Bill Text: IA SF220 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act relating to a hawk-i program purchase option, and including effective date and contingent implementation provisions.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2021-02-08 - Subcommittee: Costello, Edler, and Trone Garriott. S.J. 275. [SF220 Detail]
Download: Iowa-2021-SF220-Introduced.html
Senate
File
220
-
Introduced
SENATE
FILE
220
BY
PETERSEN
A
BILL
FOR
An
Act
relating
to
a
hawk-i
program
purchase
option,
and
1
including
effective
date
and
contingent
implementation
2
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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Section
1.
HAWK-I
PROGRAM
PURCHASE
OPTION.
1
1.
The
director
of
the
department
of
human
services
shall
2
seek
necessary
federal
waiver
authority
to
do
all
of
the
3
following:
4
a.
Establish
a
program
that
allows
individuals
with
incomes
5
above
the
maximum
income
eligibility
limit
pursuant
to
section
6
514I.8,
and
who
otherwise
meet
the
hawk-i
program
eligibility
7
requirements
pursuant
to
section
514I.8
with
the
exception
8
of
age,
the
option
of
purchasing
coverage
through
the
hawk-i
9
program
rather
than
purchasing
a
qualified
health
plan
through
10
the
health
insurance
marketplace
established
pursuant
to
the
11
federal
Patient
Protection
and
Affordable
Care
Act,
or
an
12
individual
health
plan
offered
outside
of
the
health
insurance
13
marketplace.
14
b.
To
allow
individuals
who
qualify
under
paragraph
“a”
who
15
choose
to
purchase
coverage
through
the
hawk-i
program
to
use
16
advanced
tax
credits
and
cost-sharing
credits,
if
eligible,
to
17
purchase
this
option.
18
c.
To
permit
the
hawk-i
program
purchase
option
to
be
19
offered
through
the
health
insurance
marketplace
as
a
coverage
20
option
and
to
be
compared
with
qualified
health
plans
offered
21
through
the
health
insurance
marketplace.
22
d.
Notwithstanding
the
eligibility
criterion
that
a
child
23
must
be
less
than
nineteen
years
of
age,
allow
the
hawk-i
24
purchase
option
to
be
offered
to
a
child
up
to
twenty-six
years
25
of
age.
26
2.
The
director
of
the
department
of
human
services
shall
27
coordinate
the
administration
of
the
hawk-i
program
with
28
the
hawk-i
program
purchase
option
to
maximize
efficiencies
29
and
improve
the
continuity
of
care
for
eligible
children
30
consistent
with
chapter
514I.
The
director
shall
implement
31
mechanisms
to
ensure
the
long-term
financial
sustainability
of
32
the
hawk-i
program
and
mitigate
any
adverse
financial
impacts
33
to
the
health
insurance
marketplace.
These
mechanisms
shall
34
address
issues
related
to
minimizing
adverse
selection,
the
35
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state
financial
risk
and
contribution,
and
negative
impacts
1
to
premiums
in
the
individual
and
group
insurance
market
both
2
inside
and
outside
of
the
health
insurance
marketplace.
At
a
3
minimum,
the
hawk-i
purchase
option
shall
include
all
of
the
4
following:
5
a.
Establishment
of
an
annual
per
enrollee
premium
rate
6
similar
to
the
average
rate
paid
by
the
state
to
managed
care
7
plan
contractors
under
the
hawk-i
program.
8
b.
Establishment
of
a
benefit
set
equal
to
the
benefits
9
covered
under
the
hawk-i
program.
10
c.
Establishment
of
annual
open
enrollment
periods
11
consistent
with
those
for
the
hawk-i
program.
12
d.
The
ability
of
the
director
to
adjust
the
purchase
13
option’s
actuarial
value
to
a
value
no
lower
than
eighty-seven
14
percent.
15
e.
Reimbursement
mechanisms
to
address
potential
reductions
16
in
funding
for
health
insurance
marketplace
operations.
17
f.
Reimbursement
mechanisms
to
address
potential
increased
18
costs
to
the
hawk-i
program.
19
3.
The
director
of
the
department
of
human
services
in
20
collaboration
with
the
commissioner
of
insurance
shall
report
21
to
the
chairpersons
and
ranking
members
of
the
human
resources
22
committees
and
the
joint
appropriations
subcommittee
on
health
23
and
human
services
by
September
1,
2021,
on
the
progress
of
the
24
federal
waivers
and
the
results
from
actuarial
and
economic
25
analyses
that
are
necessary
for
a
waiver
proposal.
The
report
26
shall
also
include
recommendations
regarding
any
statutory
or
27
administrative
rule
changes
necessary
to
implement
the
program.
