BILL REQ. #:  S-1982.1 

READ FIRST TIME 02/20/09.   

     AN ACT Relating to enhanced federal financing of health coverage; adding new sections to chapter 74.09 RCW; and adding a new section to chapter 41.05 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 74.09 RCW to read as follows:
     (1) The department shall submit a request to the federal department of health and human services to expand and revise the medical assistance program as codified in Title XIX of the federal social security act. The department shall take such actions as may be necessary to access federal financial participation for low-income adults at or below two hundred percent of the federal poverty level. To the extent permitted under federal law, the program revisions must reflect the following policy considerations:
     (a) The establishment of a single eligibility standard for low-income persons at or below two hundred percent of the federal poverty level, or if not permitted, expansion of the categorical eligibility to include additional adults;
     (b) The delivery of all low-income coverage programs as one program, with a common core benefit package that may be similar to the basic health benefit package or alternative benefit package that may be approved by the secretary of the federal department of health and human services, including the option of supplemental coverage for select categorical groups like children, and the aged, blind, and disabled;
     (c) A program design to include creative and innovative approaches such as, but not limited to: Coverage for preventive services with incentives to use appropriate preventive care; cost-sharing options; use of care management and care coordination programs to prompt better coordination of medical and behavioral health services; application of an innovative predictive risk model to better target care management services; and mandatory enrollment in managed care, as may be necessary;
     (d) The ability to impose enrollment limits or benefit design changes for eligibility groups that were not eligible under the Title XIX state plan in effect at the date of the waiver application.
     (2) The department shall hold stakeholder discussions to allow refinement and public comment on the proposal.
     (3) Upon development of the proposal, the department and the health care authority shall identify statutory changes that may be necessary to ensure successful and timely implementation of an apple health program for adults.

NEW SECTION.  Sec. 2   A new section is added to chapter 74.09 RCW to read as follows:
     (1) The department shall submit a Title XXI state plan amendment to the federal department of health and human services that would define coverage for children between two hundred and two hundred-fifty percent of the federal poverty level as benefits provided under the Title XIX state plan, and coverage for children up to three hundred percent of the federal poverty level as coverage under section 2103 of Title XXI.
     (2) The department shall work with the department of health to maximize the state's ability to access the federal vaccines for children program.
     (3) The department shall submit a Title XXI state plan amendment or waiver to the federal department of health and human services to allow Title XIX children to participate in the department's employer-sponsored program, as may be necessary.

NEW SECTION.  Sec. 3   A new section is added to chapter 41.05 RCW to read as follows:
     To the extent that federal funding becomes available for the operation of a health insurance exchange mechanism to facilitate access to health insurance coverage for individuals and small businesses, the health care authority may seek such funding to support operation of an exchange as authorized in federal law.

NEW SECTION.  Sec. 4   A new section is added to chapter 74.09 RCW to read as follows:
     The department shall continue to submit applications for the family planning waiver program. The department shall submit a request to the federal department of health and human services to amend the current family planning waiver program to allow:
     (1) Coverage for sexually transmitted disease testing and treatment;
     (2) A return to the eligibility standards used in 2005, including but not limited to citizenship determination based on a declaration, insurance eligibility standards comparable to 2005, and confidential service availability for minors and survivors of domestic and sexual violence; and
     (3) Increasing eligibility to two hundred fifty percent of the federal poverty level, to correspond with the eligibility for publicly funded pregnancy care services.