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General Assembly Raised Bill No. 943
January Session, 2019
LCO No. 4767
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING ME DICAID TREATMENT OF AN
INACCESSIBLE ASSET.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 17b-261 of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective July 1, 2019): 2
(a) Medical assistance shall be provided for any otherwise eligible 3
person whose income, including any available support from legally 4
liable relatives and the income of the person's spouse or dependent 5
child, is not more than one hundred forty-three per cent, pending 6
approval of a federal waiver applied for pursuant to subsection (e) of 7
this section, of the benefit amount paid to a person with no income 8
under the temporary family assistance program in the appropriate 9
region of residence and if such person is an institutionalized 10
individual as defined in Section 1917 of the Social Security Act, 42 USC 11
1396p(h)(3), and has not made an assignment or transfer or other 12
disposition of property for less than fair market value for the purpose 13
of establishing eligibility for benefits or assistance under this section. 14
Any such disposition shall be treated in accordance with Section 15 Raised Bill No. 943
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1917(c) of the Social Security Act, 42 USC 1396p(c). Any disposition of 16
property made on behalf of an applicant or recipient or the spouse of 17
an applicant or recipient by a guardian, conservator, person 18
authorized to make such disposition pursuant to a power of attorney 19
or other person so authorized by law shall be attributed to such 20
applicant, recipient or spouse. A disposition of property ordered by a 21
court shall be evaluated in accordance with the standards applied to 22
any other such disposition for the purpose of determining eligibility. 23
The commissioner shall establish the standards for eligibility for 24
medical assistance at one hundred forty-three per cent of the benefit 25
amount paid to a household of equal size with no income under the 26
temporary family assistance program in the appropriate region of 27
residence. In determining eligibility, the commissioner shall not 28
consider as income Aid and Attendance pension benefits granted to a 29
veteran, as defined in section 27-103, or the surviving spouse of such 30
veteran. Except as provided in section 17b-277 and section 17b-292, the 31
medical assistance program shall provide coverage to persons under 32
the age of nineteen with household income up to one hundred ninety-33
six per cent of the federal poverty level without an asset limit and to 34
persons under the age of nineteen, who qualify for coverage under 35
Section 1931 of the Social Security Act, with household income not 36
exceeding one hundred ninety-six per cent of the federal poverty level 37
without an asset limit, and their parents and needy caretaker relatives, 38
who qualify for coverage under Section 1931 of the Social Security Act, 39
with household income not exceeding one hundred fifty per cent of the 40
federal poverty level without an asset limit. Such levels shall be based 41
on the regional differences in such benefit amount, if applicable, unless 42
such levels based on regional differences are not in conformance with 43
federal law. Any income in excess of the applicable amounts shall be 44
applied as may be required by said federal law, and assistance shall be 45
granted for the balance of the cost of authorized medical assistance. 46
The Commissioner of Social Services shall provide applicants for 47
assistance under this section, at the time of application, with a written 48
statement advising them of (1) the effect of an assignment or transfer 49
or other disposition of property on eligibility for benefits or assistance, 50 Raised Bill No. 943
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(2) the effect that having income that exceeds the limits prescribed in 51
this subsection will have with respect to program eligibility, and (3) 52
the availability of, and eligibility for, services provided by the 53
Nurturing Families Network established pursuant to section 17b-751b. 54
For coverage dates on or after January 1, 2014, the department shall 55
use the modified adjusted gross income financial eligibility rules set 56
forth in Section 1902(e)(14) of the Social Security Act and the 57
implementing regulations to determine eligibility for HUSKY A, 58
HUSKY B and HUSKY D applicants, as defined in section 17b-290. 59
Persons who are determined ineligible for assistance pursuant to this 60
section shall be provided a written statement notifying such persons of 61
their ineligibility and advising such persons of their potential 62
eligibility for one of the other insurance affordability programs as 63
defined in 42 CFR 435.4. 64
(b) For the purposes of the Medicaid program, the Commissioner of 65
Social Services shall consider parental income and resources as 66
available to a child under eighteen years of age who is living with his 67
or her parents and is blind or disabled for purposes of the Medicaid 68
program, or to any other child under twenty-one years of age who is 69
living with his or her parents. 70
(c) For the purposes of determining eligibility for the Medicaid 71
program, an available asset is one that is actually available to the 72
applicant or one that the applicant has the legal right, authority or 73
power to obtain or to have applied for the applicant's general or 74
medical support. If the terms of a trust provide for the support of an 75
applicant, the refusal of a trustee to make a distribution from the trust 76
does not render the trust an unavailable asset. Notwithstanding the 77
provisions of this subsection, the availability of funds in a trust or 78
similar instrument funded in whole or in part by the applicant or the 79
