PRINTER'S NO. 1773

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

1407

Session of

2017

INTRODUCED BY GROVE, McGINNIS, GREINER, TOPPER, BARRAR, MILLARD,

KAUFFMAN, METZGAR, SANKEY, MILNE, RYAN, JAMES, COX, MARSICO,

SAYLOR, PHILLIPS-HILL, ROTHMAN, WHEELAND, B. MILLER, MOUL AND

providing for work requirements, lifetime limits, copayments

and health savings accounts and for health savings accounts

for Medicaid enrollees.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. The act of June 13, 1967 (P.L.31, No.21), known

as the Human Services Code, is amended by adding sections to

read:

Section 441.10. Work Requirements, Lifetime Limits,

Copayments and Health Savings Accounts.--(a) No later than

who is eighteen years of age or older and physically and

mentally capable of work. The work requirement shall require a

Medicaid enrollee to become employed, actively seek employment

as verified by the department or attend a job training program

in accordance with the following:

(i) In the case of a Medicaid enrollee who is employed or

attending job training programs in order to maintain enrollment

in the Medicaid program, the Medicaid enrollee shall work twenty

hours a week or complete twelve job training program-related

activities a month.

Medicaid program eligibility for the following time periods:

(A) Three months beginning in year two of employment.

(B) Six months beginning after the time period under clause

(A) expires.

(C) Nine months beginning after the time period under clause

(B) expires.

(iv) The time period when a Medicaid enrollee has failed to

count toward the lifetime limit of Medicaid benefits as

specified under paragraph (5).

(2) Requiring an able-bodied Medicaid enrollee who is

under paragraph (1) for the purpose of determining the Medicaid

enrollee's eligibility.

(3) Banning an individual from enrolling in a Medicaid

program if the individual has failed to comply with paragraphs

(1) and (2).

(4) Exempting a Medicaid enrollee from the requirements

under paragraphs (1) and (2) under any of the following

conditions:

(i) The Medicaid enrollee is attending high school as a

full-time student.

Income (SSI) benefits.

(vi) The Medicaid enrollee resides in a mental health

institution or correctional institution.

(vii) The Medicaid enrollee is experiencing a crisis,

serious medical condition or temporary condition that prevents

the Medicaid enrollee from actively seeking employment, such as

domestic violence or substance use treatment.

benefits, unless the Medicaid enrollee meets any of the

following conditions:

(i) The Medicaid enrollee is pregnant and has shown a work

(iii) The Medicaid enrollee is employed full time and meets

the income eligibility requirements for Medicaid and pays future

deductibles from an individual enrollee's Medicaid health

savings account under section 441.11.

(6) De veloping and imposing meaningful copayments to be paid

from an individual Medicaid enrollee's health savings account

under section 441.11 of no less than sixty-five cents (65 ¢ ) and

not more than four dollars ($4) per copayment based on an income

threshold established by the department for the purpose of

deterring the nonemergency use of emergency services and the use

General Assembly and the Independent Fiscal Office.

(a) The department shall establish a Personal Wellness and

Responsibility Account as an individual health savings account

for Medicaid enrollees.

(b) A Medicaid enrollee shall contribute a predetermined

percent of the Medicaid enrollee's income into an individual

health savings account. The amount shall be at least two percent

five percent of the Medicaid enrollee's annual gross income. The

percent of the Medicaid enrollee's income shall be assessed by

the department on a graduated scale based on the Medicaid

enrollee's income between one hundred percent and two hundred

percent of the Federal poverty limit.

(c) The department shall provide cash incentives

to promote the use of accepted preventive care services in a

cost effective manner. The use of preventive care services may

not be subject to the Medicaid enrollee's deductible under the

health savings account.

(d) After a Medicaid enrollee pays the initial deductible

from the individual Medicaid enrollee's health savings account,

the Commonwealth shall make annual deposits into the health

savings account which may be utilized by the Medicaid enrollee

percent of the Medicaid enrollee's deductible allocated from the

individual Medicaid enrollee's health savings account.

(2) A nonprofit organization operating in conjunction with

the Medicaid program may pay up to seventy-five percent of the

Medicaid enrollee's deductible allocated from the individual

Medicaid enrollee's health savings account.

(3) A Medicaid enrollee may only use money deposited in the

authorized health care services under the Medicaid program.

(4) Money remaining within an individual Medicaid enrollee's

health savings account at the end of the year shall remain in

care under the State's plan under Title XIX of the Social

Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.), the

department shall transfer all funds paid by the individual into

a health savings account.

(g) Payments allocated by the Commonwealth from an

individual Medicaid enrollee's health savings account to pay for

the Medicaid enrollee's deductibles shall not exceed three

hundred thousand dollars ($300,000) annually or one million

dollars ($1,000,000) during the Medicaid enrollee's lifetime.