Connecticut 2022 Regular Session

Connecticut Senate Bill SB00283 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 283
	4	+	LCO No. 2439 1 of 3
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	6	+	General Assembly Raised Bill No. 283
8	7		February Session, 2022
	8	+	LCO No. 2439
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	10	+
	11	+	Referred to Committee on HUMAN SERVICES
	12	+
	13	+
	14	+	Introduced by:
	15	+	(HS)
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14	20		AN ACT ELIMINATING INCOME AND ASSET LIMITS FOR THE MED -
15		-	CONNECT PROGRAM FOR PERSONS WITH DISABILITIES AND
16		-	INCREASING INCOME AND ASSET LIMITS FOR HUSKY C .
	21	+	CONNECT PROGRAM FOR PERSONS WITH DISABILITIES.
17	22		Be it enacted by the Senate and House of Representatives in General
18	23		Assembly convened:
19	24
20	25		Section 1. Section 17b-597 of the general statutes is repealed and the 1
21	26		following is substituted in lieu thereof (Effective July 1, 2022): 2
22	27		(a) The Department of Social Services shall establish and implement 3
23	28		a working persons with disabilities program to provide medical 4
24	29		assistance as authorized under 42 USC 1396a(a)(10)(A)(ii), as amended 5
25	30		from time to time, to persons who are disabled and regularly employed. 6
26	31		(b) The Commissioner of Social Services shall amend the Medicaid 7
27	32		state plan to allow persons specified in subsection (a) of this section to 8
28	33		qualify for medical assistance. The amendment shall [include the 9
29	34		following requirements: (1) That the person be engaged in a substantial 10
30	35		and reasonable work effort as determined by the commissioner and as 11
31	36		permitted by federal law and have an annual adjusted gross income, as 12
32	37		defined in Section 62 of the Internal Revenue Code of 1986, or any 13
33	38		subsequent corresponding internal revenue code of the United States, 14
34		-	as amended from time to time, of no more than seventy-five thousand 15
35		-	dollars per year; (2) a disregard of all countable income up to two 16
36		-	hundred per cent of the federal poverty level; (3) for an unmarried 17 Substitute Bill No. 283
	39	+	as amended from time to time, of no more than seventy-five thousand 15 Raised Bill No. 283
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	45	+	dollars per year; (2) a disregard of all countable income up to two 16
	46	+	hundred per cent of the federal poverty level; (3) for an unmarried 17
43	47		person, an asset limit of ten thousand dollars, and for a married couple, 18
44	48		an asset limit of fifteen thousand dollars; (4) a disregard of any 19
45	49		retirement and medical savings accounts established pursuant to 26 20
46	50		USC 220 and held by either the person or the person's spouse; (5) a 21
47	51		disregard of any moneys in accounts designated by the person or the 22
48	52		person's spouse for the purpose of purchasing goods or services that 23
49	53		will increase the employability of such person, subject to approval by 24
50	54		the commissioner; (6) a disregard of spousal income solely for purposes 25
51	55		of determination of eligibility; and (7)] require (1) that the person be 26
52	56		engaged in a substantial and reasonable work effort as determined by 27
53	57		the commissioner and as permitted by federal law; and (2) a 28
54	58		contribution of any countable income of the person or the person's 29
55	59		spouse which exceeds two hundred per cent of the federal poverty level, 30
56	60		as adjusted for the appropriate family size, equal to ten per cent of the 31
57	61		excess minus any premiums paid from income for health insurance by 32
58	62		any family member, but which does not exceed the maximum 33
59	63		contribution allowable under Section 201(a)(3) of Public Law 106-170, as 34
60	64		amended from time to time. 35
61	65		(c) The Commissioner of Social Services shall implement the policies 36
62	66		and procedures necessary to carry out the provisions of this section 37
63	67		while in the process of adopting such policies and procedures in 38
64	68		regulation form, provided notice of intent to adopt the regulations is 39
65	69		[published in the Connecticut Law Journal within twenty days after 40
66	70		implementation] posted on the eRegulations System in accordance with 41
67	71		section 17b-10. The commissioner shall define "countable income" for 42
68	72		purposes of subsection (b) of this section which shall take into account 43
69	73		impairment-related work expenses as defined in the Social Security Act. 44
70	74		Such policies and procedures shall be valid until the time final 45
71	75		regulations are effective. 46
72		-	Sec. 2. (NEW) (Effective July 1, 2022) The Commissioner of Social 47
