AN ACT

 

1Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2act to consolidate, editorially revise, and codify the public
3welfare laws of the Commonwealth," in public assistance,
<-4further providing for persons eligible for medical assistance 
5providing f<-or Pennsylvania-specific health insurance 
6coverage.

7The General Assembly of the Commonwealth of Pennsylvania
8hereby enacts as follows:

<-9Section 1. Section 441.1(a) of the act of June 13, 1967
10(P.L.31, No.21), known as the Public Welfare Code, is amended by
11adding paragraphs to read:

12Section 441.1. Persons Eligible for Medical Assistance.--(a)
13The following persons shall be eligible for medical assistance:

1* * *

2(6)  Persons who are eligible for the Medicaid expansion
3described in section 1902(a)(10)(A)(i), (ii), (iii), (iv), (v)
4or (vi) of the Social Security Act (42 U.S.C. § 1396a(a)(10)(A)
5(i) or (ii)) and whose income as determined under Federal law,
6section 1902(e)(14) of the Social Security Act (42 U.S.C. §
71396a(e)(14)) does not exceed one hundred thirty-three percent
8of the poverty line as defined in section 2110(c)(5) of the
9Social Security Act (42 U.S.C. § 1397jj(c)(5)) applicable to a
10family of the size involved, subject to section 1902(k) of the
11Social Security Act (42 U.S.C. § 1396a(k)).

12(7) The secretary:

13(i) Shall file a State Plan Amendment to implement the
14coverage described in paragraph (6) provided that the secretary
15may suspend the category of eligibility described in paragraph
16(6) if the Federal medical assistance percentages described in
17section 1905(y)(1) of the Social Security Act (42 U.S.C. §
181396d(y)(1)) is reduced.

19(ii) May also suspend the category of eligibility described
20in paragraph (6) if the Federal government disapproves the
21assessment of revenue from medicaid managed care organizations
22as defined in section 801-F and the secretary finds that such
23disapproval makes the expansion of eligibility to be
24impracticable.

25(8) Individuals eligible under paragraph (6) may be charged
26premiums or cost sharing, including deductibles, copayments and
27similar charges for medical services as permitted under Federal
28law. In establishing such premiums or cost sharing, the
29secretary shall consider the funds certified by the Budget
30Secretary as available, the cost of living and the number of

1persons who may be eligible.

2Section 2. This act shall take effect January 1, 2014.

<-3Section 1.  The act of June 13, 1967 (P.L.31, No.21), known
4as the Public Welfare Code, is amended by adding a section to
5read:

6Section 441.10.  Pennsylvania-Specific Health Insurance 
7Coverage.--(a) The department shall pursue an agreement with 
8the United States Department of Health and Human Services to 
9implement a Pennsylvania-specific demonstration program under 
10section 1115 of the Social Security Act (49 Stat. 620, 42 U.S.C. 
11§ 1315) to extend health insurance coverage to persons described 
12under section 1902(a)(10)(A)(i)(VIII) of the Social Security Act 
13(49 Stat. 620, 42 U.S.C. § 1396a(a)(10)(A)(i)(VIII)).

14(b)  The department shall administer a temporary bridge to
15the health insurance coverage established in subsection (a):

16(1)  The secretary:

17(i) Shall file a State plan amendment immediately to extend
18medical assistance to persons described under section 1902(a)
19(10)(A)(i)(VIII) of the Social Security Act (49 Stat. 620, 42
20U.S.C. § 1396a(a)(10)(A)(i)(VIII)) provided that the secretary
21may suspend the category of eligibility described in this
22paragraph if the Federal medical assistance percentages
23described in section 1905(y)(1) of the Social Security Act (49
24Stat. 620, 42 U.S.C. § 1396d(y)(1)) is reduced.

25(ii) May also suspend the category of eligibility described
26in this paragraph if the Federal Government disapproves the
27assessment of revenue from medicaid managed care organizations
28as defined in section 801-F and the secretary finds that such
29disapproval makes the expansion of eligibility to be
30impracticable.

1(2)  Authority for a temporary bridge to health insurance
2coverage shall cease ninety days after the United States
3Department of Health and Human Services and the department reach
4an agreement pursuant to subsection (a), or on December 31,
52016, whichever is sooner.

6(3)  This subsection and the expiration of the authority for 
7a temporary bridge to health insurance coverage shall not 
8constrain the secretary from filing any State plan amendments 
9within the secretary's authority.

10(c)  The department shall seek the full Federal medical
11assistance percentage under section 1905(y) of the Social
12Security Act (49 Stat. 620, 42 U.S.C. § 1396d(y) for persons
13eligible for health insurance coverage under this section and
14medical assistance under section 441.1 retroactive to the
15beginning of the calendar quarter in which this section takes
16effect.

17Section 2.  This act shall take effect immediately.