SPONSOR: Lavender
Beginning January 1, 2020, this bill extends benefits under the MO HealthNet program to individuals age 19 or older, but younger than 65, who are not otherwise eligible for MO HealthNet services, who qualify for MO HealthNet services under the provisions of the Affordable Care Act (ACA) of 2010, and who have income at or below 133% of the federal poverty level plus 5% of the applicable family size.
This bill also provides that the reimbursement rate to MO HealthNet providers for MO HealthNet services provided to individuals qualifying under the provisions of the bill must be comparable to commercial reimbursement payment levels with trend adjustment for comparable services. The higher commercial comparable rates must only apply for services provided to individuals qualifying for services under the bill.
The Department of Social Services must discontinue eligibility for the newly eligible group if the federal medical assistance percentage is less than 90% as specified for 2020 and each year thereafter or an amount determined by the MO HealthNet Oversight Committee to be necessary to maintain state budget solvency, whichever is lower, or by a vote by the General Assembly to discontinue eligibility. The department must inform eligible individuals that their benefits may be reduced or eliminated if federal funding decreases or is eliminated.
The MO HealthNet Oversight Committee must conduct research and investigate any potential health-related savings and revenues associated with expanding eligibility to persons under the bill and determine the feasibility of different options described in these provisions.
This bill is similar to HB 1624, HB 1602, SB 713, and SB 731 (2018) and HB 489 (2017).
Statutes affected: