Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 22-0707.01 Chelsea Princell x4335
SENATE BILL 22-052
Senate Committees House Committees
Health & Human Services
A BILL FOR AN ACT
C
ONCERNING ALIGNING MEDICAL ASSISTANCE INCOME ELIGIBILITY101
REQUIREMENTS WITH FEDERAL LAW .102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
The bill aligns the medicaid and children's basic health plan
income eligibility requirements for pregnant women and children with
federal law.
Current law requires money in the healthcare affordability and
sustainability fee cash fund (fund) to be used to expand eligibility for
medicaid by increasing the income eligibility level for children and
SENATE SPONSORSHIP
Jaquez Lewis,
HOUSE SPONSORSHIP
Mullica,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. pregnant women under the children's basic health plan to up to 250% of
the federal poverty line. The bill increases the eligibility level to up to
260%. Under current law, if the money in the fund is insufficient to fully
fund all the purposes of the fund, the medical services board (state board)
may reduce the percentage of the federal poverty level. The bill
authorizes the state board to reduce the percentage of the federal poverty
level to below 260%, but not below 250%.
The bill increases the medicaid income eligibility level for
pregnant women from 133% of the federal poverty level to a federally
approved specified percentage of the federal poverty level, adjusted for
family size, as set forth in rules promulgated by the state board.
The bill increases the income eligibility level under the children's
basic health plan for children and pregnant woman from 250% of the
federal poverty level to a federally approved specified percentage of the
federal poverty level, adjusted for family size, as set forth in state board
rule.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 25.5-4-402.4, amend2
(5)(b)(IV)(B) as follows:3
25.5-4-402.4. Hospitals - healthcare affordability and4
sustainability fee - legislative declaration - Colorado healthcare5
affordability and sustainability enterprise - federal waiver - fund6
created - rules - reports - repeal. (5) Healthcare affordability and7
sustainability fee cash fund. (b) All money in the fund is subject to8
federal matching as authorized under federal law and, subject to annual9
appropriation by the general assembly, shall be expended by the10
enterprise for the following purposes:11
(IV) Subject to available revenue from the healthcare affordability12
and sustainability fee and federal matching funds, to expand eligibility for13
public medical assistance by:14
(B) Increasing the eligibility level for children and pregnant15
women under the children's basic health plan to up to two hundred fifty
16
SB22-052-2- SIXTY percent of the federal poverty line;1
SECTION 2. In Colorado Revised Statutes, 25.5-5-101, amend2
(1) introductory portion and (1)(c) as follows:3
25.5-5-101. Mandatory provisions - eligible groups - rules.4
(1) In order to participate in the medicaid program, the federal5
government requires the state to provide medical assistance to certain6
eligible groups. Pursuant to federal law and except as provided in7
subsection (2) of this section, any person who is eligible for medical8
assistance under the mandated groups specified in this section shall MUST9
receive both the mandatory services that are specified in sections10
25.5-5-102 and 25.5-5-103 and the optional services that are specified in11
sections 25.5-5-202 and 25.5-5-203. Subject to the availability of federal12
financial participation, the following are the individuals or groups that are13
mandated under federal law to receive benefits under this article ARTICLE14
5 and articles 4 and 6 of this title TITLE 25.5:15
(c) Pregnant women whose family income does not exceed one16
hundred thirty-three percent of the federal poverty line, adjusted for17
family size A FEDERALLY APPROVED SPECIFIED PERCENTAGE OF THE18
FEDERAL POVERTY LINE, ADJUSTED FOR FAMILY SIZE, AS SET FORTH IN19
STATE BOARD RULE, who meet the requirements pursuant to section 190220
(a)(10)(A) of the federal "Social Security Act". Once initial eligibility has21