73		-	Services shall increase the asset limits used to determine eligibility for 48
74		-	HUSKY C, as defined in section 17b-290 of the general statutes, from (1) 49
75		-	one thousand six hundred dollars to five thousand dollars for a single 50 Substitute Bill No. 283
	76	+	This act shall take effect as follows and shall amend the following
	77	+	sections:
	78	+	Raised Bill No. 283
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82		-	person, and (2) two thousand four hundred dollars to seven thousand 51
83		-	five hundred dollars for a married couple. 52
84		-	Sec. 3. Section 17b-261 of the 2022 supplement to the general statutes 53
85		-	is repealed and the following is substituted in lieu thereof (Effective July 54
86		-	1, 2022): 55
87		-	(a) Medical assistance shall be provided for any otherwise eligible 56
88		-	person (1) whose income, including any available support from legally 57
89		-	liable relatives and the income of the person's spouse or dependent 58
90		-	child, is not more than one hundred [forty-three per cent, pending 59
91		-	approval of a federal waiver applied for pursuant to subsection (e) of 60
92		-	this section, of the benefit amount paid to a person with no income 61
93		-	under the temporary family assistance program in the appropriate 62
94		-	region of residence and if] thirty-eight per cent of the federal poverty 63
95		-	level, and (2) if such person is an institutionalized individual as defined 64
96		-	in Section 1917 of the Social Security Act, 42 USC 1396p(h)(3), [and] such 65
97		-	person has not made an assignment or transfer or other disposition of 66
98		-	property for less than fair market value for the purpose of establishing 67
99		-	eligibility for benefits or assistance under this section. Any such 68
100		-	disposition shall be treated in accordance with Section 1917(c) of the 69
101		-	Social Security Act, 42 USC 1396p(c). Any disposition of property made 70
102		-	on behalf of an applicant or recipient or the spouse of an applicant or 71
103		-	recipient by a guardian, conservator, person authorized to make such 72
104		-	disposition pursuant to a power of attorney or other person so 73
105		-	authorized by law shall be attributed to such applicant, recipient or 74
106		-	spouse. A disposition of property ordered by a court shall be evaluated 75
107		-	in accordance with the standards applied to any other such disposition 76
108		-	for the purpose of determining eligibility. [The commissioner shall 77
109		-	establish the standards for eligibility for medical assistance at one 78
110		-	hundred forty-three per cent of the benefit amount paid to a household 79
111		-	of equal size with no income under the temporary family assistance 80
112		-	program in the appropriate region of residence.] In determining 81
113		-	eligibility, the commissioner shall not consider as income Aid and 82
114		-	Attendance pension benefits granted to a veteran, as defined in section 83 Substitute Bill No. 283
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121		-	27-103, or the surviving spouse of such veteran. Except as provided in 84
122		-	section 17b-277 and section 17b-292, the medical assistance program 85
123		-	shall provide coverage to persons under the age of nineteen with 86
124		-	household income up to one hundred ninety-six per cent of the federal 87
125		-	poverty level without an asset limit and to persons under the age of 88
126		-	nineteen, who qualify for coverage under Section 1931 of the Social 89
127		-	Security Act, with household income not exceeding one hundred 90
128		-	ninety-six per cent of the federal poverty level without an asset limit, 91
129		-	and their parents and needy caretaker relatives, who qualify for 92
130		-	coverage under Section 1931 of the Social Security Act, with household 93
131		-	income not exceeding one hundred fifty-five per cent of the federal 94
132		-	poverty level without an asset limit. Such levels shall be based on the 95
133		-	regional differences in such benefit amount, if applicable, unless such 96
134		-	levels based on regional differences are not in conformance with federal 97
135		-	law. Any income in excess of the applicable amounts shall be applied as 98
136		-	may be required by said federal law, and assistance shall be granted for 99
137		-	the balance of the cost of authorized medical assistance. The 100
138		-	Commissioner of Social Services shall provide applicants for assistance 101
139		-	under this section, at the time of application, with a written statement 102
140		-	advising them of [(1)] (A) the effect of an assignment or transfer or other 103
141		-	disposition of property on eligibility for benefits or assistance, [(2)] (B) 104
