00                      CS FOR SENATE BILL NO. 27(FIN)                                                                    
01 "An Act relating to eligibility requirements for medical assistance for certain children,                               
02 pregnant women, disabled persons, and persons in medical or intermediate care                                           
03 facilities; and providing for an effective date."                                                                       
04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
05    * Section 1. AS 47.07.020(b) is amended to read:                                                                   
06            (b)  In addition to the persons specified in (a) of this section, the following                              
07       optional groups of persons for whom the state may claim federal financial                                         
08       participation are eligible for medical assistance:                                                                
09                 (1)  persons eligible for but not receiving assistance under any plan of                                
10       the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act,                                  
11       Supplemental Security Income) or a federal program designated as the successor to the                             
12       aid to families with dependent children program;                                                                  
13                 (2)  persons in a general hospital, skilled nursing facility, or                                        
14       intermediate care facility, who, if they left the facility, would be eligible for assistance                      

01       under one of the federal programs specified in (1) of this subsection;                                            
02                 (3)  persons under 21 years of age who are under supervision of the                                     
03       department, for whom maintenance is being paid in whole or in part from public                                    
04       funds, and who are in foster homes or private child-care institutions;                                            
05                 (4)  aged, blind, or disabled persons, who, because they do not meet                                    
06       income and resources requirements, do not receive supplemental security income                                    
07       under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not                                     
08       receive a mandatory state supplement, but who are eligible, or would be eligible if                               
09       they were not in a skilled nursing facility or intermediate care facility to receive an                           
10       optional state supplementary payment;                                                                             
11                 (5)  persons under 21 years of age who are in an institution designated                                 
12       as an intermediate care facility for the mentally retarded and who are financially                                
13       eligible as determined by the standards of the federal program designated as the                                  
14       successor to the aid to families with dependent children program;                                                 
15                 (6)  persons in a medical or intermediate care facility whose income                                    
16       while in the facility does not exceed $1,656 a month but who would not be eligible for                            
17       an optional state supplementary payment if they left the hospital or other facility;                              
18                 (7)  persons under 21 years of age who are receiving active treatment in                                
19       a psychiatric hospital and who are financially eligible as determined by the standards                            
20       of the federal program designated as the successor to the aid to families with                                    
21       dependent children program;                                                                                       
22                 (8)  persons under 21 years of age and not covered under (a) of this                                    
23       section, who would be eligible for benefits under the federal program designated as                               
24       the successor to the aid to families with dependent children program, except that they                            
25       have the care and support of both their natural and adoptive parents;                                             
26                 (9)  pregnant women not covered under (a) of this section and who                                       
27       meet the income and resource requirements of the federal program designated as the                                
28       successor to the aid to families with dependent children program;                                                 
29                 (10)  persons under 21 years of age not covered under (a) of this section                               
30       who the department has determined cannot be placed for adoption without medical                                   
31       assistance because of a special need for medical or rehabilitative care and who the                               

01       department has determined are hard-to-place children eligible for subsidy under                                   
02       AS 25.23.190 - 25.23.210;                                                                                         
03                 (11)  persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title                                  
04       XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom                              
05       a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title                                  
06       XVI, Social Security Act) because they meet all of the following criteria:                                        
07                      (A)  they are 18 years of age or younger and qualify as disabled                                   
08            individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act);                                       
09                      (B)  the department has determined that                                                            
10                           (i)  they require a level of care provided in a hospital,                                     
11                 nursing facility, or intermediate care facility for the mentally retarded;                              
12                           (ii)  it is appropriate to provide their care outside of an                                   
13                 institution; and                                                                                        
14                           (iii)  the estimated amount that would be spent for                                           
15                 medical assistance for their individual care outside an institution is not                              
16                 greater than the estimated amount that would otherwise be expended                                      
17                 individually for medical assistance within an appropriate institution;                                  
18                      (C)  if they were in a medical institution, they would be eligible                                 
19            for medical assistance under other provisions of this chapter; and                                           
20                      (D)  home and community-based services under a waiver                                              
21            approved by the federal government are either not available to them under this                               
22            chapter or would be inappropriate for them;                                                                  
23                 (12)  disabled persons, as described in 42 U.S.C.                                                       
24       1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under                                  
25       applicable federal regulations or guidelines, is less than 250 percent of the official                            
26       poverty line applicable to a family of that size according to the United States                               
27       Department of Health and Human Services [FEDERAL OFFICE OF                                                    
28       MANAGEMENT AND BUDGET], and who, but for earnings in excess of the limit                                          
29       established under 42 U.S.C. 1396d(q)(2)(B), would be considered to be individuals                                 
30       with respect to whom a supplemental security income is being paid under 42 U.S.C.                                 
31       1381 - 1383c; a person eligible for assistance under this paragraph who is not eligible                           

