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Regular Session, 2013
HOUSE BILL NO. 110
BY REPRESENTATIVE NORTON
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
MEDICAID: Requires that La. Medicaid eligibility standards conform to those established
by the Affordable Care Act
AN ACT1
To enact Chapter 8-B of Title 46 of the Louisiana Revised Statutes of 1950, to be comprised2
of R.S. 46:979.1 through 979.4, relative to eligibility for benefits of the medical3
assistance program; to require state participation in the medical assistance program4
expansion provided in federal law; to provide for duties of the secretary of the5
Department of Health and Hospitals; to provide relative to the medical assistance6
program state plan; to authorize promulgation of rules; and to provide for related7
matters.8
Be it enacted by the Legislature of Louisiana:9
Section 1. Chapter 8-B of Title 46 of the Louisiana Revised Statutes of 1950,10
comprised of R.S. 46:979.1 through 979.4, is hereby enacted to read as follows: 11
CHAPTER 8-B. FEDERALLY PROVIDED MEDICAL ASSISTANCE12
PROGRAM EXPANSION13
§979.1. Definitions14
As used in this Chapter, the following terms shall have the meaning ascribed15
to them in this Section:16
(1) "ACA" and "Affordable Care Act" mean the following Acts of Congress,17
collectively:18 HLS 13RS-679 ORIGINAL
HB NO. 110
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(a) The Patient Protection and Affordable Care Act, which originated as H.R.1
3590 in the One Hundred Eleventh United States Congress and became Public Law2
No. 111-148.3
(b) The Health Care and Education Reconciliation Act, which originated as4
H.R. 4872 in the One Hundred Eleventh United States Congress and became Public5
Law No. 111-152.6
(2) "Department" means the Department of Health and Hospitals.7
(3) "Medicaid" and "medical assistance program" mean the medical8
assistance program provided for in Title XIX of the Social Security Act.9
§979.2. Legislative findings; declaration10
The Legislature of Louisiana does hereby find and declare the following:11
(1) The Affordable Care Act, referred to hereafter in this Chapter as the12
"ACA", sets forth monumental health policy reforms, as it reshapes the way virtually13
all Americans will receive and finance their health care.14
(2) Among the key features of the ACA are rights and protections for health15
care consumers, accountability measures for insurance companies, expanded16
eligibility for the Medicaid program, and a requirement that every American17
maintain a minimum level of health insurance coverage.18
(3) In a decision announced on June 28, 2012, the Supreme Court of the19
United States in National Federation of Independent Business Et Al. v. Sebelius,20
Secretary of Health and Human Services, Et Al. upheld the overall constitutionality21
of the ACA; but in the same ruling, a majority of the court held that the mandatory22
expansion of Medicaid eligibility as provided in the ACA is unconstitutionally23
coercive of states, thereby making participation in the Medicaid expansion a24
voluntary proposition for states.25
(4) At twenty-five percent of the federal poverty level, or just under five26
thousand eight hundred dollars in annual income for a family of four presently, the27
income eligibility threshold of this state for Medicaid benefits for parents of28
Medicaid-eligible children is the second-lowest in the nation.29 HLS 13RS-679 ORIGINAL
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(5) All of the following provisions of the ACA apply in states which1
participate in the Medicaid expansion:2
(a) The Medicaid income eligibility threshold increases to one hundred3
thirty-three percent of the federal poverty level, or thirty thousand seven hundred4
thirty-three dollars in annual income for a family of four presently, for all persons5
of ages nineteen to sixty-four beginning on January 1, 2014.6
(b) The federal share of funding for Medicaid benefits for persons who7
became eligible due to the expansion is one hundred percent from 2014 through8
2017.9
(c) The federal share of funding for Medicaid benefits for persons who10
became eligible due to the expansion phases down from one hundred percent to11
ninety percent between 2017 and 2020, with the federal share remaining at ninety12
percent in ensuing years.13
(6) The many thousands of working poor families in Louisiana who earn14
income from employment but who cannot afford health insurance will derive the15
greatest benefits of the Medicaid expansion in this state; and correspondingly, will16
be penalized to the greatest extent financially by the provisions of the ACA if the17
state refuses to participate in the Medicaid expansion and those families fail to18
maintain health coverage as required by law after January 1, 2014.19
