Expansion of Public Programs

1. Expand Medicaid to all individuals (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% FPL. Newly eligible, non- traditional (childless adults)

2. Medicaid beneficiaries may enroll in coverage through the Exchange if they were enrolled in qualified health coverage during the six months before becoming Medicaid eligible.

3. Provide Medicaid coverage for all newborns who lack acceptable coverage and provide optional Medicaid coverage to low-income HIV-infected individuals and for family planning services to certain low-income women. In
addition, increase Medicaid payment rates for primary care providers to 100% of Medicare rates. [E&C Committee amendment: Require states to submit a state plan amendment specifying the payment rates to be paid under the state’s Medicaid program.]

4. The coverage expansions (except the optional expansions) and the enhanced provider payments will
be fully financed with federal funds. [E&C
Committee amendment: Replace full federal financing for Medicaid coverage expansions with 100% federal financing through 2014 and 90% federal financing beginning in year 2015.]

5. Require Children’s Health Insurance Program (CHIP) enrollees to obtain coverage through the Health Insurance Exchange (in the first year the Exchange is available) provided the Health Choices Commissioner determines that the Exchange has the capacity to cover these children and that procedures are in place to
ensure the timely transition of CHIP enrollees into the Exchange without an interruption of coverage. [E&C Committee amendment: Require that CHIP enrollees not be enrolled in an Exchange plan until the Secretary certifies that coverage is at least comparable to coverage under an average CHIP plan in effect in 2011. The Secretary must also determine that there are procedures to transfer CHIP enrollees into the exchange without interrupting coverage or with a written plan of treatment.]

Kennadi Lower