HB823: Health Insurance Premium Payment program; enrollment of eligible individuals.

HOUSE BILL NO. 823

Offered January 8, 2020
Prefiled January 7, 2020
A BILL to amend the Code of Virginia by adding in Article 1 of Chapter 10 of Title 32.1 a section numbered 32.1-331.04, relating to the Health Insurance Premium Payment program; enrollment of eligible individuals.
Patron-- Head

Committee Referral Pending

Be it enacted by the General Assembly of Virginia:

1. That the Code of Virginia is amended by adding in Article 1 of Chapter 10 of Title 32.1 a section numbered 32.1-331.04 as follows:

§ 32.1-331.04. Health Insurance Premium Payment program; enrollment of eligible individuals.

A. As used in this section:

"Cost effective" means that the total amount of expenditures for payment of health insurance premiums and cost sharing items required pursuant to § 1906 of the Social Security Act, 42 U.S.C § 1396d, on behalf of a person eligible for the Health Insurance Premium Assistance Program is likely to be less than the cost of providing medical assistance services pursuant to the state plan for medical assistance services.

"Health Insurance Premium Payment program" means the program established by the Department consistent with § 1906 of the Social Security Act, 42 U.S.C. § 1396e, for the purpose of assisting persons who are eligible for medical assistance services and who are covered by an employer-sponsored health insurance plan in accessing health care coverage through such health insurance plan rather than through the Commonwealth's program of medical assistance services.

B. The Department shall enroll in the Health Insurance Premium Payment program every person who is eligible for medical assistance services provided pursuant to the state plan for medical assistance services and who has a household income that is equal to or greater than 100 percent of the federal poverty level for a household the size of such person's household and meets the criteria for enrollment in such program unless enrolling the person in such program is determined not to be cost effective.

C. The Department shall remove from the Health Insurance Premium Payment program any person enrolled pursuant to subsection B who provides written notification to the Department on a form developed by the Department for such purpose that he does not wish to participate in the Health Insurance Premium Payment program. Such person shall be removed from the program within 30 days of receipt of such written notification.