says that certain children are automatically eligible to join a health program right from birth. However, this automatic eligibility is only available if the funds for it are included in the yearly budget or another law. So, even though the law allows it, the program will only work if there's money set aside.