HOUSE OF REPRESENTATIVES

H.B. NO.

2738

TWENTY-NINTH LEGISLATURE, 2018

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO CHILDREN'S HEALTH CARE.

 

 

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

 


     SECTION 1.  The legislature finds that keiki care was a pilot program of the department of human services med-QUEST division that started in 2008 as a result of Act 236, Session Laws of Hawaii 2007.  The pilot program provided health insurance to 1,974 children as of August 31, 2008.  The intended purpose of the pilot program was to provide health insurance for children who were otherwise uninsured provided that they were not eligible for other state or federal health care coverage.  The state paid $25.50 per child per month for keiki care at the total cost of $50,337 per month.  On November 1, 2008, the governor discontinued the pilot program more than two years short of the span intended by Act 236.

     Although estimates of the number of uninsured children in the State vary, there is a gap group that is ineligible for any state or federal health care coverage.  The majority of children in this gap group are those whose family income is at or just over three hundred per cent of the federal poverty level.  Others in this group may include infants born to uninsured mothers, immigrants with temporary visas, and undocumented immigrants who have been in Hawaii for less than six months.  The United States Census Bureau estimates that the total number of children in Hawaii who fell into the gap group in 2016 was 6,897.

     Children who remain uninsured typically do not receive an appropriate level of medical care.  Children who lack a source of care or who turn regularly to a hospital emergency department are unlikely to receive preventive care or early and regular management of acute or chronic health conditions.

     A study performed by the Urban Institute, a nonpartisan economic and social policy research organization, showed that regardless of age, race, ethnicity, income, or health status, uninsured children were much less likely to have received a well-child checkup within the past year and were more likely than insured children to report an unmet need for medical care that was associated with concerns about cost.

     Health insurance helps children and youth receive regular health care so they can participate in school and other activities.  Often, parents experience hardship when an uninsured child is sick because of the added stress caused by the child's medical bills.

     The purpose of this Act is to establish the Hawaii infant health care program and the Hawaii children's health care program as temporary three-year pilot programs to expand and monitor health care coverage for children in Hawaii by:

     (1)  Providing continuous, quality health care services to uninsured newborn children who are one day, but not more than thirty days of age through the Hawaii infant care program; provided that these children may enroll in the Hawaii children's health care program upon reaching thirty-one days of age;

     (2)  Providing health care coverage to certain children who are at least thirty-one days, but less than nineteen years old through a public‑private partnership between the department of human services and one or more managed care plans operating in the State under chapter 432, Hawaii Revised Statutes, that offer accident and health or sickness insurance plans; and

     (3)  Appropriating funds for these pilot programs.

     SECTION 2.  (a)  There is established the Hawaii infant health care program as a temporary three‑year pilot program to provide continuous, quality health care services to uninsured newborn children living in Hawaii who are one day, but not more than thirty days of age, with up to $10,000 of health care assistance per eligible child, subject to the appropriation of general funds for the program.

     (b)  It is not the intent of the legislature to discourage employers from offering to pay, or from paying for, dependent coverage for their employees, nor that this Act supplant employer‑sponsored dependent coverage plans.

     (c)  Services provided pursuant to the Hawaii infant health care program shall be the same as services for children covered by med-QUEST.

     (d)  The department may contract with an appropriate entity to provide health care services required by the Hawaii infant health care program.  The department of human services or its designated contractor shall directly reimburse any health care provider or managed care plan providing services to infants under the Hawaii infant health care program, subject to the appropriation of general funds for the program.

     (e)  The department shall submit a report of findings and recommendations, including any proposed legislation to the legislature no later than twenty days prior to the convening of the 2019, 2020, and 2021 regular sessions.  The report shall include:

     (1)  The number of children who were provided services through the Hawaii infant health care program;

     (2)  A list of health care providers or managed care plans participating in the program;

     (3)  The annual cost of the program; and

     (4)  Recommendations regarding continuation of the program beyond its three-year expiration and any improvements to the program.

     SECTION 3.  (a)  There is established the Hawaii children's health care program as a temporary three-year pilot program to provide health care coverage to uninsured children who live in Hawaii.  The department of human services shall provide health care coverage through a public-private partnership, established as a contract to provide health and human services pursuant to chapter 103F, Hawaii Revised Statutes, between the department and one or more managed care plans operating in the State under chapter 432, Hawaii Revised Statutes, that offer accident and health or sickness insurance plans.  Health care coverage provided shall be the same as coverage for children provided by med-QUEST.

