HOUSE BILL REPORT
ESB 5274
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. |
As Reported by House Committee On:
Appropriations
Title: An act relating to dental coverage for Pacific islanders residing in Washington.
Brief Description: Concerning dental coverage for Pacific islanders residing in Washington.
Sponsors: Senators Hasegawa, Hunt, Wilson, C., Billig, Nguyen, Conway, Das, Frockt, Keiser, Randall and Saldaña.
Brief History:
Committee Activity:
Appropriations: 4/3/19, 4/8/19 [DPA].
Brief Summary of Engrossed Bill (As Amended by Committee) |
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HOUSE COMMITTEE ON APPROPRIATIONS |
Majority Report: Do pass as amended. Signed by 19 members: Representatives Ormsby, Chair; Bergquist, 2nd Vice Chair; Robinson, 1st Vice Chair; Cody, Dolan, Fitzgibbon, Hansen, Hudgins, Jinkins, Macri, Pettigrew, Pollet, Ryu, Senn, Springer, Stanford, Sullivan, Tarleton and Tharinger.
Minority Report: Do not pass. Signed by 13 members: Representatives Stokesbary, Ranking Minority Member; MacEwen, Assistant Ranking Minority Member; Rude, Assistant Ranking Minority Member; Caldier, Chandler, Dye, Hoff, Kraft, Mosbrucker, Schmick, Steele, Sutherland and Ybarra.
Staff: Catrina Lucero (786-7192).
Background:
Under the federal Patient Protection and Affordable Care Act (ACA), each state must establish a health benefit exchange through which consumers may compare and purchase individual and small group coverage, access premium and cost-sharing subsidies, and apply for Medicaid coverage. Washington's health benefit exchange, the Washington Healthplanfinder, is a public-private partnership governed by a board consisting of members with expertise in the health care system and health care coverage. Stand-alone dental plans may be offered on the health benefit exchange, but must be certified by the exchange. Federal premium subsidies are not available for dental plans offered to individuals on the exchange.
Under the Compact of Free Association (COFA), citizens of the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau may live and work in the United States and serve in the United States military. Citizens of COFA nations are also eligible for premium assistance through the exchanges established by the ACA. Citizens of COFA nations are, however, ineligible for Medicaid.
The Legislature created the Pacific Island Citizens Health Care Premium Assistance Program (Premium Assistance Program) in 2018 to provide premium and cost sharing assistance to COFA citizens who enroll in a silver qualified health plan on the individual market, have an income less than 133 percent of the federal poverty level, and are ineligible for federal or state medical assistance programs.
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Summary of Amended Bill:
The COFA Islander Dental Program (Dental Program) is established. The Health Care Authority (HCA) must pay the premium for purchasing a qualified dental plan and the total out-of-pocket costs for services rendered by in-network dental providers, for eligible persons, subject to availability of amounts appropriated for this purpose.
To be eligible for the program an individual must be eligible for the COFA Premium Assistance Program under RCW 43.71A.020 or:
be a Washington resident;
be a COFA citizen;
enroll in a qualified dental plan on the health benefit exchange;
have an income less than 133 percent of the federal poverty level; and
be enrolled in Medicare.
The HCA may disqualify a participant if they:
no longer meet eligibility criteria;
fail to comply with the Dental Program procedural or documentation requirements;
fail to notify the HCA of a change of address in a timely manner;
withdraw their application or request termination of coverage; or
commit fraud that results in an insurer rescinding the policy.
The HCA must establish:
an application, enrollment, and renewal processes;
the qualified dental plans that are eligible for reimbursement by the Dental Program;
procedural requirements for participation in the Dental Program; and
open enrollment and special enrollment periods consistent with the enrollment periods of the Washington Healthplanfinder.
The first open enrollment period must begin by November 1, 2020. The HCA, in consultation with the Washington Commission on Asian Pacific American Affairs, must establish a community education and outreach program to facilitate participation in the program. Funding for the education and outreach campaign is subject to appropriations.
Amended Bill Compared to Engrossed Bill:
The premium payments and out-of-pocket costs paid by the HCA for clients enrolled in the COFA dental program are made subject to the availability of the amounts appropriated. The COFA premium assistance and dental program advisory committee are extended for an additional year to December 31, 2021.
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Appropriation: None.
Fiscal Note: Available. New fiscal note requested on March 14, 2019.
Effective Date of Amended Bill: The bill contains an emergency clause and takes effect immediately.
Staff Summary of Public Testimony:
(In support) The compacts with the Federated States of Micronesia, Republic of Palau, and the Marshall Islands are a result of the United States using these countries for strategic military purposes and as nuclear testing grounds. People from COFA nations work and pay taxes in Washington but do not have adequate access to dental care. Including dental coverage into the Premium Assistance Program implemented by the Legislature in 2018 will bring the state closer to offering Medicaid parity for these individuals. Oral health is an important component and determinate of overall health. Children are more likely to access dental care when their caregivers also have access to dental care. Insurance coverage increases access to preventative and restorative care, avoiding more costly care later. Pacific Islanders experience health disparities in regards to oral health outcomes. An oral health survey found that by third grade 75 percent of Pacific Islanders have tooth decay as compared to 46 percent of Caucasian third graders.
(Opposed) None.
Persons Testifying: Litonya Lester, Children's Alliance; and Alison Mondi, Arcora Foundation.
Persons Signed In To Testify But Not Testifying: None.