SENATE BILL REPORT

EHB 2003

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Title: An act relating to premium payments for children's health coverage for children in families with income greater than two hundred percent of the federal poverty level who are not eligible for the federal children's health insurance program.

Background: The Department of Social and Health Services (DSHS) operates the Apple Health for Kids program, which provides medical coverage for children under age 19 in families with incomes at or below 300 percent of the federal poverty level. Apple Health for Kids includes three programs for financing this coverage. The joint state-federal Medicaid program provides coverage for children with family incomes at or below 133 percent of poverty. The joint state-federal Children's Health Insurance Program (CHIP) provides coverage for children with family incomes above 133 percent and at or below 300 percent of the poverty level. The state-funded Children's Health Program (CHP) provides coverage for children with family incomes at or below 300 percent of poverty who are not eligible for Medicaid or CHIP due to their immigration status.

Families with incomes between 200 and 250 percent of poverty are required to pay premiums of $20 per child per month for Apple Health coverage, and those with incomes between 251 and 300 percent of poverty are required to pay $30 per child per month.

Families with incomes above 300 percent of the FPL may purchase Apple Health coverage from the DSHS without state subsidy.

Summary of Bill: For a child who is not eligible for the federal Medicaid or CHIP programs to be covered by Apple Health for Children, families with incomes greater than 200 percent of poverty must pay a premium equal to the estimated cost of the child's coverage. The premium is not to exceed the average per capita state cost of coverage under the state funded CHP component of the program.