(7) Therefore the legislature declares that due to compelling moral and20
economic reasons, participation in the expansion of Medicaid as provided in the21
ACA is in the best interest of this state.22
§979.3. Purposes23
The purposes of this state in expanding Medicaid eligibility to conform to the24
standards provided in the ACA, as required by this Chapter, are as follows:25
(1) To maximize the number of Louisianians who are covered by some form26
of health insurance.27 HLS 13RS-679 ORIGINAL
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(2) To provide basic health coverage to the working poor of the state who1
are not offered insurance through their employer and do not earn enough money to2
meet basic family needs and pay for private health insurance.3
(3) To protect the working poor and other financially vulnerable persons4
from being forced to obtain private insurance or be penalized financially, as provided5
in the ACA, for not maintaining health coverage.6
(4) To assure health care providers who serve low- to moderate-income7
persons of some amount of compensation for the care they provide, as the Medicaid8
expansion is partly funded by a dramatic reduction in funding to federal programs9
which currently finance care for the uninsured.10
(5) To avert the economic and human costs of crises in both access to health11
care and health services financing which are likely to result from not participating12
in an expansion of a federal program while other major programs which finance13
medical care for the uninsured and the indigent are being drastically reduced.14
§979.4. Expansion of Medicaid eligibility; duties of the secretary of the Department15
of Health and Hospitals16
On or before September 1, 2013, the secretary of the department shall take17
all of the following actions:18
(1) File a Medicaid state plan amendment with the Centers for Medicare and19
Medicaid Services to provide that beginning on January 1, 2014, eligibility standards20
for medical assistance program benefits in Louisiana shall conform to the minimum21
eligibility standards as provided in the Patient Protection and Affordable Care Act22
(P.L. 111-148) and codified in federal regulations relative to medical assistance23
program coverage (42 CFR 435.119).24
(2) Promulgate all rules and regulations in accordance with the25
Administrative Procedure Act as are necessary to implement the provisions of this26
Chapter.27
Section 2. This Act shall become effective upon signature by the governor or, if not28
signed by the governor, upon expiration of the time for bills to become law without signature29 HLS 13RS-679 ORIGINAL
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by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If1
vetoed by the governor and subsequently approved by the legislature, this Act shall become2
effective on the day following such approval.3
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Norton HB No. 110
Abstract: Requires that La. Medicaid eligibility standards conform to those established by
the Affordable Care Act.
Proposed law requires the secretary of DHH to take such actions as are necessary to expand
Louisiana's Medicaid eligibility standards to conform to those established by the Affordable
Care Act (ACA) commencing on January 1, 2014. Provides that such actions by the
secretary shall include:
(1)On or before September 1, 2013, filing of the Medicaid state plan amendment
necessary to expand Medicaid eligibility in accordance with proposed law.
(2)On or before September 1, 2013, promulgating all rules and regulations as are
necessary to expand Medicaid eligibility in accordance with proposed law.
Proposed law declares that the purposes of the state in expanding Medicaid eligibility as
provided in proposed law are as follows:
(1)To maximize the number of Louisianians who are covered by some form of health
insurance.
(2)To provide basic health coverage to the working poor of the state who are not offered
insurance through their employer and do not earn enough money to meet basic
family needs and pay for private health insurance.
(3)To protect the working poor and other financially vulnerable persons from being
forced to obtain private insurance or be penalized financially, as provided in the
ACA, for not maintaining health coverage.
(4)To assure health care providers who serve low- to moderate-income persons of some
amount of compensation for the care they provide.
(5)To avert the economic and human costs of crises in both access to health care and
health services financing which are likely to result from not participating in an
expansion of a federal program while other major programs which finance medical
care for the uninsured and the indigent are being drastically reduced.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 46:979.1-979.4)