Representative Rosemary T. Lesser proposes the following substitute bill:


1     
PREGNANCY MEDICAID COVERAGE AMENDMENTS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Rosemary T. Lesser

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill extends eligibility for pregnant women under Medicaid.
10     Highlighted Provisions:
11          This bill:
12          ▸     authorizes the Medicaid program to extend Medicaid coverage to pregnant women
13     with a household income at or below the levels established in this bill.
14     Money Appropriated in this Bill:
15          None
16     Other Special Clauses:
17          None
18     Utah Code Sections Affected:
19     AMENDS:
20          26-36b-208, as last amended by Laws of Utah 2021, Chapter 367
21     ENACTS:
22          26B-3-201, Utah Code Annotated 1953
23     

24     Be it enacted by the Legislature of the state of Utah:
25          Section 1. Section 26-36b-208 is amended to read:

26          26-36b-208. Medicaid Expansion Fund.
27          (1) There is created an expendable special revenue fund known as the Medicaid
28     Expansion Fund.
29          (2) The fund consists of:
30          (a) assessments collected under this chapter;
31          (b) intergovernmental transfers under Section 26-36b-206;
32          (c) savings attributable to the health coverage improvement program as determined by
33     the department;
34          (d) savings attributable to the enhancement waiver program as determined by the
35     department;
36          (e) savings attributable to the Medicaid waiver expansion as determined by the
37     department;
38          (f) savings attributable to the inclusion of psychotropic drugs on the preferred drug list
39     under Subsection 26-18-2.4(3) as determined by the department;
40          (g) revenues collected from the sales tax described in Subsection 59-12-103(12);
41          (h) gifts, grants, donations, or any other conveyance of money that may be made to the
42     fund from private sources;
43          (i) interest earned on money in the fund; and
44          (j) additional amounts as appropriated by the Legislature.
45          (3) (a) The fund shall earn interest.
46          (b) All interest earned on fund money shall be deposited into the fund.
47          (4) (a) A state agency administering the provisions of this chapter may use money from
48     the fund to pay the costs, not otherwise paid for with federal funds or other revenue sources, of:
49          (i) the health coverage improvement program;
50          (ii) the enhancement waiver program;
51          (iii) a Medicaid waiver expansion; [and]
52          (iv) the outpatient upper payment limit supplemental payments under Section
53     26-36b-210[.]; and
54          (v) the Medicaid coverage for pregnant women described in Section 26B-3-201.
55          (b) A state agency administering the provisions of this chapter may not use:
56          (i) funds described in Subsection (2)(b) to pay the cost of private outpatient upper

57     payment limit supplemental payments; or
58          (ii) money in the fund for any purpose not described in Subsection (4)(a).
59          Section 2. Section 26B-3-201 is enacted to read:
60          26B-3-201. Medicaid coverage for pregnant women.
61          (1) (a) On or before July 1, 2023, the division shall request a Medicaid state plan
62     amendment from CMS to provide Medicaid coverage to pregnant women with a household
63     income less than or equal to 185% of the federal poverty level.
64          (b) On or before January 1, 2024, the division shall request a Medicaid waiver from
65     CMS to provide Medicaid coverage to pregnant women with a household income less than or
66     equal to 200% of the federal poverty level.
67          (2) If a waiver or state plan amendment described in Subsection (1) is approved, the
68     department shall implement the coverage as soon as practicable to the extent the waiver or state
69     plan amendment is approved by CMS.
70          (3) If the coverage described in Subsection (1) is implemented, the department may
71     only pay the state portion of costs for the coverage under this section with appropriations from
72     the Medicaid Expansion Fund created in Section 26-36b-208.