142		-	the effect that having income that exceeds the limits prescribed in this 105
143		-	subsection will have with respect to program eligibility, and [(3)] (C) the 106
144		-	availability of, and eligibility for, services provided by the Connecticut 107
145		-	Home Visiting System, established pursuant to section 17b-751b. For 108
146		-	coverage dates on or after January 1, 2014, the department shall use the 109
147		-	modified adjusted gross income financial eligibility rules set forth in 110
148		-	Section 1902(e)(14) of the Social Security Act and the implementing 111
149		-	regulations to determine eligibility for HUSKY A, HUSKY B and 112
150		-	HUSKY D applicants, as defined in section 17b-290. Persons who are 113
151		-	determined ineligible for assistance pursuant to this section shall be 114
152		-	provided a written statement notifying such persons of their ineligibility 115
153		-	and advising such persons of their potential eligibility for one of the 116
154		-	other insurance affordability programs as defined in 42 CFR 435.4. 117 Substitute Bill No. 283
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161		-	(b) For the purposes of the Medicaid program, the Commissioner of 118
162		-	Social Services shall consider parental income and resources as available 119
163		-	to a child under eighteen years of age who is living with his or her 120
164		-	parents and is blind or disabled for purposes of the Medicaid program, 121
165		-	or to any other child under twenty-one years of age who is living with 122
166		-	his or her parents. 123
167		-	(c) For the purposes of determining eligibility for the Medicaid 124
168		-	program, an available asset is one that is actually available to the 125
169		-	applicant or one that the applicant has the legal right, authority or 126
170		-	power to obtain or to have applied for the applicant's general or medical 127
171		-	support. If the terms of a trust provide for the support of an applicant, 128
172		-	the refusal of a trustee to make a distribution from the trust does not 129
173		-	render the trust an unavailable asset. Notwithstanding the provisions of 130
174		-	this subsection, the availability of funds in a trust or similar instrument 131
175		-	funded in whole or in part by the applicant or the applicant's spouse 132
176		-	shall be determined pursuant to the Omnibus Budget Reconciliation Act 133
177		-	of 1993, 42 USC 1396p. The provisions of this subsection shall not apply 134
178		-	to a special needs trust, as defined in 42 USC 1396p(d)(4)(A), as 135
179		-	amended from time to time. For purposes of determining whether a 136
180		-	beneficiary under a special needs trust, who has not received a disability 137
181		-	determination from the Social Security Administration, is disabled, as 138
182		-	defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or 139
183		-	the commissioner's designee, shall independently make such 140
184		-	determination. The commissioner shall not require such beneficiary to 141
185		-	apply for Social Security disability benefits or obtain a disability 142
186		-	determination from the Social Security Administration for purposes of 143
187		-	determining whether the beneficiary is disabled. 144
188		-	(d) The transfer of an asset in exchange for other valuable 145
189		-	consideration shall be allowable to the extent the value of the other 146
190		-	valuable consideration is equal to or greater than the value of the asset 147
191		-	transferred. 148
192		-	(e) The Commissioner of Social Services [shall seek a waiver from 149
193		-	federal law to permit federal financial participation for Medicaid 150 Substitute Bill No. 283
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200		-	expenditures for families with incomes of one hundred forty-three per 151
201		-	cent of the temporary family assistance program payment standard] 152
202		-	may seek federal approval for a Medicaid waiver or a Medicaid state 153
203		-	plan amendment to implement the provisions of this section. 154
204		-	(f) To the extent [permitted by] permissible under federal law, 155
205		-	Medicaid eligibility shall be extended for one year to a family that 156
206		-	becomes ineligible for medical assistance under Section 1931 of the 157
207		-	Social Security Act due to income from employment by one of its 158
208		-	members who is a caretaker relative or due to receipt of child support 159
209		-	income. A family receiving extended benefits on July 1, 2005, shall 160
210		-	receive the balance of such extended benefits, provided no such family 161
211		-	shall receive more than twelve additional months of such benefits. 162
