Bill Text: IA SF63 | 2023-2024 | 90th 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 16-0)
Status: (Introduced) 2023-01-17 - Subcommittee: Edler, Costello, and Petersen. S.J. 143. [SF63 Detail]
Download: Iowa-2023-SF63-Introduced.html
Senate
File
63
-
Introduced
SENATE
FILE
63
BY
PETERSEN
,
WEINER
,
CELSI
,
BOULTON
,
DOTZLER
,
JOCHUM
,
QUIRMBACH
,
T.
TAYLOR
,
DONAHUE
,
KNOX
,
BENNETT
,
TRONE
GARRIOTT
,
WINCKLER
,
GIDDENS
,
BISIGNANO
,
and
WAHLS
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
health
and
human
2
services
shall
seek
necessary
federal
waiver
authority
to
do
3
all
of
the
following:
4
a.
To
establish
a
program
that
allows
individuals
who
meet
5
either
of
the
following
conditions
the
option
of
purchasing
6
coverage
through
the
hawk-i
program
rather
than
purchasing
a
7
qualified
health
plan
through
the
health
insurance
marketplace
8
established
pursuant
to
the
federal
Patient
Protection
and
9
Affordable
Care
Act,
or
an
individual
health
plan
offered
10
outside
of
the
health
insurance
marketplace:
11
(1)
Individuals
with
incomes
above
the
maximum
income
12
eligibility
limit
pursuant
to
section
514I.8,
who
otherwise
13
meet
the
hawk-i
program
eligibility
requirements
pursuant
to
14
section
514I.8
with
the
exception
of
age.
15
(2)
Pregnant
individuals
who
meet
the
age
requirements
for
16
the
hawk-i
program
pursuant
to
section
514I.8,
regardless
of
17
whether
the
individual’s
family
income
meets
the
maximum
income
18
eligibility
limit
pursuant
to
section
514I.8.
19
b.
To
allow
individuals
who
qualify
under
paragraph
“a”
who
20
choose
to
purchase
coverage
through
the
hawk-i
program
to
use
21
advanced
tax
credits
and
cost-sharing
credits,
if
eligible,
to
22
purchase
this
option.
23
c.
To
permit
the
hawk-i
program
purchase
option
to
be
24
offered
through
the
health
insurance
marketplace
as
a
coverage
25
option
and
to
be
compared
with
qualified
health
plans
offered
26
through
the
health
insurance
marketplace.
27
d.
Notwithstanding
the
eligibility
criterion
that
a
child
28
must
be
less
than
nineteen
years
of
age
pursuant
to
paragraph
29
“a”,
subparagraph
(1),
allow
the
hawk-i
purchase
option
to
be
30
offered
to
a
child
up
to
twenty-six
years
of
age.
31
2.
The
director
of
health
and
human
services
shall
32
coordinate
the
administration
of
the
hawk-i
program
with
33
the
hawk-i
program
purchase
option
to
maximize
efficiencies
34
and
improve
the
continuity
of
care
for
eligible
children
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consistent
with
chapter
514I.
The
director
shall
implement
1
mechanisms
to
ensure
the
long-term
financial
sustainability
of
2
the
hawk-i
program
and
mitigate
any
adverse
financial
impacts
3
to
the
health
insurance
marketplace.
These
mechanisms
shall
4
address
issues
related
to
minimizing
adverse
selection,
the
5
state
financial
risk
and
contribution,
and
negative
impacts
6
to
premiums
in
the
individual
and
group
insurance
market
both
7
inside
and
outside
of
the
health
insurance
marketplace.
At
a
8
minimum,
the
hawk-i
purchase
option
shall
include
all
of
the
9
following:
10
a.
Establishment
of
an
annual
per
enrollee
premium
rate
11
similar
to
the
average
rate
paid
by
the
state
to
managed
care
12
plan
contractors
under
the
hawk-i
program.
13
b.
Establishment
of
a
benefit
set
equal
to
the
benefits
14
covered
under
the
hawk-i
program.
15
c.
Establishment
of
annual
open
enrollment
periods
16
consistent
with
those
for
the
hawk-i
program.
17
d.
The
ability
of
the
director
to
adjust
the
purchase
18
option’s
actuarial
value
to
a
value
no
lower
than
eighty-seven
19
percent.
20
e.
Reimbursement
mechanisms
to
address
potential
reductions
21
in
funding
for
health
insurance
marketplace
operations.
22
f.
Reimbursement
mechanisms
to
address
potential
increased
23
costs
to
the
hawk-i
program.
24
3.
The
director
of
the
department
of
health
and
human
25
services
in
collaboration
with
the
commissioner
of
insurance
26
shall
report
to
the
chairpersons
and
ranking
members
of
27
the
health
and
human
services
committees
and
the
joint
28
appropriations
subcommittee
on
health
and
human
services
by
29
September
1,
2023,
on
the
progress
of
the
federal
waivers
and
30
the
results
from
actuarial
and
economic
analyses
that
are
31
necessary
for
a
waiver
proposal.
