H.B. 276 Enrolled

1

MEDICAID COVERED AT WORK PREMIUM
2 SUBSIDY
3 2006 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Kory M. Holdaway
6 Senate Sponsor: Scott K. Jenkins
7 Cosponsor:Ralph Becker 8
9 LONG TITLE
10 General Description:
11 This bill amends provisions related to Utah's Medicaid program.
12 Highlighted Provisions:
13 This bill:
14 . directs the Department of Health to take steps to promote increased participation in
15 employer sponsored health insurance as a means to increase health care coverage
16 among the uninsured.
17 Monies Appropriated in this Bill:
18 This bill appropriates:
19 . as an ongoing appropriation subject to future budget constraints, $267,500 from the
20 General Fund for fiscal year 2006-07 to the Division of Health Care Financing
21 within the Department of Health.
22 Other Special Clauses:
23 None
24 Utah Code Sections Affected:
25 AMENDS:
26 26-18-3.5, as last amended by Chapter 323, Laws of Utah 2004
27
28 Be it enacted by the Legislature of the state of Utah:
29 Section 1. Section 26-18-3.5 is amended to read:

30 26-18-3.5. Copayments by recipients -- Employer sponsored plans.
31 (1) The department shall selectively provide for enrollment fees, premiums,
32 deductions, cost sharing or other similar charges to be paid by recipients, their spouses, and
33 parents, within the limitations of federal law and regulation.
34 (2) (a) The department shall seek approval under the department's Section 1115
35 Medicaid waiver to cap enrollment fees for the Primary Care Network Demonstration Project
36 in accordance with Subsection (2)(b).
37 (b) Pursuant to a waiver obtained under Subsection (2)(a), the department shall cap
38 enrollment fees for the primary care network at $15 per year for those persons who, after July
39 1, 2003, are eligible to begin receiving General Assistance under Section 35A-3-401 .
40 (c) Beginning July 1, 2004, and pursuant to a waiver obtained under Subsection (2)(a),
41 the department shall cap enrollment fees for the primary care network at $25 per year for those
42 persons who have an income level that is below 50% of the federal poverty level.
43 (3) Beginning May 1, 2006, within appropriations by the Legislature and as a means to
44 increase health care coverage among the uninsured, the department shall take steps to promote
45 increased participation in employer sponsored health insurance, including:
46 (a) maximizing the health insurance premium subsidy provided under the state's
47 Primary Care Network Demonstration Project by:
48 (i) ensuring that state funds are matched by federal funds to the greatest extent
49 allowable; and
50 (ii) as the department determines appropriate, seeking federal approval to do one or
51 more of the following:
52 (A) eliminate or otherwise modify the annual enrollment fee;
53 (B) eliminate or otherwise modify the schedule used to determine the level of subsidy
54 provided to an enrollee each year;
55 (C) reduce the maximum number of participants allowable under the subsidy program;
56 or
57 (D) otherwise modify the program in a manner that promotes enrollment in employer

58 sponsored health insurance; and
59 (b) exploring the use of other options, including the development of a waiver under the
60 Medicaid Health Insurance Flexibility Demonstration Initiative or other federal authority.
61 Section 2. Appropriation.
62 As an ongoing appropriation subject to future budget constraints, there is appropriated
63 from the General Fund for fiscal year 2006-07, $267,500 to the Division of Health Care
64 Financing within the Department of Health to take steps to promote increased participation in
65 employer sponsored health insurance, including maximizing the employer sponsored insurance
66 premium subsidy provided under the state's Primary Care Network Demonstration Project
67 under Subsection 26-18-3.5 (3).