Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 446 Third Substitute (2015GS)

Sponsor

Rep. Dunnigan, J.

Final action

House/ filed 3/12/2015

Outcome

Failed / filed without passage

Summary

What it does

• This bill:
• defines terms;
• instructs the Department of Health to apply for a waiver from federal statutory and regulatory law to:
• extend coverage under the primary care network to adults below 100% of the federal poverty level;
• extend traditional Medicaid benefits to certain adults without a dependent child;
• extend traditional Medicaid benefits to certain adults with a dependent child; and
• provide financial sustainability for the waiver by permitting the state to adjust the percentage of poverty level covered, either up or down, based on program costs and the state budget; and
• instructs the Department of Health to continue negotiations with the federal government to obtain greater flexibility for any future Medicaid expansion.

Every vote on this bill

Bill text

EXTENSION OF PRIMARY CARE NETWORK AND
MEDICAID BENEFITS UNDER EXISTING 70/30
FEDERAL/STATE COST SHARING AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: James A. Dunnigan
Senate Sponsor: 
 Brian E. Shiozawa
LONG TITLE
General Description:
This bill authorizes the extension of primary care network benefits to adults under
100% of the federal poverty level and extension of traditional Medicaid benefits to
certain adults without a dependent child and certain adults with a dependent child.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ instructs the Department of Health to apply for a waiver from federal statutory and
regulatory law to:
• extend coverage under the primary care network to adults below 100% of the
federal poverty level;
• extend traditional Medicaid benefits to certain adults without a dependent child;
• extend traditional Medicaid benefits to certain adults with a dependent child;
and
• provide financial sustainability for the waiver by permitting the state to adjust
the percentage of poverty level covered, either up or down, based on program
costs and the state budget; and
▸ instructs the Department of Health to continue negotiations with the federal
government to obtain greater flexibility for any future Medicaid expansion.
Money Appropriated in this Bill:
This bill appropriates:
▸ for fiscal years 2014-2015 and 2015-2016, ongoing:
• funding for the primary care network expansion and the coverage for certain
adults in the traditional Medicaid program, including estimated woodwork
effect.
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-18-18
, as enacted by Laws of Utah 2013, Chapter 477
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-18-18
 is amended to read:
26-18-18.
Optional Medicaid expansion.
(1) For purposes of this section
:
(a) "Adult expansion population" means individuals who:
(i) are described in 42 U.S.C. Sec. 1396a(10)(A)(i)(VIII); and
(ii) are not otherwise eligible for Medicaid as mandatory categorically needy
individuals.
(b) "
PPACA
"
 [
is as
] 
means the same as that term is
 defined in Section 
31A-1-301
.
(2) The department and the governor shall not expand the state's Medicaid program to
the [
optional
] 
adult expansion
 population under PPACA unless:
[
(a) the Health Reform Task Force has completed a thorough analysis of a statewide
charity care system;
]
[
(b) the department and its contractors have:
]
[
(i) completed a thorough analysis of the impact to the state of expanding the state's
Medicaid program to optional populations under PPACA; and
]
[
(ii) made the analysis conducted under Subsection (2)(b)(i) available to the public;
]
[
(c) the governor or the governor's designee has reported the intention to expand the
state Medicaid program under PPACA to the Legislature in compliance with the legislative
review process in Sections 
63M-1-2505.5
 and 
26-18-3
; and
]
(a) the department implements a program for the adult expansion population in
accordance with Subsections (3) and (4); or
[
(d)
] 
(b)
 notwithstanding Subsection 
63J-5-103
(2), the governor submits the request
for expansion of the Medicaid program for [
optional
] 
the adult expansion
 populations to the
Legislature under the high impact federal funds request process required by Section 
63J-5-204
,
Legislative review and approval of certain federal funds request.
(3) The department shall amend the state Medicaid plan and obtain from the Centers
for Medicare and Medicaid Services within the United States Department of Health and
Human Services waivers from federal statutory and regulatory law necessary to implement a
plan to extend Medicaid services to an individual in the adult expansion population, within
appropriations from the Legislature:
(a) if the individual is:
(i) a childless adult who is at or below a percentage of the federal poverty level:
(A) that is designated by the department;
