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H0376.....................................................by WAYS AND MEANS
HEALTH INSURANCE ACCESS CARD - Amends and adds to existing law to set forth
provisions for the Idaho Health Insurance Access Card Act; to state
legislative purpose; to define terms; to provide for a CHIP Plan B; to
provide for the Children's Access Card Program; to provide for the Small
Business Health Insurance Pilot Program; to provide for the Idaho Health
Insurance Access Card; and to provide for the deposit of certain premium
tax funds to the Idaho Health Insurance Access Card Fund and to specify
distribution.
03/19 House intro - 1st rdg - to printing
03/20 Rpt prt - to Health/Wel
03/21 Ref'd to Bus
03/28 Rpt out - rec d/p - to 2nd rdg
03/31 2nd rdg - to 3rd rdg
04/01 3rd rdg - PASSED - 53-17-0
AYES -- Andersen, Barraclough, Bedke, Bell, Bieter, Black, Block,
Boe, Bolz, Bradford, Campbell, Cannon, Collins, Cuddy, Deal, Denney,
Douglas, Edmunson, Ellsworth, Eskridge, Field(18), Gagner, Garrett,
Henbest, Jaquet, Jones, Kellogg, Lake, Langhorst, Martinez, Meyer,
Miller, Mitchell, Naccarato, Nielsen, Ridinger, Ring, Ringo, Robison,
Rydalch, Sayler, Shepherd, Shirley, Skippen, Smith(30), Smith(24),
Smylie, Snodgrass, Stevenson, Tilman, Trail, Wills, Mr. Speaker
NAYS -- Barrett, Bauer, Clark, Crow, Eberle, Field(23), Harwood,
Kulczyk, Langford, McGeachin, McKague, Moyle, Raybould, Roberts,
Sali, Schaefer, Wood
Absent and excused -- None
Floor Sponsors - Black & Gagner
Title apvd - to Senate
04/02 Senate intro - 1st rdg - to Com/HuRes
04/04 Rpt out - rec d/p - to 2nd rdg
04/07 2nd rdg - to 3rd rdg
04/09 3rd rdg - PASSED - 34-0-1
AYES -- Andreason, Bailey, Brandt, Bunderson, Burkett, Burtenshaw,
Calabretta, Cameron, Compton, Darrington, Davis, Gannon, Geddes,
Goedde, Hill, Ingram, Kennedy, Keough, Little, Lodge, Malepeai(Kumm),
Marley, McKenzie, McWilliams, Noh, Pearce, Richardson, Schroeder,
Sorensen, Stegner, Stennett, Sweet, Werk, Williams
NAYS -- None
Absent and excused -- Noble
Floor Sponsor - Cameron
Title apvd - to House
04/10 To enrol
04/14 Rpt enrol - Sp signed
04/15 Pres signed
04/16 To Governor
04/22 Governor signed
Session Law Chapter 308
Effective: 07/01/03
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-seventh Legislature First Regular Session - 2003
