SF 2315 (LSB 6851XS (1) 91)

SENATE FILE 2315

BY  GUTH

A BILL FOR

An Act relating to eligibility for the Medicaid for employed persons with disabilities program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 249A.3, subsection 2, paragraph a, subparagraph (1), Code 2026, is amended to read as follows:
   (1)  (a)  As allowed under 42 U.S.C. §1396a(a)(10)(A)(ii)(XIII), individuals with disabilities, who are less than sixty-five years of age, who are members of families whose income is less than two hundred fifty three hundred percent of the most recently revised official poverty guidelines published by the United States department of health and human services for the family, who have earned income and who are eligible for mandatory medical assistance or optional medical assistance under this section if earnings are disregarded. As allowed by 42 U.S.C. §1396a(r)(2), unearned income shall also be disregarded in determining whether an individual is eligible for assistance under this subparagraph. For the purposes of determining the amount of an individual’s resources under this subparagraph and as allowed by 42 U.S.C. §1396a(r)(2), a maximum of ten thousand dollars of available resources for an individual and twenty-one thousand dollars of available resources for a couple shall be disregarded, and any additional resources held in a retirement account, in a pension account, in a medical savings account, or in any other account approved under rules adopted by the department shall also be disregarded.
   (b)  Individuals eligible for assistance under this subparagraph, whose individual income exceeds one hundred fifty percent of the official poverty guidelines published by the United States department of health and human services for an individual, shall pay a premium. The amount of the premium shall be based on a sliding fee schedule adopted by rule of the department and shall be based on a percentage of the individual’s income. The maximum premium payable by an individual whose income exceeds one hundred fifty percent of the official poverty guidelines shall be commensurate with the cost of state employees’ group health insurance in this state. The payment to and acceptance by an automated case management system or the department of the premium required under this subparagraph shall not automatically confer initial or continuing program eligibility on an individual.  The department shall maintain a page on the department’s internet site where individuals can electronically pay any premium owed by an individual to the department. A premium paid to and accepted by the department’s premium payment process that is subsequently determined to be untimely or to have been paid on behalf of an individual ineligible for the program shall be refunded to the remitter in accordance with rules adopted by the department. Any unpaid premium shall be a debt owed to the department.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to eligibility for the Medicaid for employed persons with disabilities program (MEPD).
   Code section 249A.3 sets forth program eligibility criteria for MEPD pursuant to 42 U.S.C. §1396a. The bill amends current eligibility provisions requiring the department to cap premiums for individuals whose income falls below 250 percent of the federal poverty level (FPL), and that any acceptance by the department of the payment of a premium does not automatically confer initial or continuing MEPD eligibility on an individual. Code section 249A.3 also requires HHS to not consider certain assets when determining asset eligibility under MEPD.
   The bill requires that HHS extend MEPD eligibility to those with household incomes up to 300 percent of the FPL. Moneys in a pension fund are not to be considered by HHS for purposes of determining asset eligibility under MEPD. The bill provides that HHS must allow for the electronic payment of MEPD premiums through a page maintained on the department’s internet site.