Section 15925.
Cal. Welfare and Institutions Code - WIC § 15925.
in effect(a)
This part shall be known, and may be cited, as the Health Care Reform Eligibility, Enrollment, and Retention Planning Act.
(b)
(1)
The California Health and Human Services Agency, in consultation with the State Department of Health Care Services (department), Managed Risk Medical Insurance Board (MRMIB), the California Health Benefit Exchange (Exchange), the Office of Technology and Solutions Integration, counties, health care service plans, consumer advocates, and other stakeholders shall undertake a planning and development process regarding this part and aspects of the federal Patient Protection and Affordable Care Act (PPACA) (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and regulations or guidance issued pursuant to these acts, related to eligibility for, and enrollment and retention in, state health subsidy programs.
(2)
The planning and development process shall provide stakeholders the opportunity to provide meaningful input into the planning and development of the aspects of eligibility, enrollment, and retention identified in this section. This process
shall be completed in time for all of the following to occur:
(A)
The certification and approval of the eligibility, enrollment, and retention system, as required by PPACA and regulations and guidance issued thereunder.
(B)
The approval of enhanced federal funding for Medi-Cal eligibility system development, implementation, and maintenance.
(C)
The readiness of the eligibility, enrollment, and retention processes to accept and process applications, as required by federal law.
(3)
The planning and development process shall consider issues, including, but not limited to, all of the following:
(A)
Whether to use the application developed by the federal Secretary of Health and Human Services,
pursuant to Section 1413 of the PPACA (42 U.S.C. Sec. 18083), or whether to develop a separate state form.
(B)
What process to use for Medi-Cal eligibility determinations for non-Modified Adjusted Gross Income (MAGI) populations, including whether to develop a supplemental application form and how the applications will be processed.
(C)
Whether to adopt a process for hospitals to enroll infants deemed eligible for Medi-Cal under Section 1396a(e)(4) of Title 42 of the United States Code or the Healthy Families Program under Section 12693.70 of the Insurance Code immediately online, without an application.
(D)
What data collection standards to utilize for the collection of race, ethnicity, primary language, and disability status.
(E)
Whether to create a
process to allow recipients to provide an update to eligibility information in between renewal dates and to have the option to renew eligibility at the time of the update, resetting the renewal date.
(F)
Whether to renew eligibility for a state health subsidy program based on information from a public benefits program, if the recipient is otherwise eligible.
(G)
Protections for the confidentiality of personal information.
(H)
What process to use to enable applicants determined eligible for and recipients of a state health subsidy program to choose a health plan, if applicable.
(4)
The agency shall provide the appropriate fiscal and policy committees of the Legislature with information reflecting the process conducted pursuant to paragraph (1) by July 1,
2012, regarding policy and statutory changes needed to develop and implement the eligibility, enrollment, and retention system for health coverage in compliance with this part.
(c)
The information reporting requirement imposed under paragraph (4) of subdivision (b) is inoperative on January 1, 2016, pursuant to Section 10231.5 of the Government Code.
References
referencesCal. Insurance Code - INS § 12693.70.
referencesCal. Government Code - GOV § 10231.5.
referencesCal. Welfare and Institutions Code - WIC § 1413.
referencesCal. Welfare and Institutions Code - WIC § 1396a.
Source: CA Legislative Counsel Bulk DataURL: https://downloads.leginfo.legislature.ca.gov/pubinfo_2025.zipFetched: 6/27/2026