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 376
BY WAYS AND MEANS COMMITTEE
1 AN ACT
2 RELATING TO THE IDAHO HEALTH INSURANCE ACCESS CARD ACT; AMENDING CHAPTER 2,
3 TITLE 56, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 56-236, IDAHO CODE,
4 TO PROVIDE A SHORT TITLE; AMENDING CHAPTER 2, TITLE 56, IDAHO CODE, BY THE
5 ADDITION OF A NEW SECTION 56-237, IDAHO CODE, TO STATE LEGISLATIVE PUR-
6 POSE; AMENDING CHAPTER 2, TITLE 56, IDAHO CODE, BY THE ADDITION OF A NEW
7 SECTION 56-238, IDAHO CODE, TO DEFINE TERMS; AMENDING CHAPTER 2, TITLE 56,
8 IDAHO CODE, BY THE ADDITION OF A NEW SECTION 56-239, IDAHO CODE, TO SET
9 FORTH PROVISIONS FOR CHIP PLAN B; AMENDING CHAPTER 2, TITLE 56, IDAHO
10 CODE, BY THE ADDITION OF A NEW SECTION 56-240, IDAHO CODE, TO SET FORTH
11 PROVISIONS FOR THE CHILDREN'S ACCESS CARD PROGRAM; AMENDING CHAPTER 2,
12 TITLE 56, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 56-241, IDAHO CODE,
13 TO SET FORTH PROVISIONS FOR THE SMALL BUSINESS HEALTH INSURANCE PILOT PRO-
14 GRAM; AMENDING CHAPTER 2, TITLE 56, IDAHO CODE, BY THE ADDITION OF A NEW
15 SECTION 56-242, IDAHO CODE, TO SET FORTH PROVISIONS FOR THE IDAHO HEALTH
16 INSURANCE ACCESS CARD; AND AMENDING SECTION 41-406, IDAHO CODE, TO PROVIDE
17 FOR THE DEPOSIT OF CERTAIN PREMIUM TAX FUNDS TO THE IDAHO HEALTH INSURANCE
18 ACCESS CARD FUND AND TO SPECIFY DISTRIBUTION.
19 Be It Enacted by the Legislature of the State of Idaho:
20 SECTION 1. That Chapter 2, Title 56, Idaho Code, be, and the same is
21 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
22 ignated as Section 56-236, Idaho Code, and to read as follows:
23 56-236. SHORT TITLE. This act shall be known and may be cited as the
24 "Idaho Health Insurance Access Card Act."
25 SECTION 2. That Chapter 2, Title 56, Idaho Code, be, and the same is
26 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
27 ignated as Section 56-237, Idaho Code, and to read as follows:
28 56-237. PURPOSE. The purpose and intent of this act is to promote the
29 availability of health insurance to children and families and to adults who
30 are employed by small businesses in Idaho and their dependent spouses whose
31 families' gross incomes fall within one hundred eighty-five percent (185%) of
32 the federal poverty guidelines.
33 SECTION 3. That Chapter 2, Title 56, Idaho Code, be, and the same is
34 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
35 ignated as Section 56-238, Idaho Code, and to read as follows:
36 56-238. DEFINITIONS. As used in this act:
37 (1) "Children's access card program" means the program created in section
38 56-240, Idaho Code.
39 (2) "CHIP Plan A" means the existing Idaho children's health insurance
2
1 program for children eligible under federal title XXI whose families' gross
2 incomes do not exceed one hundred fifty percent (150%) of the federal poverty
3 guidelines.
4 (3) "CHIP Plan B" means the program created in section 56-239, Idaho
5 Code.
6 (4) "Department" means the department of health and welfare.
7 (5) "Director" means the director of the department of health and wel-
8 fare.
9 (6) "Eligible adult" means a person:
10 (a) Over eighteen (18) years of age living in Idaho;
11 (b) Whose family's gross income is equal to or less than one hundred
12 eighty-five percent (185%) of the federal poverty guidelines; and
13 (c) Who is employed full time by a small employer, meaning an employer
14 with two (2) to fifty (50) employees and as such term is defined in sec-
15 tion 41-4703, Idaho Code, and who is eligible for health insurance cover-
16 age under a small employer health benefit plan regulated under chapter 47,
17 title 41, Idaho Code, or the dependent spouse of such employee.
18 (7) "Eligible child" means a child under nineteen (19) years of age liv-
19 ing in Idaho whose family's gross income falls within federal poverty guide-
20 lines for CHIP Plan A or CHIP Plan B. Children currently eligible for CHIP
21 under federal title XXI may elect to participate in either the Idaho
22 children's health insurance program (CHIP Plan A) or the children's access
23 card program. Children whose family's gross income is between one hundred
24 fifty percent (150%) and one hundred eighty-five percent (185%) of the federal
25 poverty guidelines may elect to participate in either the CHIP Plan B or the
26 children's access card program.
27 (8) "Health benefit plan" means any hospital or medical policy or certif-
28 icate, any subscriber contract provided by a hospital or professional service
29 corporation, or managed care organization subscriber contract. Health benefit
30 plan does not include policies or certificates of insurance for specific dis-
31 ease, hospital confinement indemnity, accident-only, credit, dental, vision,
32 medicare supplement, long-term care, or disability income insurance, student
33 health benefits only coverage issued as a supplement to liability insurance,
34 worker's compensation or similar insurance, automobile medical payment insur-
35 ance or nonrenewable short-term coverage issued for a period of twelve (12)
36 months or less.
