Legislature(2023 - 2024)ADAMS 519
04/30/2024 09:00 AM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB260 | |
| HB307 | |
| HB122 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 260 | TELECONFERENCED | |
| += | HB 307 | TELECONFERENCED | |
| += | HB 122 | TELECONFERENCED | |
HOUSE BILL NO. 260
"An Act repealing programs for catastrophic illness
assistance and medical assistance for chronic and
acute medical conditions."
9:07:03 AM
Representative Stapp introduced himself as the sponsor of
HB 260 and invited his staff to offer a brief overview.
HONOUR MILLER-AUSTIN, STAFF, REPRESENTATIVE WILL STAPP,
introduced herself and reviewed the bill. She explained
that HB 260 would repeal the program for Catastrophic
Illness and Medical Assistance (CAMA) for chronic and acute
medical conditions. The program would be removed from the
Division of Public Assistance (DPA) and be repealed from
statute.
Co-Chair Johnson noted that she was pleased to see a
decrease in the fiscal note.
9:08:55 AM
RENEE GAYHART, DIRECTOR, DIVISION OF HEALTH CARE SERVICES,
DEPARTMENT OF HEALTH, reviewed the fiscal impact note with
control code nrZLx [FN2] from the Department of Health
(DOH). She confirmed that the fiscal note indicated that
the state would save money if the bill were to pass and
CAMA were to be repealed.
Representative Josephson asked if the bill could result in
individuals ceasing to receive coverage from Medicaid or
the Affordable Care Act (ACA).
9:09:50 AM
DEB ETHERIDGE, DIRECTOR, DIVISION OF PUBLIC HEALTH,
DEPARTMENT OF HEALTH, responded that the individuals who
utilized CAMA were immigrants who had a five-year waiting
period for Medicaid; however, benefits were offered through
the federally facilitated marketplace. If an individual was
denied a benefit and was in the five-year waiting period, a
referral would automatically be made to the federally
facilitated marketplace and the individual's application
would be processed by the marketplace.
Representative Josephson understood that there could be
instances where both circumstances could be true, and an
individual could be ineligible for both Medicaid and the
ACA.
Ms. Etheridge responded that if there was an individual who
was eligible to access the narrow scope of benefits through
CAMA, it was likely to be on a secondary payer source. She
shared that no one had been receiving benefits through CAMA
and there had been no payments for the last few years, but
it was difficult to predict the future. The benefits were
generally available through the federally facilitated
marketplace.
Representative Josephson understood that ACA should be
affordable by definition. He asked how out-of-pocket
payments worked under the various programs.
Ms. Etheridge responded that individuals would qualify for
premium tax credits through the marketplace and ACA plans.
She was not an expert on the insurance plans offered
through the marketplace and thought the question would be
better posed to someone with more expertise.
9:12:28 AM
Representative Stapp responded that the answer was that
eligibility was income-based. As income decreased,
eligibility for premium tax credits increased. He clarified
that insurance payments were lower for individuals who made
less money.
Representative Hannan asked about the savings in the fiscal
note. She asked if the savings were due to staffing
reductions alone or if savings also resulted from the
eradication of application reviews.
Ms. Gayhart responded that the full $153,900 savings
indicated in the fiscal note included services and did not
include staffing costs.
Representative Hannan asked whether it was anticipated that
it would cost $153,900 to provide services to the
individuals who were currently receiving services through
CAMA.
Ms. Gayhart responded that the figure represented the
amount that had been carried over since Medicaid expansion
started in 2016.
Representative Hannan asked if it was carryover because
Medicaid was not expanded or whether it was simply the
amount that was typically allocated in the budget.
Ms. Gayhart responded that it was the dollar amount that
was anticipated to be the average after expansion, knowing
that the bulk of the population would receive services
through the federal marketplace. The funding had been in
place since expansion in 2016.
Representative Stapp understood that it was the money
included in grants and benefits and was budgeted for every
year. The audited actuals showed that the money lapsed
every year.
9:15:24 AM
Ms. Etheridge reviewed the zero fiscal impact note from DOH
with control code YuxUQ [FN1]. The costs to repeal CAMA
could easily be absorbed by the Division of Public Health
(DPH). She explained that the division would shut off
portions of the program in the eligibility system and the
option to apply for CAMA would be removed from the
applications. Any references in DPH manuals would also be
removed.
Representative Hannan highlighted that the fiscal note
specified that CAMA could be used as a last resort for
people who experienced chronic conditions and the program
was utilized particularly by seasonal workers. She asked
for more information on the potential usage of CAMA. She
understood that seasonal workers would not receive a full
year of coverage. She noted that the state had many
seasonal workers in the fishing industry and tourism
industry.
Md. Etheridge responded that the limited scope of
eligibility was for immigrants with a five-year waiting
period for Medicaid. The scope of service was limited to
specific diagnoses and specific outpatient services. A
seasonal worker could potentially apply for the CAMA
program, but could also be eligible for a marketplace
insurance benefit. She understood that there was a special
enrollment period that allowed eligible individuals to
apply at any time and not only during open enrollment.
Representative Stapp understood that if an individual were
to become unemployed and lose healthcare coverage, the
individual could still enroll in the marketplace during a
special enrollment period.
Representative Hannan asked for a few examples of the
specific diagnoses of the CAMA program.
Ms. Etheridge responded that covered under CAMA were people
with terminal illnesses, cancer requiring chemotherapy,
chronic diabetes or diabetes encephalitis, chronic seizure
disorder, chronic mental illness, and chronic hypertension.
9:19:40 AM
Representative Galvin understood that immigrants had a
five-year waiting period for Medicaid. She asked if an
individual waiting for Medicaid eligibility who developed
cancer would still be eligible for ACA.
Ms. Etheridge responded that individuals would be eligible
for an option under ACA or the federally facilitated
marketplace.
Representative Galvin understood that immigrants could
apply through the special enrollment period and receive
immediate coverage.
Ms. Etheridge replied that an individual would be eligible
to receive coverage on the first day of the next month
following the application.
9:21:44 AM
Co-Chair Johnson MOVED to REPORT HB 260 out of committee
with individual recommendations and the accompanying fiscal
notes.
There being no objection, it was so ordered.
HB 260 was REPORTED out of committee with seven "do pass"
recommendations and three "no recommendation"
recommendations and with one previously published fiscal
impact note: FN2 (DOH); and one previously published zero
fiscal impact note: FN1 (DOH).
9:22:27 AM
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 122 Public Testimony Rec'd by 042924.pdf |
HFIN 4/30/2024 9:00:00 AM |
HB 122 |
| HB 307 Public Testimony Rec'd by 043029.pdf |
HFIN 4/30/2024 9:00:00 AM |
HB 307 |