BILL REQ. #:  S-2634.1 

Read first time 04/22/13.   Referred to Committee on Ways & Means.

     AN ACT Relating to requesting and implementing a federal waiver to allow Washington to expand the medicaid program through private insurance markets; adding a new section to chapter 74.09 RCW; and creating a new section.

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

NEW SECTION.  Sec. 1   (1) The legislature finds that:
     (a) On March 23, 2010, President Barack Obama signed into law the patient protection and affordable care act and the health care and education reconciliation act of 2010, collectively known as the affordable care act;
     (b) The affordable care act requires that states expand their medicaid programs to include coverage for all individuals whose incomes are at or below one hundred thirty-three percent of the federal poverty guidelines;
     (c) The United States supreme court has found that the medicaid expansion aspect of the affordable care act shifts medicaid from a program for the neediest in society to a comprehensive plan to provide universal health insurance coverage;
     (d) The state has made great progress in establishing a Washington health benefit exchange to serve people over one hundred thirty-three percent of the federal poverty guidelines as a marketplace for insurance as required under the affordable care act.
     (2) Individuals who will be newly eligible for medicaid under the affordable care act deserve the same choices in their health care coverage as those being served in the Washington health benefit exchange will have. Making the Washington health benefit exchange available to the thousands of people in Washington who will be forced to receive health care through the medicaid expansion will give individuals a choice in their health care and allow them to maintain the same health insurance and health care providers if their income changes.
     (3) The legislature intends to require the health care authority to work with the Washington health benefit exchange to develop and request a waiver from the United States department of health and human services to provide health insurance to those individuals who are newly eligible for medicaid through the Washington health benefit exchange.

NEW SECTION.  Sec. 2   A new section is added to chapter 74.09 RCW to read as follows:
     (1) By July 1, 2014, the authority shall apply to the secretary of the United States department of health and human services for a waiver to authorize Washington state to enroll individuals at or below a modified adjusted gross income of one hundred thirty-three percent of the federal poverty guidelines in the Washington health benefit exchange, rather than medicaid. The waiver must allow Washington residents at or below a modified adjusted gross income of one hundred thirty-three percent of the federal poverty guidelines to receive premium assistance and cost-sharing subsidies to allow them to purchase health insurance through the Washington health benefit exchange. The waiver must combine federal and state sources of funds up to the same amount and the same proportion that would have been used had the enrollees been covered through medicaid.
     (2) The authority, in collaboration with the Washington health benefit exchange, shall submit a report to the legislature by December 1, 2013, with details of the operational and fiscal elements of the waiver proposal.