28
Sec.
2.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
29
importance,
takes
effect
upon
enactment.
30
Sec.
3.
CONTINGENT
IMPLEMENTATION.
Implementation
of
any
31
waiver
provision
that
requires
a
state
financial
contribution
32
shall
be
contingent
on
further
legislative
action
to
approve
33
the
state’s
contribution.
34
EXPLANATION
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The
inclusion
of
this
explanation
does
not
constitute
agreement
with
1
the
explanation’s
substance
by
the
members
of
the
general
assembly.
2
This
bill
directs
the
director
of
human
services
to
seek
3
necessary
federal
waiver
authority
to:
establish
a
program
4
that
allows
individuals
with
incomes
above
the
maximum
income
5
eligibility
limit
under
the
hawk-i
program
(currently
300
6
percent
of
the
federal
poverty
level),
and
who
otherwise
meet
7
the
hawk-i
program
eligibility
requirements
(with
the
exception
8
of
the
age
limitation
of
less
than
19
years
of
age),
the
9
option
of
purchasing
coverage
for
a
child
through
the
hawk-i
10
program
rather
than
purchasing
a
qualified
health
plan
through
11
the
health
insurance
marketplace
established
pursuant
to
the
12
federal
Patient
Protection
and
Affordable
Care
Act,
or
an
13
individual
health
plan
offered
outside
of
the
health
insurance
14
marketplace;
to
allow
individuals
who
qualify
and
choose
to
15
purchase
coverage
through
the
hawk-i
program
to
use
advanced
16
tax
credits
and
cost-sharing
credits,
if
eligible,
to
purchase
17
the
option;
to
permit
the
hawk-i
program
purchase
option
to
be
18
offered
through
the
health
insurance
marketplace
as
a
coverage
19
option
and
to
be
compared
with
qualified
health
plans
offered
20
through
the
health
insurance
marketplace;
and
notwithstanding
21
the
eligibility
criterion
that
a
child
must
be
less
than
19
22
years
of
age,
allow
the
hawk-i
purchase
option
to
be
offered
to
23
a
child
up
to
26
years
of
age.
24
The
bill
directs
the
director
of
the
department
of
human
25
services
to
coordinate
the
administration
of
the
hawk-i
26
program
with
the
hawk-i
program
purchase
option
to
maximize
27
efficiencies
and
improve
the
continuity
of
care
for
eligible
28
children;
and
to
implement
mechanisms
to
ensure
the
long-term
29
financial
sustainability
of
the
hawk-i
program
and
mitigate
any
30
adverse
financial
impacts
to
the
health
insurance
marketplace.
31
The
mechanisms
are
to
address
issues
related
to
minimizing
32
adverse
selection,
the
state
financial
risk
and
contribution,
33
and
negative
impacts
to
premiums
in
the
individual
and
34
group
insurance
market
both
inside
and
outside
of
the
health
35
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insurance
marketplace.
1
At
a
minimum,
the
hawk-i
purchase
option
must
include:
2
establishment
of
an
annual
per
enrollee
premium
rate
similar
3
to
the
average
rate
paid
by
the
state
to
managed
care
plan
4
contractors
under
the
hawk-i
program;
establishment
of
a
5
benefit
set
equal
to
the
benefits
covered
under
the
hawk-i
6
program;
establishment
of
annual
open
enrollment
periods
7
consistent
with
those
for
the
hawk-i
program;
the
ability
of
8
the
director
of
the
department
of
human
services
to
adjust
the
9
purchase
option’s
actuarial
value
to
a
value
no
lower
than
10
87
percent;
reimbursement
mechanisms
to
address
potential
11
reductions
in
funding
for
health
insurance
marketplace
12
operations;
and
reimbursement
mechanisms
to
address
potential
13
increased
costs
to
the
hawk-i
program.
14
The
director
of
the
department
of
human
services
in
15
collaboration
with
the
commissioner
of
insurance
shall
report
16
to
the
chairpersons
and
ranking
members
of
the
house
and
17
senate
human
resources
committees
and
the
joint
appropriations
18
subcommittee
on
health
and
human
services
by
September
1,
19
2021,
on
the
progress
of
the
federal
waivers
and
the
results
20
from
actuarial
and
economic
analyses
that
are
necessary
for
a
21
waiver
proposal.
The
report
shall
also
include
recommendations
22
regarding
any
statutory
or
administrative
rule
changes
23
necessary
to
implement
the
program.
24
The
bill
takes
effect
upon
enactment.
Implementation
of
any
25
waiver
provision
that
requires
a
state
financial
contribution
26
is
contingent
on
further
legislative
action
to
approve
the
27
state’s
contribution.
28
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