SENATE BILL REPORT

                  2SHB 1714

              As Reported By Senate Committee On:

            Health & Long-Term Care, April 1, 1997

Title:  An act relating to basic health plan eligibility for persons eligible for medicare.

Brief Description:  Establishing basic health plan eligibility for certain persons eligible for medicare.

Sponsors:  House Committee on Appropriations (originally sponsored by Representative McMorris).

Brief History:

Committee Activity:  Health & Long‑Term Care:  3/27/97, 4/1/97 [DP-WM].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  Do pass and be referred to Committee on Ways & Means.

  Signed by Senators Deccio, Chair; Wood, Vice Chair; Benton, Franklin, Strannigan and Wojahn.

Staff:  Jonathan Seib (786-7427)

Background:  Medicare is a federal health insurance program for people 65 or older and certain disabled people.  Medicare Part A refers to hospital insurance, limited nursing home care, home health, and hospice.

Generally, those 65 and older can get premium-free Medicare Part A benefits based on their or their spouse's employment.  Some, however, do not have enough Social Security work credits.  They are eligible for Part A benefits, but must pay a monthly premium to receive them.

To be eligible for coverage by the state's Basic Health Plan, a person must not be eligible for Medicare.  A person is considered eligible for Medicare even if the requirement to pay premiums prevents them from enrolling.  Thus, some people meet all the requirements for being a subsidized enrollee in the Basic Health Plan, except that they are eligible for Medicare Part A coverage that they cannot afford.

The Health Care Authority estimates that between 7,400 and 11,400 people in Washington are eligible but not enrolled in Medicare Part A and have an income of less than 200 percent of poverty.

Summary of Bill:  A person who is eligible for Medicare is eligible to enroll in the Basic Health Plan as a subsidized enrollee if the person: (1) pays premiums in order to receive Medicare Part A coverage; (2) worked, or has a spouse that worked, for an employer who did not make contributions to Social Security, thus making the individual ineligible for premium-free Medicare Part A coverage; and (3) meets the eligibility criteria established by the Basic Health Plan administrator.

Other technical changes are made.

The bill contains a null and void clause.

Appropriation:  None.

Fiscal Note:  Available for original bill.  Requested for second substitute bill March 24, 1997.

Effective Date:  Sections 1 and 2 take effect January 1, 1998.  The remainder of the bill takes effect ninety days after adjournment of session in which bill is passed.

Testimony For:  This bill is intended to provide access to health insurance to a relatively small group of persons who, because of some unique circumstances, do not have access to Medicare or to the BHP.

Testimony Against:  None.

Testified:  Representative Cathy McMorris, prime sponsor (pro).