(B) which may not exceed 33% of the federal poverty level; and
(C) that is specifically funded for this program in the fiscal year; or
(ii) an adult who has a dependent child and is at or below a percentage of the federal
poverty level:
(A) that is designated by the department;
(B) which may not exceed 64% of the federal poverty level; and
(C) that is specifically funded for this program in the fiscal year; and
(b) if the Medicaid program is permitted to adjust the percentage of the federal poverty
level designated under Subsection (3)(a)(i) or (ii), either up or down, as necessary to respond to
the adult expansion population program costs and the state budget.
(4) The department shall request a waiver from the Centers for Medicare and Medicaid
Services within the United States Department of Health and Human Services from federal
statutory and regulatory law necessary to amend the state Medicaid plan to continue the state's
primary care network for adults who:
(a) are not covered under Subsection (3)(a);
(b) are below 100% of the federal poverty level; and
(c) can be covered in the primary care network within appropriations from the
Legislature.
(5) (a) If the department obtains waivers under Subsection (3), the department shall
amend the state Medicaid plan and implement the Medicaid program in accordance with the
waivers under Subsection (3).
(b) If the department obtains waivers under Subsections (3) and (4), the department
shall amend the state Medicaid plan and implement the Medicaid program in accordance with
the waivers under Subsections (3) and (4).
(c) The department may not implement a waiver under Subsection (4) without also
implementing a waiver under Subsection (3).
(6) The department shall:
(a) continue to negotiate with the Centers for Medicare and Medicaid Services for
additional waivers from federal statutory and regulatory law necessary to implement a plan
with additional state flexibility and increased federal match rates;
(b) comply with the reporting and the legislative approval process required by
Subsection (2)(b) before expanding Medicaid to any portion of the adult expansion population
that differs from the provisions of Subsections (3) and (4); and
(c) annually report to the Legislature's Health Reform Task Force, on or before
November interim day, regarding the enrollment in the Medicaid program, the primary care
network program and costs to the state for each of the programs.
Section 2. 
Appropriation.
Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, for
the fiscal year beginning July 1, 2014 and ending June 30, 2015, the following sums of money
are appropriated from resources not otherwise appropriated, or reduced from amounts
previously appropriated, out of the funds or accounts indicated. These sums of money are in
addition to any amounts previously appropriated for fiscal year 2015.
To Department of Health - Medicaid and Health Financing
From General Fund, One-time
$93,000
From Federal Funds
$128,000
Schedule of Programs:
Director's Office $221,000
To Department of Health - Medicaid Mandatory Services
From General Fund, One-time
$50,000
From Federal Funds
$450,000
Schedule of Programs:
Medicaid Management Information
System Replacement $500,000
Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, for
the fiscal year beginning July 1, 2015 and ending June 30, 2016, the following sums of money
are appropriated from resources not otherwise appropriated, or reduced from amounts
previously appropriated, out of the funds or accounts indicated. These are additions to any
amounts previously appropriated for fiscal year 2016.
To Department of Human Services - Substance Abuse and Mental Health
From General Fund
($2,000,000)
Schedule of Programs:
Mental Health Centers ($78,600)
Local Substance Abuse Services ($1,921,400)
To Department of Health - Medicaid and Health Financing
From General Fund
$323,000
From Federal Funds
$480,500
Schedule of Programs:
Director's Office $803,500
To Department of Health - Medicaid Optional Services
From General Fund
$23,000,000
From Federal Funds
$53,000,000
Schedule of Programs:
Other Optional Services $76,000,000
To Utah Department of Corrections - Department of Medical Services
From General Fund
($1,000,000)
Schedule of Programs:
Medical Services ($1,000,000)
To Department of Workforce Services - Operations and Policy
From General Fund
$1,633,200
From General Fund, One-time
$15,200
From Federal Funds
$1,770,300
Schedule of Programs:
Eligibility Services $3,266,400
Information Technology $152,300
To Department of Health - Mandatory Services
From General Fund
$10,000,000
From General Fund, One-time
$100,000
From Federal Funds
$27,900,000
Schedule of Programs:
Other Mandatory Services $37,000,000
Medicaid Management Information
Systems Replacement $1,000,000
Legislative Review Note
 as of 3-3-15 8:56 AM
Office of Legislative Research and General Counsel