been established, the pregnant woman is continuously eligible throughout22
the pregnancy and for the sixty days following the pregnancy, even if the23
woman's eligibility would otherwise terminate during such period due to24
an increase in income.25
SECTION 3. In Colorado Revised Statutes, 25.5-5-201, amend26
(1) introductory portion and (1)(m.5) as follows:27
SB22-052
-3- 25.5-5-201. Optional provisions - optional groups - rules.1
(1) The federal government allows the state to select optional groups to2
receive medical assistance. Pursuant to federal law, any person who is3
eligible for medical assistance under the optional groups specified in this4
section shall MUST receive both the mandatory services specified in5
sections 25.5-5-102 and 25.5-5-103 and the optional services specified in6
sections 25.5-5-202 and 25.5-5-203. Subject to the availability of federal7
financial aid funds, the following are the individuals or groups that8
Colorado has selected as optional groups to receive medical assistance9
pursuant to this article ARTICLE 5 and articles 4 and 6 of this title 25.5:10
(m.5) Pregnant women, whose family income does not exceed one11
hundred eighty-five percent of the federal poverty line, adjusted for12
family size A FEDERALLY APPROVED SPECIFIED PERCENTAGE OF THE13
FEDERAL POVERTY LINE, ADJUSTED FOR FAMILY SIZE, SET FORTH IN STATE14
BOARD RULE;15
SECTION 4. In Colorado Revised Statutes, 25.5-8-103, amend16
(4)(a)(I), (4)(a)(II), (4)(b)(I), and (4)(b)(II) as follows:17
25.5-8-103. Definitions - rules. As used in this article 8, unless18
the context otherwise requires:19
(4) "Eligible person" means:20
(a) (I) A person who is less than nineteen years of age, whose21
family income does not exceed two hundred fifty percent of the federal22
poverty line, adjusted for family size A FEDERALLY APPROVED SPECIFIED23
PERCENTAGE OF THE FEDERAL POVERTY LINE , ADJUSTED FOR FAMILY SIZE,24
AS SET FORTH IN STATE BOARD RULE.25
(II) Notwithstanding the provisions of subsection (4)(a)(I) of this26
section, if the money in the healthcare affordability and sustainability fee27
SB22-052
-4- cash fund established pursuant to section 25.5-4-402.4 (5), together with1
the corresponding federal matching funds, is insufficient to fully fund all2
of the purposes described in section 25.5-4-402.4 (5)(b), after receiving3
recommendations from the Colorado healthcare affordability and4
sustainability enterprise established pursuant to section 25.5-4-402.4 (3),5
for persons less than nineteen years of age, the state board may by rule6
adopted pursuant to the provisions of section 25.5-4-402.4 (6)(b)(III)7
reduce the percentage of the federal poverty line to below two hundred8
fifty SIXTY percent, but the percentage shall not be reduced to below two9
hundred five FIFTY percent.10
(b) (I) A pregnant woman whose family income does not exceed11
two hundred fifty percent of the federal poverty line, adjusted for family12
size A FEDERALLY APPROVED SPECIFIED PERCENTAGE OF THE FEDERAL13
POVERTY LINE, ADJUSTED FOR FAMILY SIZE, AS SET FORTH IN STATE BOARD14
RULE, and who is not eligible for medicaid.15
(II) Notwithstanding the provisions of subsection (4)(b)(I) of this16
section, if the money in the healthcare affordability and sustainability fee17
cash fund established pursuant to section 25.5-4-402.4 (5), together with18
the corresponding federal matching funds, is insufficient to fully fund all19
of the purposes described in section 25.5-4-402.4 (5)(b), after receiving20
recommendations from the Colorado healthcare affordability and21
sustainability enterprise established pursuant to section 25.5-4-402.4 (3),22
for pregnant women, the state board by rule adopted pursuant to the23
provisions of section 25.5-4-402.4 (6)(b)(III) may reduce the percentage24
of the federal poverty line to below two hundred fifty SIXTY percent, but25
the percentage shall not be reduced to below two hundred five FIFTY26
percent.27
SB22-052
-5- SECTION 5. Safety clause. The general assembly hereby finds,1
determines, and declares that this act is necessary for the immediate2
preservation of the public peace, health, or safety.3
SB22-052
-6-