     (b)  It is not the intent of the legislature to discourage employers from offering to pay, or from paying for, dependent coverage for their employees, nor that this Act supplant employer‑sponsored dependent coverage plans.

     (c)  To qualify, a child shall:

     (1)  Be between thirty-one days and nineteen years old;

     (2)  Be living in Hawaii;

     (3)  Have been uninsured continually for at least six months; provided that infants thirty-one days to six months of age shall have been uninsured continually since birth; and

     (4)  Have been ineligible during the six months the child was uninsured for any other state or federal health care coverage and be currently ineligible for any other state or federal health care coverage; provided that:

          (A)  All children enrolled in a managed care plan's children's plan as of the effective date of this Act shall be eligible for enrollment in the Hawaii children's health care program without being subject to the requirement of being uninsured for the preceding six months in paragraph (3);

          (B)  Children who are between thirty-one days and nineteen years old who become ineligible for a state or federal health care coverage program due to an increase in family income may enroll in the program upon disenrollment from the applicable state or federal health care coverage program; and

          (C)  Uninsured newborn children who were enrolled in the Hawaii infant health care program shall be immediately eligible for enrollment in the Hawaii children's health care program at thirty-one days of age.

     (d)  The department of human services and the managed care plans shall share equally in the cost of the premium for each child enrolled in the program subject to the appropriation of general funds for the program.

     (e)  The department of human services shall pay the State's share of the premiums under the program on a quarterly basis.

     (f)  The managed care plans participating in the pilot program shall be responsible for determining the eligibility of program applicants and of enrolling applicants in the pilot program.

     (g)  The managed care plans participating in the program shall provide a quarterly report to the department of human services and the legislature on the number of children enrolled in the program.

     (h)  The department shall ensure that other private organizations have the opportunity to partner with the State to offer coverage to uninsured children under the program; provided that plan benefits to be provided shall be the same as services for children covered by med-QUEST and managed care plans under subsection (a).

     (i)  The department of human services and any participating managed care plan shall report to the legislature no later than twenty days prior to the start of the 2019, 2020, and 2021 regular sessions on:

     (1)  Any problems experienced with the program involving crowding out eligible participants;

     (2)  Instances of individuals cancelling or losing previous health care coverage to receive coverage for themselves or their children under the Hawaii children's health care program;

     (3)  An accounting of funding used and for what purposes;

     (4)  Any other problems encountered in the administration of the program; and

     (5)  Any proposed legislation including recommendations regarding continuation of the program beyond its three-year termination and any improvements to the program.

     SECTION 4.  It is the legislature's intent to make health care services and coverage for uninsured children more accessible for qualified individuals and thereby increase the overall health of Hawaii's residents, promote healthy communities, and protect the public health and welfare.  It is not the intent of the legislature to discourage employers from offering to pay, or from paying for, dependent coverage for their employees, nor that this Act supplant employer‑sponsored dependent coverage plans.

     SECTION 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $150,000 or so much thereof as may be necessary for fiscal year 2018-2019 to provide continuous, quality health care services to uninsured newborn children who are one day, but not more than thirty days of age through the Hawaii infant health care program.

     The sum appropriated shall be expended by the department of human services for the purposes of section 2 of this Act.

     SECTION 6.  There is appropriated out of the general revenues of the State of Hawaii the sum of $700,000 or so much thereof as may be necessary for fiscal year 2018-2019 to fund the Hawaii children's health care program pursuant to section 3 of this Act.

     The sum appropriated shall be expended by the department of human services for the purposes of section 3 of this Act.

     SECTION 7.  There is appropriated out of the general revenues of the State of Hawaii the sum of $52,000 or so much thereof as may be necessary for fiscal year 2018-2019 for two full‑time equivalent permanent (2.00 FTE) eligibility worker I positions for the Hawaii infant care program.

     The sum appropriated shall be expended by the department of human services for the purposes of section 2 of this Act.

     SECTION 8.  There is appropriated out of the general revenues of the State of Hawaii the sum of $50,000 or so much thereof as may be necessary for fiscal year 2018-2019 for administrative costs, including the purchase of computer equipment, office furniture, and other supplies and equipment necessary to implement section 2 of this Act.

     The sum appropriated shall be expended by the department of human services for the purposes of section 2 of this Act.

     SECTION 9.  This Act shall take effect on July 1, 2018 and shall be repealed on June 30, 2021.

 

INTRODUCED BY:

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Report Title:

Children's Health Care Program; Appropriations

 

Description:

Creates a three-year pilot program to expand availability of health care services coverage for infants and children living in Hawaii.  Appropriates funds.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.