HB 140: "An Act expanding medical assistance coverage for eligible children and pregnant women; relating to cost sharing for certain recipients of medical assistance; and providing for an effective date."
00 HOUSE BILL NO. 140 01 "An Act expanding medical assistance coverage for eligible children and pregnant 02 women; relating to cost sharing for certain recipients of medical assistance; and 03 providing for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 06 to read: 07 SHORT TITLE. This Act may be known as the No Child Left Uninsured Act. 08 * Sec. 2. AS 47.07.020(b) is amended to read: 09 (b) In addition to the persons specified in (a) of this section, the following 10 optional groups of persons for whom the state may claim federal financial 11 participation are eligible for medical assistance: 12 (1) persons eligible for but not receiving assistance under any plan of 13 the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act, 14 Supplemental Security Income) or a federal program designated as the successor to the
01 aid to families with dependent children program; 02 (2) persons in a general hospital, skilled nursing facility, or 03 intermediate care facility, who, if they left the facility, would be eligible for assistance 04 under one of the federal programs specified in (1) of this subsection; 05 (3) persons under 21 years of age who are under supervision of the 06 department, for whom maintenance is being paid in whole or in part from public 07 funds, and who are in foster homes or private child-care institutions; 08 (4) aged, blind, or disabled persons, who, because they do not meet 09 income and resources requirements, do not receive supplemental security income 10 under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not 11 receive a mandatory state supplement, but who are eligible, or would be eligible if 12 they were not in a skilled nursing facility or intermediate care facility to receive an 13 optional state supplementary payment; 14 (5) persons under 21 years of age who are in an institution designated 15 as an intermediate care facility for the mentally retarded and who are financially 16 eligible as determined by the standards of the federal program designated as the 17 successor to the aid to families with dependent children program; 18 (6) persons in a medical or intermediate care facility whose income 19 while in the facility does not exceed $1,656 a month but who would not be eligible for 20 an optional state supplementary payment if they left the hospital or other facility; 21 (7) persons under 21 years of age who are receiving active treatment in 22 a psychiatric hospital and who are financially eligible as determined by the standards 23 of the federal program designated as the successor to the aid to families with 24 dependent children program; 25 (8) persons under 21 years of age and not covered under (a) of this 26 section, who would be eligible for benefits under the federal program designated as 27 the successor to the aid to families with dependent children program, except that they 28 have the care and support of both their natural and adoptive parents; 29 (9) pregnant women not covered under (a) of this section and who 30 meet the income and resource requirements of the federal program designated as the 31 successor to the aid to families with dependent children program;
01 (10) persons under 21 years of age not covered under (a) of this section 02 who the department has determined cannot be placed for adoption without medical 03 assistance because of a special need for medical or rehabilitative care and who the 04 department has determined are hard-to-place children eligible for subsidy under 05 AS 25.23.190 - 25.23.210; 06 (11) persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title 07 XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom 08 a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title 09 XVI, Social Security Act) because they meet all of the following criteria: 10 (A) they are 18 years of age or younger and qualify as disabled 11 individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); 12 (B) the department has determined that 13 (i) they require a level of care provided in a hospital, 14 nursing facility, or intermediate care facility for the mentally retarded; 15 (ii) it is appropriate to provide their care outside of an 16 institution; and 17 (iii) the estimated amount that would be spent for 18 medical assistance for their individual care outside an institution is not 19 greater than the estimated amount that would otherwise be expended 20 individually for medical assistance within an appropriate institution; 21 (C) if they were in a medical institution, they would be eligible 22 for medical assistance under other provisions of this chapter; and 23 (D) home and community-based services under a waiver 24 approved by the federal government are either not available to them under this 25 chapter or would be inappropriate for them; 26 (12) disabled persons, as described in 42 U.S.C. 27 1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under 28 applicable federal regulations or guidelines, is less than 250 percent of the official 29 poverty line applicable to a family of that size according to the federal Office of 30 Management and Budget, and who, but for earnings in excess of the limit established 31 under 42 U.S.C. 1396d(q)(2)(B), would be considered to be individuals with respect to
