HOUSE OF REPRESENTATIVES

H.B. NO.

760

TWENTY-SIXTH LEGISLATURE, 2011

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to persons with disabilities.

 

 

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

 


     SECTION 1.  The legislature finds that working-age adults with disabilities need adequate health insurance, but their options for insurance coverage are limited, even with the federal Affordable Care Act.  Many who have part-time jobs may not be covered through their employer prepaid health care insurance or employer-sponsored health insurance, which forces them to turn to government-sponsored programs, such as medicaid.  However, those who earn more than the allowable amount will be ineligible for medicaid coverage, especially those who receive unearned income who have not paid into private or public disability insurance programs such as social security disability insurance.

     The medicaid buy-in programs, enabled by the federal Balanced Budget Act of 1997 and the federal Ticket to Work and Work Incentives Improvement Act of 1999, allow working adults with disabilities, who do not have employer prepaid or employer-sponsored health care coverage or who earn more than the allowable ceiling, to obtain medicaid coverage.  The medicaid buy-in programs also help persons who need secondary coverage through medicaid, including persons with medicare.  In return, recipients "buy into" the medicaid program, typically by paying premiums based on income.  As of December 31, 2008, forty-two states were operating a medicaid buy-in program to extend medicaid coverage to working people with disabilities, with total nationwide enrollment of more than ninety thousand persons.

     The purpose of this Act is to:

     (1)  Establish a medicaid buy-in program for working people with disabilities; and

     (2)  Allow the president of the senate and the speaker of the house of representatives to establish from time to time, a medicaid shortfall joint legislative task force to examine issues relating to medicaid shortfalls, including the medicaid buy-in program for working people with disabilities.

     SECTION 2.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§346‑    Program to provide medical assistance to certain persons who are employed and have a disability.  (a)  There is established within the department a medicaid buy-in program for working people with disabilities.  The purpose of the medicaid buy-in program for working people with disabilities is to furnish health care services to certain persons who are employed and have disabilities.

     (b)  To qualify for the medicaid buy-in program for working people with disabilities, the recipient shall be required to:

     (1)  Be a resident of the State;

     (2)  Be at least sixteen years of age;

     (3)  Have a disability as defined by the Social Security Administration; provided that the income and resource requirements of the program are met;

     (4)  Be engaged in paid work, including part-time and full‑time work;

     (5)  Have a gross income that does not exceed four hundred per cent of the federal poverty level for an individual or a couple using the Social Security Administration's counting method and as determined by the department pursuant to administrative rules; and

     (6)  Have non-exempt resources that do not exceed $20,000 for an individual or $40,000 for a couple.

     (c)  The department shall establish the medicaid buy-in program for working people with disabilities by:

     (1)  Amending the state plan in the manner set forth in Title 42 United States Code Section 1396a (a)(10)(A)(ii)(XIII) or Title 42 United States Code Section 1396a (a)(10)(A)(ii)(XV); and

     (2)  Amending the section 1115 medicaid waiver for the QUEST expanded access managed care program from the federal government to carry out the medicaid buy-in program for working people with disabilities.

     (d)  The department may require a recipient participating in the medicaid buy-in program for working people with disabilities to pay a premium or other cost-sharing charges in a manner that is consistent with federal law.

     (e)  For purposes of this section, "medicaid buy-in" refers to an offer of health care services coverage to persons with disabilities who are working and earning more than the allowable limits under regular medicaid, for the purpose of providing an opportunity to have health care coverage through medicaid.

     (f)  The department shall adopt rules pursuant to chapter 91 necessary for purposes of this section."

     SECTION 3.  The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"CHAPTER      

JOINT LEGISLATIVE TASK FORCE ON MEDICAID

     §   ‑1  Joint legislative task force on medicaid; authority to establish.  The president of the senate and the speaker of the house of representatives may, from time to time, establish a medicaid shortfall joint legislative task force to examine issues relating to medicaid shortfalls, including the medicaid buy-in program for working people with disabilities.  The chairs of the committee on human services of the respective houses of the legislature shall co-chair the task force.  Legislative members of the committee on human services of the respective houses of the legislature shall be members of the task force.  The task force may conduct meetings, briefings, and hearings, as appropriate, and recommend legislation pursuant thereto."

     SECTION 4.  There is appropriated out of the general revenues of the State of Hawaii the sum of $3,100,000 or so much thereof as may be necessary for fiscal year 2011-2012 and the same sum or so much thereof as may be necessary for fiscal year 2012-2013 for the employment training and placement program as the state's share of funding to be matched by federal funds received pursuant to medicaid buy-in; provided that $500,000 per annum shall be provided by the University of Hawaii for administration and setup under the direction of the department of human services.

     The sums appropriated shall be expended by the department of human services for the purposes of this Act.

     SECTION 5.  New statutory material is underscored.

     SECTION 6.  This Act shall take effect upon its approval; provided that section 4 shall take effect on July 1, 2011.

 

INTRODUCED BY:

_____________________________

 

 


 


 

 

Report Title:

Medicaid; Persons with Disabilities; Appropriation

 

Description:

Establishes a medicaid buy-in program for working people with disabilities.  Allows the formation of a medicaid shortfall joint legislative task force to examine issues relating to medicaid shortfalls.  Makes matching fund appropriation for employment training and placement.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.