37 (9) "Small business health insurance pilot program" means the program
38 created in section 56-241, Idaho Code.
39 SECTION 4. That Chapter 2, Title 56, Idaho Code, be, and the same is
40 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
41 ignated as Section 56-239, Idaho Code, and to read as follows:
42 56-239. CHIP PLAN B. (1) There is hereby created in the department a CHIP
43 Plan B that shall be made available by the department to eligible children, as
44 defined in section 56-238, Idaho Code, whose family's gross income is between
45 one hundred fifty percent (150%) and one hundred eighty-five percent (185%) of
46 the federal poverty guidelines. The director shall implement the program by
47 adopting rules recommended by the board of the Idaho high risk reinsurance
48 pool created in section 41-5502, Idaho Code, that authorize policies of health
49 insurance for children enrolled in the CHIP Plan B.
50 (2) There is hereby created a CHIP Plan B advisory board which shall
51 advise the Idaho high risk reinsurance pool board concerning issues related to
52 the CHIP Plan B. The board shall consist of eight (8) members, four (4) mem-
53 bers to be appointed by the director and four (4) members to be appointed by
3
1 the governor. At least two (2) members of the board shall be parents of chil-
2 dren who are eligible to participate in the CHIP Plan B.
3 SECTION 5. That Chapter 2, Title 56, Idaho Code, be, and the same is
4 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
5 ignated as Section 56-240, Idaho Code, and to read as follows:
6 56-240. CHILDREN'S ACCESS CARD PROGRAM. (1) There is hereby created in
7 the department a children's access card program that shall, through the Idaho
8 health insurance access card program, make payments to the insurance company
9 providing coverage under a health benefit plan, as defined in section 56-238,
10 Idaho Code, for a child who is eligible for federal title XXI benefits under
11 CHIP Plan A or CHIP Plan B. In each month the insurance coverage is in effect,
12 a one hundred dollar ($100) payment shall be applied to the monthly insurance
13 premium billed each month by the insurance company with a maximum payment of
14 three hundred dollars ($300) for all dependent children in the family. The
15 director shall implement the program by adopting rules recommended by the
16 board of the Idaho high risk reinsurance pool created in section 41-5502,
17 Idaho Code.
18 (2) Participation in the children's access card program by any employer
19 shall be optional. Nothing in this act shall be construed to mandate or
20 require that an employer participate in the children's access card program.
21 (3) There is hereby created a children's access card program advisory
22 board which shall advise the Idaho high risk reinsurance pool board concerning
23 issues related to the children's access card program. The board shall consist
24 of eight (8) members, four (4) members to be appointed by the director and
25 four (4) members to be appointed by the governor. At least two (2) members of
26 the board shall be parents of children who are eligible to participate in the
27 children's access card program.
28 SECTION 6. That Chapter 2, Title 56, Idaho Code, be, and the same is
29 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
30 ignated as Section 56-241, Idaho Code, and to read as follows:
31 56-241. SMALL BUSINESS HEALTH INSURANCE PILOT PROGRAM. (1) There is
32 hereby created in the department a small business health insurance pilot pro-
33 gram that shall be made available to up to one thousand (1,000) eligible
34 adults, as defined in section 56-238, Idaho Code, based on available funding.
35 The director shall implement the program by adopting rules recommended by the
36 board of the Idaho high risk reinsurance pool created in section 41-5502,
37 Idaho Code, providing for the payment of the benefit authorized in subsection
38 (2) of this section through the use of the Idaho health insurance access card.
39 (2) The small business health insurance pilot program shall, through the
40 Idaho health insurance access card program, pay to the insurance company pro-
41 viding insurance coverage through policies regulated under chapter 47, title
42 41, Idaho Code, for an adult enrolled in the small employer health insurance
43 pilot program, for each month the insurance coverage is in effect, a one hun-
44 dred dollar ($100) payment to be applied to the monthly insurance premium
45 billed each month by the insurance company.
46 (3) Participation in the small business health insurance pilot program by
47 any employer shall be optional. Nothing in this act shall be construed to man-
48 date or require that an employer participate in the pilot program. Small
49 employers who choose to participate in the small business health insurance
50 pilot program shall contribute at least fifty percent (50%) of the employee
51 premium and at least fifty percent (50%) of the combination of employee and
4
1 dependent spouse contribution percentage for those employees and their depend-
2 ent spouses who are enrolled in the small business health insurance pilot pro-
3 gram.