01 whom a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c; a 02 person eligible for assistance under this paragraph who is not eligible under another 03 provision of this section shall pay a premium or other cost-sharing charges according 04 to a sliding fee scale that is based on income as established by the department in 05 regulations; 06 (13) persons under 19 years of age who are not covered under (a) of 07 this section and whose household income does not exceed 200 percent of the federal 08 poverty guideline as defined by the federal Office of Management and Budget 09 and revised under 42 U.S.C. 9902(2) 10 [(A) $1,635 A MONTH IF THE HOUSEHOLD CONSISTS 11 OF ONE PERSON; 12 (B) $2,208 A MONTH IF THE HOUSEHOLD CONSISTS OF 13 TWO PERSONS; 14 (C) $2,782 A MONTH IF THE HOUSEHOLD CONSISTS OF 15 THREE PERSONS; 16 (D) $3,355 A MONTH IF THE HOUSEHOLD CONSISTS OF 17 FOUR PERSONS; 18 (E) $3,928 A MONTH IF THE HOUSEHOLD CONSISTS OF 19 FIVE PERSONS; 20 (F) $4,501 A MONTH IF THE HOUSEHOLD CONSISTS OF 21 SIX PERSONS; 22 (G) $5,074 A MONTH IF THE HOUSEHOLD CONSISTS OF 23 SEVEN PERSONS; 24 (H) $5,647 A MONTH IF THE HOUSEHOLD CONSISTS OF 25 EIGHT PERSONS; 26 (I) $5,647 A MONTH, PLUS AN ADDITIONAL $574 A 27 MONTH FOR EACH EXTRA PERSON ABOVE EIGHT PERSONS WHO 28 IS IN THE HOUSEHOLD IF THE HOUSEHOLD CONSISTS OF NINE 29 PERSONS OR MORE]; 30 (14) pregnant women who are not covered under (a) of this section and 31 whose household income does not exceed 200 percent of the federal poverty
01 guideline as defined by the federal Office of Management and Budget and revised 02 under 42 U.S.C. 9902(2) 03 [(A) $2,208 A MONTH IF THE HOUSEHOLD CONSISTS 04 OF TWO PERSONS; 05 (B) $2,782 A MONTH IF THE HOUSEHOLD CONSISTS OF 06 THREE PERSONS; 07 (C) $3,355 A MONTH IF THE HOUSEHOLD CONSISTS OF 08 FOUR PERSONS; 09 (D) $3,928 A MONTH IF THE HOUSEHOLD CONSISTS OF 10 FIVE PERSONS; 11 (E) $4,501 A MONTH IF THE HOUSEHOLD CONSISTS OF 12 SIX PERSONS; 13 (F) $5,074 A MONTH IF THE HOUSEHOLD CONSISTS OF 14 SEVEN PERSONS; 15 (G) $5,647 A MONTH IF THE HOUSEHOLD CONSISTS OF 16 EIGHT PERSONS; 17 (H) $5,647 A MONTH, PLUS AN ADDITIONAL $574 A 18 MONTH FOR EACH EXTRA PERSON ABOVE EIGHT PERSONS WHO 19 IS IN THE HOUSEHOLD IF THE HOUSEHOLD CONSISTS OF NINE 20 PERSONS OR MORE]; 21 (15) persons who have been diagnosed with breast or cervical cancer 22 and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII). 23 * Sec. 3. AS 47.07 is amended by adding a new section to read: 24 Sec. 47.07.022. Extended medical assistance coverage for children; costs. 25 (a) In addition to the persons specified in AS 47.07.020, a person who resides in the 26 state and who meets the criteria under (b) of this section is eligible for extended 27 medical assistance coverage equivalent to the mandatory and optional services 28 described under AS 47.07.030 if the person submits an annual application and 29 contribution as specified in (c) of this section. 30 (b) The department shall administer a program of extended medical assistance 31 coverage for a person
01 (1) who is under 19 years of age; 02 (2) whose household income is between 200 and 350 percent of the 03 federal poverty guideline as defined by the federal Office of Management and Budget 04 and revised under 42 U.S.C. 9902(2); and 05 (3) whose parent or legal guardian certifies that the person is not 06 covered under a health insurance policy. 07 (c) The program administered under this section must include an annual 08 application and sliding scale contribution, payable under terms specified in regulations 09 adopted by the department. The regulations must 10 (1) include the option of an assignment of an applicant's permanent 11 fund dividend and the permanent fund dividend of a parent, legal guardian, or other 12 authorized representative of an applicant; and 13 (2) set the contribution amount between $200 and $1,200, beginning 14 with $200 for a person whose household income is between 201 percent and 225 15 percent of the federal poverty guideline and increasing progressively based on the 16 person's household income. 17 (d) In addition to the annual contribution established under (c) of this section, 18 the department shall impose a copayment of 20 percent for medical services and 19 prescription drug costs covered under the program for a person whose household 20 income is between 250 and 350 percent of the federal poverty guideline. 21 * Sec. 4. AS 47.07.042(d) is amended to read: 22 (d) In addition to the requirements established under (a) and (b) of this section, 23 the department shall [MAY] require premiums or cost-sharing contributions from 24 recipients who are eligible for benefits under AS 47.07.022. The 25 [AS 47.07.020(b)(13) AND WHOSE HOUSEHOLD INCOME IS GREATER THAN 26 THE APPLICABLE AMOUNT SET OUT IN (f) OF THIS SECTION. IF THE 27 DEPARTMENT REQUIRES PREMIUMS OR COST-SHARING 28 CONTRIBUTIONS UNDER THIS SUBSECTION, THE] department 29 (1) shall adopt in regulation a sliding scale for those premiums or 30 contributions based on household income; 31 (2) may not exceed the maximums allowed under federal law; and
01 (3) shall implement a system by which the department or its designee 02 collects those premiums or contributions. 03 * Sec. 5. AS 47.07.042(f) is repealed. 04 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 05 read: 06 TRANSITION: REGULATIONS. The Department of Health and Social Services may 07 proceed to adopt regulations necessary to implement the changes made by this Act. The 08 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the 09 effective date of secs. 1 - 5 of this Act. 10 * Sec. 7. Section 6 of this Act takes effect immediately under AS 01.10.070(c). 11 * Sec. 8. Except as provided in sec. 7 of this Act, this Act takes effect July 1, 2008.