The
report
shall
also
include
32
recommendations
regarding
any
statutory
or
administrative
rule
33
changes
necessary
to
implement
the
program.
34
Sec.
2.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
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importance,
takes
effect
upon
enactment.
1
Sec.
3.
CONTINGENT
IMPLEMENTATION.
Implementation
of
any
2
waiver
provision
that
requires
a
state
financial
contribution
3
shall
be
contingent
on
further
legislative
action
to
approve
4
the
state’s
contribution.
5
EXPLANATION
6
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
7
the
explanation’s
substance
by
the
members
of
the
general
assembly.
8
This
bill
directs
the
director
of
health
and
human
services
9
to
seek
necessary
federal
waiver
authority
to
establish
10
a
program
that
allows
individuals
who
meet
either
of
two
11
criteria
the
option
of
purchasing
coverage
through
the
12
hawk-i
program.
The
two
criteria
are:
individuals
with
13
incomes
above
the
maximum
income
eligibility
limit
under
the
14
hawk-i
program
(currently
300
percent
of
the
federal
poverty
15
level),
and
who
otherwise
meet
the
hawk-i
program
eligibility
16
requirements
(with
the
exception
of
the
age
limitation
of
17
less
than
19
years
of
age);
or
pregnant
individuals
who
met
18
the
age
requirement
(less
than
19
years
of
age)
regardless
of
19
whether
the
individual’s
family
income
meets
the
maximum
income
20
eligibility
limit
under
the
program.
The
option
would
also
21
allow
individuals
who
qualify
and
choose
to
purchase
coverage
22
through
the
hawk-i
program
to
use
advanced
tax
credits
and
23
cost-sharing
credits,
if
eligible,
to
purchase
the
option;
to
24
permit
the
hawk-i
program
purchase
option
to
be
offered
through
25
the
health
insurance
marketplace
as
a
coverage
option
and
to
be
26
compared
with
qualified
health
plans
offered
through
the
health
27
insurance
marketplace;
and
notwithstanding
the
eligibility
28
criterion
that
a
child
must
be
less
than
19
years
of
age
under
29
the
first
specified
criterion,
allow
the
hawk-i
purchase
option
30
to
be
offered
to
a
child
up
to
26
years
of
age.
31
The
bill
directs
the
director
of
health
and
human
services
32
to
coordinate
the
administration
of
the
hawk-i
program
with
33
the
hawk-i
program
purchase
option
to
maximize
efficiencies
34
and
improve
the
continuity
of
care
for
eligible
children;
and
35
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to
implement
mechanisms
to
ensure
the
long-term
financial
1
sustainability
of
the
hawk-i
program
and
mitigate
any
adverse
2
financial
impacts
to
the
health
insurance
marketplace.
The
3
mechanisms
are
to
address
issues
related
to
minimizing
adverse
4
selection,
the
state
financial
risk
and
contribution,
and
5
negative
impacts
to
premiums
in
the
individual
and
group
6
insurance
market
both
inside
and
outside
of
the
health
7
insurance
marketplace.
8
At
a
minimum,
the
hawk-i
purchase
option
must
include:
9
establishment
of
an
annual
per
enrollee
premium
rate
similar
10
to
the
average
rate
paid
by
the
state
to
managed
care
plan
11
contractors
under
the
hawk-i
program;
establishment
of
a
12
benefit
set
equal
to
the
benefits
covered
under
the
hawk-i
13
program;
establishment
of
annual
open
enrollment
periods
14
consistent
with
those
for
the
hawk-i
program;
the
ability
15
of
the
director
of
health
and
human
services
to
adjust
the
16
purchase
option’s
actuarial
value
to
a
value
no
lower
than
17
87
percent;
reimbursement
mechanisms
to
address
potential
18
reductions
in
funding
for
health
insurance
marketplace
19
operations;
and
reimbursement
mechanisms
to
address
potential
20
increased
costs
to
the
hawk-i
program.
21
The
director
of
health
and
human
services
in
collaboration
22
with
the
commissioner
of
insurance
shall
report
to
the
23
chairpersons
and
ranking
members
of
the
house
and
senate
health
24
and
human
services
committees
and
the
joint
appropriations
25
subcommittee
on
health
and
human
services
by
September
1,
26
2023,
on
the
progress
of
the
federal
waivers
and
the
results
27
from
actuarial
and
economic
analyses
that
are
necessary
for
a
28
waiver
proposal.
The
report
shall
also
include
recommendations
29
regarding
any
statutory
or
administrative
rule
changes
30
necessary
to
implement
the
program.
31
The
bill
takes
effect
upon
enactment.
Implementation
of
any
32
waiver
provision
that
requires
a
state
financial
contribution
33
is
contingent
on
further
legislative
action
to
approve
the
34
state’s
contribution.
35
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