212		-	(g) An institutionalized spouse applying for Medicaid and having a 163
213		-	spouse living in the community shall be required, to the maximum 164
214		-	extent permitted by law, to divert income to such community spouse in 165
215		-	order to raise the community spouse's income to the level of the 166
216		-	minimum monthly needs allowance, as described in Section 1924 of the 167
217		-	Social Security Act. Such diversion of income shall occur before the 168
218		-	community spouse is allowed to retain assets in excess of the 169
219		-	community spouse protected amount described in Section 1924 of the 170
220		-	Social Security Act. The Commissioner of Social Services, pursuant to 171
221		-	section 17b-10, may implement the provisions of this subsection while 172
222		-	in the process of adopting regulations, provided the commissioner 173
223		-	[prints] posts notice of intent to adopt the regulations [in the 174
224		-	Connecticut Law Journal within] on the eRegulations System not later 175
225		-	than twenty days [of] after adopting such policy. Such policy shall be 176
226		-	valid until the time final regulations are effective. 177
227		-	(h) To the extent permissible under federal law, an institutionalized 178
228		-	individual, as defined in Section 1917 of the Social Security Act, 42 USC 179
229		-	1396p(h)(3), shall not be determined ineligible for Medicaid solely on 180
230		-	the basis of the cash value of a life insurance policy worth less than ten 181
231		-	thousand dollars provided the individual is pursuing the surrender of 182
232		-	the policy. 183 Substitute Bill No. 283
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239		-	(i) Medical assistance shall be provided, in accordance with the 184
240		-	provisions of subsection (e) of section 17a-6, to any child under the 185
241		-	supervision of the Commissioner of Children and Families who is not 186
242		-	receiving Medicaid benefits, has not yet qualified for Medicaid benefits 187
243		-	or is otherwise ineligible for such benefits. Medical assistance shall also 188
244		-	be provided to any child in the behavioral services program operated 189
245		-	by the Department of Developmental Services who is not receiving 190
246		-	Medicaid benefits, has not yet qualified for Medicaid benefits or is 191
247		-	otherwise ineligible for benefits. To the extent practicable, the 192
248		-	Commissioner of Children and Families and the Commissioner of 193
249		-	Developmental Services shall apply for, or assist such child in qualifying 194
250		-	for, the Medicaid program. 195
251		-	(j) The Commissioner of Social Services shall provide Early and 196
252		-	Periodic Screening, Diagnostic and Treatment program services, as 197
253		-	required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 198
254		-	42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal 199
255		-	regulations, to all persons who are under the age of twenty-one and 200
256		-	otherwise eligible for medical assistance under this section. 201
257		-	(k) A veteran, as defined in section 27-103, and any member of his or 202
258		-	her family, who applies for or receives assistance under the Medicaid 203
259		-	program, shall apply for all benefits for which he or she may be eligible 204
260		-	through the United States Department of Veterans Affairs or the United 205
261		-	States Department of Defense. 206
262		-	(l) On and after January 1, 2023, the Commissioner of Social Services 207
263		-	shall, within available appropriations, provide state-funded medical 208
264		-	assistance to any child eight years of age and younger, regardless of 209
265		-	immigration status, (1) whose household income does not exceed two 210
266		-	hundred one per cent of the federal poverty level without an asset limit, 211
267		-	and (2) who does not otherwise qualify for (A) Medicaid, (B) the 212
268		-	Children's Health Insurance Program, or (C) an offer of affordable, 213
269		-	employer-sponsored insurance, as defined in the Affordable Care Act, 214
270		-	as an employee or a dependent of an employee. 215 Substitute Bill No. 283
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277		-	This act shall take effect as follows and shall amend the following
278		-	sections:
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280	84		Section 1 July 1, 2022 17b-597
281		-	Sec. 2 July 1, 2022 New section
282		-	Sec. 3 July 1, 2022 17b-261
283	85
284		-	HS Joint Favorable Subst.
	86	+	Statement of Purpose:
	87	+	To eliminate income and asset limits for working persons with
	88	+	disabilities to qualify for Medicaid.
	89	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	90	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	91	+	underlined.]
285	92