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OLR Bill Analysis
HB 6687 (as amended by House "A")*
Emergency Certification
AN ACT CONCERNING MEDICAL ASSISTANCE FOR CHILDREN
AND ADULTS WITHOUT HEALTH CARE COVERAGE.
SUMMARY
This bill requires the Department of Social Services (DSS) to extend
eligibility for medical assistance, subject to income limits and within
available appropriations, to certain groups of people regardless of
immigration status, who do not otherwise qualify for health care
coverage. The bill extends this coverage to (1) children under age 9 and
(2) women for 12 months after giving birth.
The bill also requires the DSS commissioner to amend the
Children’s Health Insurance Program (CHIP) state plan to provide
medical assistance for prenatal care through the “unborn child
option.” This is a state option that allows states to consider an unborn
child a low-income child eligible for prenatal care coverage if other
CHIP eligibility requirements are met.
The bill also requires the Office of Health Strategy (OHS) executive
director to study the feasibility of offering health care coverage for (1)
income-eligible children ages 9 to 18, regardless of immigration status,
and (2) adults with household income up to 200% of the federal
poverty level (FPL) who do not currently qualify for medical assistance
due to household income. The executive director must report on the
plans to the Appropriations, Human Services, and Insurance and Real
Estate committees by July 1, 2022.
Lastly, the bill allows the DSS commissioner to (1) seek a state
innovation waiver under section 1332 of the Affordable Care Act
(ACA) or (2) enter into contractual agreements with other states, in
accordance with established procedures, as needed to perform duties 2021HB-06687-R01-BA.DOCX
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under the bill. Section 1332 of the ACA allows states to waive certain
ACA requirements in order to customize their health insurance
systems to better meet the state’s context and needs while retaining the
basic protections of the ACA.
*House Amendment “A” delays the implementation date for
provisions requiring coverage for children and postpartum care;
establishes lack of coverage from other sources as a requirement for
eligibility; specifies that medical assistance is state-funded; requires the
OHS director, rather than DSS, to study further expansions; and adds
the provision authorizing a 1332 waiver and contracts with other
states.
EFFECTIVE DATE: October 1, 2021, except the report requirement
is effective upon passage.
§§ 1 & 3 — CHILDREN UNDER AGE 9
The bill requires the DSS commissioner, beginning January 1, 2023,
to provide state-funded medical assistance, within available
appropriations, to children under age 9, regardless of immigration
status, with household incomes (1) up to 201% of FPL with no asset
limit and (2) over 201% of FPL and up to 323% of FPL. Under the bill,
eligible children are those who do not otherwise qualify for (1)
Medicaid, (2) CHIP, or (3) an offer of affordable, employer-sponsored
insurance as defined in the ACA as an employee or employee’s
dependent.
§ 2 — POSTPARTUM CARE F OR WOMEN
The bill requires the DSS commissioner, on or after April 1, 2023, to
provide state-funded medical assistance, within available
appropriations, for postpartum care to women for 12 months after
birth who (1) do not qualify for Medicaid due to immigration status
and (2) have household incomes up to 263% of FPL.
§ 4 — UNBORN CHILD OPTION FOR PRENATAL CARE
The bill requires the DSS commissioner to amend the CHIP state
plan to provide medical assistance for prenatal care through the 2021HB-06687-R01-BA.DOCX
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“unborn child option.” This is a state option that allows states to
consider an unborn child a low-income child eligible for coverage of
prenatal care if other CHIP eligibility requirements are met. According
to the federal Centers for Medicare and Medicaid Services, the
requirement to meet other CHIP eligibility criteria applies to the child
and not the mother.
The commissioner must provide medical assistance for prenatal care
through this option by April 1, 2022. CHIP is jointly funded by the
state and federal government and is administered by DSS according to
federal requirements. The state provides CHIP coverage under
HUSKY B, which covers children in families with household incomes
between 196% and 318% of the federal poverty limit.
§ 5 — STUDY ON FEASIBILITY OF EXPANDING HEALTH CARE
COVERAGE
The bill requires the OHS executive director to study the feasibility
of offering health care coverage for the following groups:
1. income-eligible children ages 9 to 18, regardless of immigration
status, who are not otherwise eligible for other coverage (i.e.,
under Medicaid, CHIP, or an offer of affordable employer
sponsored insurance as defined in the ACA as an employee or
employee’s dependent) and
2. adults with household income up to 200% of FPL who do not
otherwise qualify for other coverage (i.e., under medical
assistance programs (e.g., Medicaid), employer-sponsored
insurance as defined in the ACA as an employee or employee’s
dependent, or health care coverage through the Connecticut
Health Insurance Exchange due to household income).
The bill requires the OHS director to conduct the studies in
consultation with the Office of Policy and Management, DSS, the
Connecticut Insurance Department, and the Connecticut Health
Insurance Exchange.
The bill requires the study on health care coverage for income- 2021HB-06687-R01-BA.DOCX
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eligible children to include:
1. the age groups that would be provided medical assistance in
each year, and the appropriations needed to do so,
2. income eligibility criteria and health care coverage consistent
with assistance the state provides under Medicaid and CHIP,
and
3. recommendations for identifying and enrolling eligible
children.
The bill requires the study on health care coverage for adults to
include:
1. household income caps for adults who would be provided
health care coverage in each year, and the appropriations
needed to do so;
2. health care coverage consistent with medical assistance the state
provides under Medicaid generally and HUSKY D specifically;
and
3. recommendations for identifying and enrolling eligible adults.
The bill requires the OHS executive director to report on the studies
to the Appropriations, Human Services, and Insurance and Real Estate
committees by July 1, 2022.
BACKGROUND
Related Bills
sSB 910 (File 130), favorably reported by the Appropriations and
Human Services committees, requires DSS to extend Medicaid
coverage for postpartum care to 12 months after a mother gives birth.
sSB 911 (File 115), favorably reported by the Human Services
Committee, requires DSS to amend the CHIP plan to provide medical
assistance for prenatal care through the unborn child option. 2021HB-06687-R01-BA.DOCX
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SB 956 (File 516), favorably reported by the Appropriations and
Human Services committees, requires DSS to provide medical
assistance, within available appropriations, to people regardless of
their immigration status, if they otherwise meet income eligibility
guidelines.
Federal Poverty Level
The U.S. Department of Health and Human Services establishes the
FPL (“federal poverty level”) annually. Table 1 shows the number of
people in a household and the annual FPL amounts for 2021 at various
percentages, rounded to the nearest dollar.
Table 1: FPL Amounts at Various Percentages
Number of
People in
Household
100% 200% 201% 263% 323%
1 $12,880 $25,760 $25,889 $33,874 $41,602
2 $17,420 $34,840 $35,014 $45,815 $56,267
3 $21,960 $43,920 $44,140 $57,755 $70,931