4 (4) There is hereby created a small business health insurance advisory
5 board which shall advise the Idaho high risk reinsurance pool board concerning
6 issues related to the small business health insurance pilot program. The board
7 shall consist of eight (8) members, four (4) members to be appointed by the
8 director and four (4) members to be appointed by the governor. At least four
9 (4) members of the board shall be representatives of small businesses, meaning
10 those with two (2) to fifty (50) employees, that offer employee health benefit
11 plans regulated under chapter 47, title 41, Idaho Code.
12 SECTION 7. That Chapter 2, Title 56, Idaho Code, be, and the same is
13 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
14 ignated as Section 56-242, Idaho Code, and to read as follows:
15 56-242. IDAHO HEALTH INSURANCE ACCESS CARD. (1) The director shall
16 develop an Idaho health insurance access card program in the department to
17 implement the children's access card program and the small business health
18 insurance pilot program.
19 (2) (a) There is hereby created and established in the state treasury a
20 fund to be known as the "Idaho health insurance access card fund." Moneys
21 in the fund shall be maintained in three (3) subaccounts, identified
22 respectively as the "CHIP Plan B subaccount," the "children's access card
23 program subaccount" and the "small business health insurance pilot program
24 subaccount." Appropriations, matching federal funds, grants, donations and
25 moneys from other sources shall be paid into the fund. The department
26 shall administer the fund. Any interest earned on the investment of idle
27 moneys in the fund shall be returned to and deposited in the fund.
28 (b) Moneys in the CHIP Plan B subaccount, the children's access card pro-
29 gram subaccount and the small business health insurance pilot program
30 subaccount shall be expended pursuant to appropriation for the payment of
31 benefits and capped administrative costs of the department.
32 (3) The director shall apply for waivers of federal title XXI and title
33 XIX to subsidize health care coverage under the CHIP Plan B, the children's
34 access card program and the small business health insurance pilot program.
35 Federal matching funds received by the department to provide coverage under
36 CHIP Plan B, the children's access card program and the small business health
37 insurance pilot program shall be deposited in the appropriate subaccount.
38 (4) The director is authorized to promulgate rules recommended by the
39 board of the Idaho high risk reinsurance pool to implement the CHIP Plan B,
40 the children's access card program and the small business health insurance
41 pilot program.
42 (5) Insurers offering health benefit plans regulated under chapter 47,
43 title 41, Idaho Code, shall accept payment for such plans under the small
44 business health insurance pilot program pursuant to rules promulgated by the
45 department. Insurers offering health benefit plans, as defined in section
46 56-238, Idaho Code, shall accept payment for such plans under the children's
47 access card program.
48 (6) The CHIP Plan B and the children's access card program shall be
49 implemented by July 1, 2004. Implementation of the small business health
50 insurance pilot program shall begin on July 1, 2005.
51 SECTION 8. That Section 41-406, Idaho Code, be, and the same is hereby
52 amended to read as follows:
5
1 41-406. DEPOSIT AND REPORT OF FEES, LICENSES AND TAXES. (1) The director
2 shall transmit all taxes, fines and penalties collected by him to the state
3 treasurer as provided under section 59-1014, Idaho Code. The director shall
4 file with the state controller a statement of each deposit thus made. All such
5 funds received shall be deposited into the department of insurance suspense
6 account.
7 Such funds shall be distributed as follows:
8 (a) The director may deposit up to twenty percent (20%) of the funds
9 received in the insurance refund account which is hereby created for the
10 purpose of repaying overpayments of any taxes, fines, and penalties or
11 other erroneous receipts. There is hereby appropriated out of the insur-
12 ance refund account so much thereof as shall be necessary for the payment
13 of refunds. Any unencumbered balance remaining in the insurance refund
14 account on June 30 of each and every year in excess of forty thousand dol-
15 lars ($40,000) shall be transferred to the general fund and the state con-
16 troller is hereby authorized and directed on such dates to make such
17 transfers unless the board of examiners, which is hereby authorized to do
18 so, changes the date of transfer or sum to be transferred.