01       under another provision of this section shall pay a premium or other cost-sharing                                 
02       charges according to a sliding fee scale that is based on income as established by the                            
03       department in regulations;                                                                                        
04                 (13)  persons under 19 years of age who are not covered under (a) of                                    
05       this section and whose household income does not exceed 175 percent of the federal                            
06       poverty guideline as defined by the United States Department of Health and                                    
07       Human Services and revised under 42 U.S.C. 9902(2)                                                            
08                      [(A)  $1,635 A MONTH IF THE HOUSEHOLD CONSISTS                                                     
09            OF ONE PERSON;                                                                                               
10                      (B)  $2,208 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
11            TWO PERSONS;                                                                                                 
12                      (C)  $2,782 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
13            THREE PERSONS;                                                                                               
14                      (D)  $3,355 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
15            FOUR PERSONS;                                                                                                
16                      (E)  $3,928 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
17            FIVE PERSONS;                                                                                                
18                      (F)  $4,501 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
19            SIX PERSONS;                                                                                                 
20                      (G)  $5,074 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
21            SEVEN PERSONS;                                                                                               
22                      (H)  $5,647 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
23            EIGHT PERSONS;                                                                                               
24                      (I)  $5,647 A MONTH, PLUS AN ADDITIONAL $574 A                                                     
25            MONTH FOR EACH EXTRA PERSON ABOVE EIGHT PERSONS WHO                                                          
26            IS IN THE HOUSEHOLD IF THE HOUSEHOLD CONSISTS OF NINE                                                        
27            PERSONS OR MORE];                                                                                            
28                 (14)  pregnant women who are not covered under (a) of this section and                                  
29       whose household income does not exceed 175 percent of the federal poverty line as                             
30       defined by the United States Department of Health and Human Services and                                      
31       revised under 42 U.S.C. 9902(2)                                                                               

01                      [(A)  $2,208 A MONTH IF THE HOUSEHOLD CONSISTS                                                     
02            OF TWO PERSONS;                                                                                              
03                      (B)  $2,782 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
04            THREE PERSONS;                                                                                               
05                      (C)  $3,355 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
06            FOUR PERSONS;                                                                                                
07                      (D)  $3,928 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
08            FIVE PERSONS;                                                                                                
09                      (E)  $4,501 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
10            SIX PERSONS;                                                                                                 
11                      (F)  $5,074 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
12            SEVEN PERSONS;                                                                                               
13                      (G)  $5,647 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
14            EIGHT PERSONS;                                                                                               
15                      (H)  $5,647 A MONTH, PLUS AN ADDITIONAL $574 A                                                     
16            MONTH FOR EACH EXTRA PERSON ABOVE EIGHT PERSONS WHO                                                          
17            IS IN THE HOUSEHOLD IF THE HOUSEHOLD CONSISTS OF NINE                                                        
18            PERSONS OR MORE];                                                                                            
19                 (15)  persons who have been diagnosed with breast or cervical cancer                                    
20       and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII).                                     
21    * Sec. 2. 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 may require premiums or cost-sharing contributions from recipients                                 
24       who are eligible for benefits under AS 47.07.020(b)(13) and whose household income                                
25       is between 150 and 175 percent of the federal poverty line [GREATER THAN                                      
26       THE APPLICABLE AMOUNT SET OUT IN (f) OF THIS SECTION]. If the                                                     
27       department requires premiums or cost-sharing contributions under this subsection, the                             
28       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. 3. AS 47.07.042(f) is repealed.                                                                             
04    * Sec. 4. This Act takes effect immediately under AS 01.10.070(c).