00                             SENATE BILL NO. 277                                                                         
01 "An Act relating to eligibility requirements for medical assistance for certain children,                               
02 pregnant women, and persons in medical or intermediate care facilities; and providing                                   
03 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 300 percent of the supplemental security                                
17       income benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act)                             
18       [$1,656 A MONTH] but who would not be eligible for an optional state                                              
19       supplementary payment if they left the hospital or other facility;                                                
20                 (7)  persons under 21 years of age who are receiving active treatment in                                
21       a psychiatric hospital and who are financially eligible as determined by the standards                            
22       of the federal program designated as the successor to the aid to families with                                    
23       dependent children program;                                                                                       
24                 (8)  persons under 21 years of age and not covered under (a) of this                                    
25       section, who would be eligible for benefits under the federal program designated as                               
26       the successor to the aid to families with dependent children program, except that they                            
27       have the care and support of both their natural and adoptive parents;                                             
28                 (9)  pregnant women not covered under (a) of this section and who                                       
29       meet the income and resource requirements of the federal program designated as the                                
30       successor to the aid to families with dependent children program;                                                 
31                 (10)  persons under 21 years of age not covered under (a) of this section                               
01       who the department has determined cannot be placed for adoption without medical                                   
02       assistance because of a special need for medical or rehabilitative care and who the                               
03       department has determined are hard-to-place children eligible for subsidy under                                   
04       AS 25.23.190 - 25.23.210;                                                                                         
05                 (11)  persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title                                  
06       XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom                              
07       a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title                                  
08       XVI, Social Security Act) because they meet all of the following criteria:                                        
09                      (A)  they are 18 years of age or younger and qualify as disabled                                   
10            individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act);                                       
11                      (B)  the department has determined that                                                            
12                           (i)  they require a level of care provided in a hospital,                                     
13                 nursing facility, or intermediate care facility for the mentally retarded;                              
14                           (ii)  it is appropriate to provide their care outside of an                                   
15                 institution; and                                                                                        
16                           (iii)  the estimated amount that would be spent for                                           
17                 medical assistance for their individual care outside an institution is not                              
18                 greater than the estimated amount that would otherwise be expended                                      
19                 individually for medical assistance within an appropriate institution;                                  
20                      (C)  if they were in a medical institution, they would be eligible                                 
21            for medical assistance under other provisions of this chapter; and                                           
22                      (D)  home and community-based services under a waiver                                              
23            approved by the federal government are either not available to them under this                               
24            chapter or would be inappropriate for them;                                                                  
25                 (12)  disabled persons, as described in 42 U.S.C.                                                       
26       1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under                                  
27       applicable federal regulations or guidelines, is less than 250 percent of the official                            
28       poverty line applicable to a family of that size according to the federal Office of                               
29       Management and Budget, and who, but for earnings in excess of the limit established                               
30       under 42 U.S.C. 1396d(q)(2)(B), would be considered to be individuals with respect to                             
31       whom a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c; a                                 
01       person eligible for assistance under this paragraph who is not eligible under another                             
02       provision of this section shall pay a premium or other cost-sharing charges according                             
03       to a sliding fee scale that is based on income as established by the department in                                
04       regulations;                                                                                                      
05                 (13)  persons under 19 years of age who are not covered under (a) of                                    
06       this section and whose household income does not exceed 200 percent of the federal                            
07       poverty guideline as defined by the federal Office of Management and Budget                                   
08       and revised under 42 U.S.C. 9902(2)                                                                           
09                      [(A)  $1,635 A MONTH IF THE HOUSEHOLD CONSISTS                                                     
10            OF ONE PERSON;                                                                                               
11                      (B)  $2,208 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
12            TWO PERSONS;                                                                                                 
13                      (C)  $2,782 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
14            THREE PERSONS;                                                                                               
15                      (D)  $3,355 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
16            FOUR PERSONS;                                                                                                
17                      (E)  $3,928 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
18            FIVE PERSONS;                                                                                                
19                      (F)  $4,501 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
20            SIX PERSONS;                                                                                                 
21                      (G)  $5,074 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
22            SEVEN PERSONS;                                                                                               
23                      (H)  $5,647 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
24            EIGHT PERSONS;                                                                                               
25                      (I)  $5,647 A MONTH, PLUS AN ADDITIONAL $574 A                                                     
26            MONTH FOR EACH EXTRA PERSON ABOVE EIGHT PERSONS WHO                                                          
27            IS IN THE HOUSEHOLD IF THE HOUSEHOLD CONSISTS OF NINE                                                        
28            PERSONS OR MORE];                                                                                            
29                 (14)  pregnant women who are not covered under (a) of this section and                                  
30       whose household income does not exceed 200 percent of the federal poverty line as                             
31       defined by the federal Office of Management and Budget and revised under 42                                   
01       U.S.C. 9902(2)                                                                                                
02                      [(A)  $2,208 A MONTH IF THE HOUSEHOLD CONSISTS                                                     
03            OF TWO PERSONS;                                                                                              
04                      (B)  $2,782 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
05            THREE PERSONS;                                                                                               
06                      (C)  $3,355 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
07            FOUR PERSONS;                                                                                                
08                      (D)  $3,928 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
09            FIVE PERSONS;                                                                                                
10                      (E)  $4,501 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
11            SIX PERSONS;                                                                                                 
12                      (F)  $5,074 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
13            SEVEN PERSONS;                                                                                               
14                      (G)  $5,647 A MONTH IF THE HOUSEHOLD CONSISTS OF                                                   
15            EIGHT PERSONS;                                                                                               
16                      (H)  $5,647 A MONTH, PLUS AN ADDITIONAL $574 A                                                     
17            MONTH FOR EACH EXTRA PERSON ABOVE EIGHT PERSONS WHO                                                          
18            IS IN THE HOUSEHOLD IF THE HOUSEHOLD CONSISTS OF NINE                                                        
19            PERSONS OR MORE];                                                                                            
20                 (15)  persons who have been diagnosed with breast or cervical cancer                                    
21       and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII).                                     
22    * Sec. 2. AS 47.07.042(d) is amended to read:                                                                      
23            (d)  In addition to the requirements established under (a) and (b) of this section,                          
24       the department may require premiums or cost-sharing contributions from recipients                                 
25       who are eligible for benefits under AS 47.07.020(b)(13) and whose household income                                
26       is between 150 and 200 percent of the federal poverty line [GREATER THAN                                      
27       THE APPLICABLE AMOUNT SET OUT IN (f) OF THIS SECTION]. If the                                                     
28       department requires premiums or cost-sharing contributions under this subsection, the                             
29       department                                                                                                        
30                 (1)  shall adopt in regulation a sliding scale for those premiums or                                    
31       contributions based on household income;                                                                          
01                 (2)  may not exceed the maximums allowed under federal law; and                                         
02                 (3)  shall implement a system by which the department or its designee                                   
03       collects those premiums or contributions.                                                                         
04    * Sec. 3. AS  47.07.042(f) is repealed.                                                                            
05    * Sec. 4. This Act takes effect immediately under AS 01.10.070(c).