19 (b) That portion of the premium tax, payable to the public employee
20 retirement fund as provided in section 59-1394, Idaho Code, shall be dis-
21 tributed to that fund.
22 (c) That portion of the premium tax necessary to cover administrative
23 costs incurred by the department in placing insurance companies or any
24 other insurance entities into receivership or under administrative super-
25 vision, and such costs cannot be satisfied from the assets of these compa-
26 nies or entities, shall be distributed to the insurance insolvency admin-
27 istrative fund which is hereby created. There is hereby appropriated out
28 of the insurance insolvency administrative fund so much thereof as shall
29 be necessary, but not to exceed two hundred thousand dollars ($200,000) in
30 any one (1) fiscal year, for the payment of the department's administra-
31 tive expenses incurred in carrying out such receiverships or supervision.
32 A balance of one hundred thousand dollars ($100,000) shall be maintained
33 in this fund on June 30 of each year.
34 (d) After all other deductions authorized in this section have been made,
35 if the premium tax remaining exceeds forty-five million dollars
36 ($45,000,000), one-fourth (1/4) of such excess is hereby appropriated and
37 shall be paid to the Idaho high risk individual reinsurance pool estab-
38 lished in chapter 55, title 41, Idaho Code, and one-fourth (1/4) of such
39 excess above fifty-five million dollars ($55,000,000) is hereby appropri-
40 ated and shall be paid to the Idaho health insurance access card fund,
41 established in section 56-242, Idaho Code, with eighty percent (80%) of
42 such moneys to be appropriated to the CHIP Plan B subaccount and the
43 children's access card program subaccount and twenty percent (20%) of such
44 moneys, not to exceed one million two hundred thousand dollars
45 ($1,200,000) per year, to be appropriated to the small business health
46 insurance pilot program subaccount.
47 (e) The balance of the premium tax, fines and penalties shall be distrib-
48 uted to the general fund of the state of Idaho.
49 (f) All moneys received for fees, licenses and miscellaneous charges col-
50 lected shall be distributed to the insurance administrative account.
51 (2) The director shall make and file with the state controller an item-
52 ized statement of the fees, licenses, taxes, fines and penalties collected by
53 him during the preceding month, and shall deliver a certified copy of the
54 statement to the state treasurer.
STATEMENT OF PURPOSE
RS 13172C2
The purpose of this bill is to give families of children eligible
for the Children's Health Insurance Program (CHIP) a choice
between enrolling their children in CHIP and enrolling their
children in a new Health Insurance Access Card program. The
Health Insurance Access Card is a premium assistance program that
would provide support for purchase of commercial insurance
(either employer-sponsored or individual plans). The bill would
also create a capped expansion of CHIP from 150% of federal
poverty to 185% of federal poverty. This expanded CHIP, called
CHIP Plan B, would have fewer benefits and some beneficiary cost-
sharing as compared to the current CHIP, which gives
beneficiaries Medicaid-level benefits. The Health Insurance
Access Card would be a program choice for both current and
expanded CHIP eligibles. Further, the bill would create a capped
pilot program for adults enrolled in small businesses (2 to 50
employees) in which employees and/or their dependent spouses up
to 185% of federal poverty could enroll in the Health Insurance
Access Card program. This would grant adult beneficiaries
limited financial support for purchase of employer-sponsored
small group health insurance plans. This segment of the program
is meant to facilitate creation and maintenance of employer-based
small group health insurance plans.
FISCAL IMPACT
There is no fiscal impact on the General Fund. The Idaho Health
Insurance Access Card proposal is funded with future receipts of
premium tax. The requests are one-fourth of the premium tax
above $55 million. We are currently below $55 million but
anticipate hitting that level in the next year or so. The
premium tax collected is deposited in a trust account established
within CHIP's and is matched on an 80%/20% basis. If we were to
collect $2 million of premium tax, it would be matched with $8
million of federal funds. That would generate over 8000 access
cards at $1,200 a year. It is also hoped that we might obtain
grants and other funds as well.
Contact
Name: Sen. Dean Cameron
(208) 332-1000
Roy Eiguren, Givens Pursley
(208-388-1200)
Kate Vanden Broek, Idaho State Planning Grant
(208) 367-4777
STATEMENT OF PURPOSE/FISCAL NOTE H 376