SB-1108: Medi-Cal: Conditions of Eligibility or Coverage

Session: 2017-2018
Author: Hernandez
Status: Signed into Law (Chaptered)
AAP-CA Position: Support
To view the status of this bill on the State Website, click here.

This bill would prohibit the Department of Health Care Services from seeking or obtaining a Medicaid demonstration project or waivers to require work or community engagement activities as a condition of Medi-Cal eligibility or coverage, or to require waiting periods, time limits, or coverage lockouts.



AAP Positional Letter

August 21, 2018

The Honorable Ed Hernandez
State Capitol, Room 2080
Sacramento, CA 95814

RE:​ SB 1108 (Hernandez) Medi-Cal: Conditions of Eligibility or Coverage
AAP-CA Position: Support

Dear Senator Hernandez,

The American Academy of Pediatrics, California (AAP-CA), representing over 5,000 California pediatricians, strongly supports SB 1108 (Hernandez), which clarifies that the purpose of the Medi-Cal program is to provide healthcare to low-income Californians who cannot afford it. SB 1108 would prevent the Department of Health Care Services from seeking a federal waiver that imposes barriers on receiving Medi-Cal, such as work requirements or lock-out periods.

The Trump Administration has issued a State Medicaid Director letter encouraging states to apply for waivers that include work requirements, and has since approved such waivers in four states with several pending. The Administration has also approved waivers with Medicaid lock-out periods and is currently reviewing requests to impose time limits on receiving Medicaid and enrollment caps on a state’s Medicaid program.

According to the Kaiser Family Foundation, nearly 8 in 10 Medicaid adults live in working families, and those who do not work face issues such as illness, disability or caregiving responsibilities.

Since most Medicaid beneficiaries who can work already do so, it seems unnecessary to put in place provisions aimed to promote work within this already vulnerable population. By creating barriers to coverage, fewer people would be able to address health issues that might be keeping them from seeking employment, making these requirements counter-productive. Additionally, a work requirement would increase the amount of paperwork and could cost the state and county more money to oversee the program.

SB 1108 would prevent California from seeking such waivers by only allowing waivers that further the goal of providing healthcare to low-income Californians. Should the Trump Administration try to impose work requirements or any other reductions to Medi-Cal eligibility on a waiver application, California could not accept those conditions.

California is proud of its efforts to implement the Affordable Care Act, resulting in millions of low-income residents gaining Medi-Cal coverage. Prior to implementation, nearly 20% of Californians were uninsured; now less than 7% are. SB 1108 would safeguard these gains made and ensure that low-income Californians do not lose their health care.

Pediatrician members of AAP California Chapters 1, 2, 3 and 4 statewide support proposed legislation SB 1108 . Thank you for your public service and leadership on behalf of the health and wellbeing of children, youth, and families in California.


Kris Calvin
Chief Executive Officer, American Academy of Pediatrics, California

cc: AAP-CA Leadership; Lobbyist Lydia Bourne