applicant's spouse shall be determined pursuant to the Omnibus 80
Budget Reconciliation Act of 1993, 42 USC 1396p. The provisions of 81
this subsection shall not apply to a special needs trust, as defined in 42 82
USC 1396p(d)(4)(A), as amended from time to time. For purposes of 83
determining whether a beneficiary under a special needs trust, who 84 Raised Bill No. 943
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has not received a disability determination from the Social Security 85
Administration, is disabled, as defined in 42 USC 1382c(a)(3), the 86
Commissioner of Social Services, or the commissioner's designee, shall 87
independently make such determination. The commissioner shall not 88
require such beneficiary to apply for Social Security disability benefits 89
or obtain a disability determination from the Social Security 90
Administration for purposes of determining whether the beneficiary is 91
disabled. 92
(d) The transfer of an asset in exchange for other valuable 93
consideration shall be allowable to the extent the value of the other 94
valuable consideration is equal to or greater than the value of the asset 95
transferred. 96
(e) The Commissioner of Social Services shall seek a waiver from 97
federal law to permit federal financial participation for Medicaid 98
expenditures for families with incomes of one hundred forty-three per 99
cent of the temporary family assistance program payment standard. 100
(f) To the extent [permitted by] permissible under federal law, 101
Medicaid eligibility shall be extended for one year to a family that 102
becomes ineligible for medical assistance under Section 1931 of the 103
Social Security Act due to income from employment by one of its 104
members who is a caretaker relative or due to receipt of child support 105
income. A family receiving extended benefits on July 1, 2005, shall 106
receive the balance of such extended benefits, provided no such family 107
shall receive more than twelve additional months of such benefits. 108
(g) An institutionalized spouse applying for Medicaid and having a 109
spouse living in the community shall be required, to the maximum 110
extent permitted by law, to divert income to such community spouse 111
in order to raise the community spouse's income to the level of the 112
minimum monthly needs allowance, as described in Section 1924 of 113
the Social Security Act. Such diversion of income shall occur before the 114
community spouse is allowed to retain assets in excess of the 115
community spouse protected amount described in Section 1924 of the 116 Raised Bill No. 943
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Social Security Act. The Commissioner of Social Services, pursuant to 117
section 17b-10, may implement the provisions of this subsection while 118
in the process of adopting regulations, provided the commissioner 119
[prints] publishes notice of intent to adopt the regulations [in the 120
Connecticut Law Journal within twenty days of] on the eRegulations 121
System prior to adopting such policy. Such policy shall be valid until 122
the time final regulations are effective. 123
(h) To the extent permissible under federal law, an institutionalized 124
individual, as defined in Section 1917 of the Social Security Act, 42 125
USC 1396p(h)(3), shall not be determined ineligible for Medicaid solely 126
on the basis of the cash value of a life insurance policy worth less than 127
ten thousand dollars provided the individual is pursuing the 128
surrender of the policy. 129
(i) To the extent permissible under federal law, an individual who 130
has applied for Medicaid and otherwise qualifies for Medicaid shall 131
not be determined ineligible on the basis of a single, unliquidated 132
asset, provided such individual presents evidence acceptable to the 133
Commissioner of Social Services that such asset is inaccessible to the 134
individual because it is not possible to liquidate the asset in fewer than 135
thirty days. 136
[(i)] (j) Medical assistance shall be provided, in accordance with the 137
provisions of subsection (e) of section 17a-6, to any child under the 138
supervision of the Commissioner of Children and Families who is not 139
receiving Medicaid benefits, has not yet qualified for Medicaid benefits 140
or is otherwise ineligible for such benefits. Medical assistance shall also 141
be provided to any child in the behavioral services program operated 142
by the Department of Developmental Services who is not receiving 143
Medicaid benefits, has not yet qualified for Medicaid benefits or is 144
otherwise ineligible for benefits. To the extent practicable, the 145
Commissioner of Children and Families and the Commissioner of 146
Developmental Services shall apply for, or assist such child in 147
qualifying for, the Medicaid program. 148 Raised Bill No. 943
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[(j)] (k) The Commissioner of Social Services shall provide Early and 149
Periodic Screening, Diagnostic and Treatment program services, as 150
required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 151
42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal 152
regulations, to all persons who are under the age of twenty-one and 153
otherwise eligible for medical assistance under this section. 154
[(k)] (l) A veteran, as defined in section 27-103, and any member of 155
his or her family, who applies for or receives assistance under the 156
Medicaid program, shall apply for all benefits for which he or she may 157
be eligible through the United States Department of Veterans Affairs 158
or the United States Department of Defense. 159
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2019 17b-261
Statement of Purpose:
To allow a person to become eligible for Medicaid if he or she
otherwise qualifies but for one inaccessible asset that cannot be
liquidated in fewer than thirty days.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]