SENATE BILL REPORT
SB 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 Senate Committee On:
Health & Long Term Care, February 6, 2019
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: Health & Long Term Care: 1/30/19, 2/06/19 [DP-WM].
Brief Summary of Bill |
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SENATE COMMITTEE ON HEALTH & LONG TERM CARE |
Majority Report: Do pass and be referred to Committee on Ways & Means.
Signed by Senators Cleveland, Chair; Randall, Vice Chair; O'Ban, Ranking Member; Bailey, Becker, Conway, Dhingra, Frockt, Keiser and Van De Wege.
Staff: Evan Klein (786-7483)
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.
In 2018, the Pacific Island Citizens Health Care Premium Assistance Program (Premium Assistance Program) was enacted to provide premium assistance to COFA citizens who enroll in a silver qualified health plan on the individual market, make less than 133 percent of the federal poverty, and are ineligible for federal or state medical assistance programs.
Summary of Bill: The COFA islander dental care program (Dental Program) is established, requiring the Health Care Authority (HCA) to 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 COFA islanders.
COFA islanders are eligible for the Dental Program, if they are eligible for the Premium Assistance Program, or if they:
are a Washington resident;
enroll in a qualified dental plan on the health benefit exchange;
have an income less than 133 percent of the federal poverty level; and
are enrolled in Medicare.
A person is disqualified for the Dental Program if they:
no longer meet eligibility criteria;
fail to comply with the Dental Program procedural or documentation requirements;
fail to notify 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:
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;
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, 2019; and
a comprehensive community education and outreach campaign that must begin no later than September 1, 2019.
The Premium Assistance Program advisory committee must advise the HCA on the Dental Program. Reimbursement for advisory committee members' transportation and travel expenses is no longer made subject to appropriations.
Appropriation: None.
Fiscal Note: Requested on January 16, 2019.
Creates Committee/Commission/Task Force that includes Legislative members: No.
Effective Date: The bill contains an emergency clause and takes effect immediately.
Staff Summary of Public Testimony: PRO: The COFA agreement was in part to help alleviate guilt of the United States, who used their home islands as target practice for nuclear bombs. The COFA agreement provides these citizens residency in the United States, but does not provide them health coverage. The state took on the responsibility to provide these COFA citizens medical coverage, and this bill extends dental coverage to these individuals. This bill, by extending dental coverage, will make the total medical package comparable to Medicaid. There will be automatic enrollment in the dental benefit, for people who are enrolled in the medical program. Oral healthcare helps alleviate a number of health disparities. Pacific Islanders have a higher rate of tooth decay than white residents, and these disparities range from childhood through adulthood. It is important to think about the long term effects and harm that lack of oral care can cause.
Persons Testifying: PRO: Senator Bob Hasegawa, Prime Sponsor; Alison Mondi, Arcora Foundation; Emily Lovell, Washington State Dental Association; Brenda Kelek; Litonya Lester, Children's Alliance.
Persons Signed In To Testify But Not Testifying: No one.