SENATE BILL REPORT

                   HB 1982

              As Reported By Senate Committee On:

            Health & Long-Term Care, March 25, 1997

Title:  An act relating to defining basic health plan eligibility for persons in institutions.

Brief Description:  Limiting basic health plan eligibility for persons in institutions.

Sponsors:  Representatives Dyer, Cody and Backlund; by request of Health Care Authority.

Brief History:

Committee Activity:  Health & Long‑Term Care:  3/19/97, 3/25/97 [DPA].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  Do pass as amended.

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

Staff:  Don Sloma (786-7319)

Background:   A Basic Health Plan (BHP) enrollee is defined as an individual not eligible for Medicare, who resides in an area of the state served by a managed health care system participating in the plan, and whose gross family income at the time of enrollment does not exceed twice the federal poverty level.

This definition does not exclude persons confined or residing in a government-operated institution.  The administrator of the BHP is concerned that if such institutions begin enrolling confined persons, there will be a substantial increase in health service utilization and related premium costs.

Summary of Amended Bill:  The striking amendment amends the definition of BHP enrollee to exclude a person confined or residing in a government-operated institution, unless eligibility criteria adopted by the administrator is met.  The Health Care Authority must adopt such criteria in consultation with appropriate state and local government agencies.

Amended Bill Compared to Original Bill:  The requirement for HCA to consult with state and local government agencies is added.

Appropriation:  None.

Fiscal Note:  Requested on February 19, 1997.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  The bill is needed to control BHP costs and stop it from being used to supplement medical services budgets of jails, prisons and state institutions.

Testimony Against:  Without careful rule writing, the bill could result in family members of jail inmates being denied BHP.

Testified:  Dennis Martin, Health Care Authority (pro); Kathy  Gerke, Association of Cities (con).