REPORT TITLE:
Health Services


DESCRIPTION:
Appropriates $1 in FY 2000-2001 for use by the DHS to raise the
income eligibility of the medically needy program to 133% of the
assistance allowance.  (HB3016 HD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        3016
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO MEDICAL ASSISTANCE TO LOW-INCOME PERSONS.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The legislature finds that a significant number
 
 2 of individuals in the State are unable to receive necessary
 
 3 health care services due to overly restrictive federal and state
 
 4 regulations.  Many of these individuals are persons who derive
 
 5 their income solely or largely from Social Security and have
 
 6 terminal, debilitating, or life-threatening illnesses.  Due to
 
 7 these unwieldy regulations, some persons must spend nearly half
 
 8 of their monthly income to qualify for medicaid, while others
 
 9 cannot afford to "spend-down" and therefore must do without
 
10 critical health care, including necessary treatment and services
 
11 for sexually transmitted diseases, AIDS, and family health
 
12 services.
 
13      The legislature recognizes that the concept of spend-down is
 
14 generally related to eligibility for medicaid's medically needy
 
15 program.  However, federal requirements do not allow states to
 
16 defer spend-down requirements.  To do so would cause a state to
 
17 be in noncompliance with federal requirements resulting in the
 
18 withholding of federal funding.  In fact, the medicaid spend-down
 
19 requirements apply to all persons who are eligible under the
 

 
Page 2                                                     3016
                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1 medically needy program, and under federal provisions, exceptions
 
 2 are not allowed for any group of individuals.
 
 3      Under the medicaid program, there is a provision that allows
 
 4 a state to expand coverage to persons who are above the medicaid
 
 5 income level but are low income and deemed "medically needy".
 
 6 Section 346-14, Hawaii Revised Statutes, empowers the department
 
 7 of human services to establish the income eligibility level for
 
 8 the medically needy program at one hundred thirty-three per cent
 
 9 of the assistance allowance, subject to the appropriation of
 
10 state funds and availability of federal matching assistance.  The
 
11 legislature finds that if the income eligibility level for the
 
12 medically needy program were raised, then health care services
 
13 could be expanded to assist those who are deemed medically and
 
14 financially needy.
 
15      The legislature further finds that the federal share of
 
16 matching medicaid funds, currently at 51.01 per cent, will be
 
17 increasing to 53.85 per cent.  This 2.84 per cent increase in the
 
18 federal matching share is a source of funding that can be applied
 
19 directly to assist the medically needy program.
 
20      The purpose of this Act is to provide necessary funds to
 
21 enable the department of human services to raise the income
 
22 eligibility level for the medically needy program.
 

 
 
 
Page 3                                                     3016
                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1      SECTION 2.  There is appropriated out of the general
 
 2 revenues of the State of Hawaii the sum of $1 or so much thereof
 
 3 as may be necessary for fiscal year 2000-2001 to raise the income
 
 4 eligibility of the medically needy program to one hundred thirty-
 
 5 three per cent of the assistance allowance.
 
 6      SECTION 3.  The sum appropriated shall be expended by the
 
 7 department of human services for the purposes of this Act.
 
 8      SECTION 4.  This Act shall take effect on July 1, 2000.