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Regular Session, 2013
HOUSE BILL NO. 449
BY REPRESENTATIVE BURRELL
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
MEDICAID: Provides for a time-limited expansion of Medicaid eligibility standards in La.
to conform such standards to those provided in the Affordable Care Act until Dec.
31, 2016
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 979.5, relative to the medical assistance program; to3
provide for eligibility for benefits of the medical assistance program; to require state4
participation in the medical assistance program expansion provided in federal law;5
to provide for duties of the secretary of the Department of Health and Hospitals; to6
provide relative to the medical assistance program state plan; to authorize7
promulgation of rules; to establish a termination date for state participation in8
medical assistance program expansion; and to provide for related matters.9
Be it enacted by the Legislature of Louisiana:10
Section 1. Chapter 8-B of Title 46 of the Louisiana Revised Statutes of 1950,11
comprised of R.S. 46:979.1 through 979.5, is hereby enacted to read as follows: 12
CHAPTER 8-B. MEDICAL ASSISTANCE PROGRAM EXPANSI ON13
§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-1045 ORIGINAL
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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
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 111-152.6
(2) "Centers for Medicare and Medicaid Services" means the division of the7
United States Department of Health and Human Services of that name which8
regulates the Medicaid program.9
(3) "Department" means the Department of Health and Hospitals.10
(4) "Medicaid" and "medical assistance program" mean the medical11
assistance program provided for in Title XIX of the Social Security Act.12
(5) "Secretary" means the secretary of the Department of Health and13
Hospitals.14
§979.2. Legislative findings; declaration15
A. The Legislature of Louisiana does hereby find and declare the following:16
(1) The Affordable Care Act, referred to hereafter in this Chapter as the17
"ACA", sets forth health policy reforms which reshape the way virtually all18
Americans will receive and finance their health care.19
(2) In a decision announced on June 28, 2012, the Supreme Court of the20
United States in National Federation of Independent Business Et Al. v. Sebelius,21
Secretary of Health and Human Services, Et Al. upheld the overall constitutionality22
of the ACA; but in the same ruling, a majority of the court held that the mandatory23
expansion of Medicaid eligibility as provided in the ACA is unconstitutionally24
coercive of states, thereby making participation in the Medicaid expansion a25
voluntary proposition for each state.26
(3) At twenty-five percent of the federal poverty level, or just under five27
thousand eight hundred dollars in annual income for a family of four presently, the28 HLS 13RS-1045 ORIGINAL
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income eligibility threshold of this state for Medicaid benefits for parents of1
Medicaid-eligible children is the second-lowest in the nation.2
(4) Pursuant to provisions of the ACA, federal regulations, and guidance3
issued by the Centers for Medicare and Medicaid Services, the following conditions4
shall apply in each state which participates in the Medicaid expansion:5
(a) The Medicaid income eligibility threshold increases to one hundred6
thirty-three percent of the federal poverty level, or thirty thousand seven hundred7
thirty-three dollars in annual income for a family of four presently, for all persons8
of ages nineteen to sixty-four beginning on January 1, 2014.9
(b) The federal share of funding for Medicaid benefits for persons who10
became eligible due to the expansion is one hundred percent from 2014 through11
2017.12
(c) The federal share of funding for Medicaid benefits for persons who13
became eligible due to the expansion phases down from one hundred percent to14
ninety percent between 2017 and 2020, with the federal share remaining at ninety15
percent in ensuing years.16
(d) Acceptance of full federal financing of an expanded Medicaid program17
during any part of the first three years of the expansion does not obligate the state to18
continue its expanded Medicaid program subsequently.19
(5) Within federally provided guidelines, the secretary of the department20
may establish and modify eligibility standards for the Medicaid program through21
amendments to the Medicaid state plan and to administrative rules providing for22
operation of the program.23
(6) The legislature declares that participation in the expansion of Medicaid24
eligibility as provided in the ACA with an option to discontinue such participation25
at any point is in the best interest of the state.26
§979.3. Purposes27
The purposes of this state in expanding Medicaid eligibility to conform to the28
standards provided in the ACA, as required by this Chapter, are as follows:29 HLS 13RS-1045 ORIGINAL
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(1) To maximize the number of Louisianians who are covered by some form1
of health insurance.2
(2) To provide basic health coverage to the working poor of the state who3
are not offered insurance through their employer and do not earn enough money to4
meet basic family needs and pay for private health insurance.5
(3) To assure health care providers who serve low- to moderate-income6
persons of some amount of compensation for the care they provide, as the ACA7
provides for a dramatic reduction in funding to federal programs which currently8
finance care for the uninsured as a means of financing the Medicaid expansion.9
(4) To avail the state of an expanding resource for medical care for its10
neediest citizens while other sources of financing for such care are being drastically11
diminished.12
§979.4. Expansion of Medicaid eligibility; duties of the secretary of the Department13
of Health and Hospitals14
On or before September 1, 2013, the secretary of the department shall take15
all of the following actions:16
(1) File a Medicaid state plan amendment with the Centers for Medicare and17
Medicaid Services to provide that beginning on January 1, 2014, eligibility standards18
for medical assistance program benefits in Louisiana conform to the minimum19
eligibility standards as provided in the Patient Protection and Affordable Care Act20
(P.L. 111-148) and codified in federal regulations relative to medical assistance21
program coverage (42 CFR 435.119).22
(2) Promulgate all rules and regulations in accordance with the23
Administrative Procedure Act as are necessary to implement the provisions of this24
Chapter.25
§979.5. Expanded Medicaid eligibility; termination26
A. The provisions of this Chapter shall terminate on December 31, 2016.27
B. The secretary is hereby authorized to take such actions as are necessary28
to revise the Medicaid income eligibility threshold to any level allowed by federal29 HLS 13RS-1045 ORIGINAL
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law other than that provided in R.S. 46:979.4, and to cause such revised income1
eligibility threshold to take effect no sooner than January 1, 2017.2
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)]
Burrell HB No. 449
Abstract: Provides for a time-limited expansion of Medicaid eligibility standards in La. to
conform such standards to those provided in the Affordable Care Act until Dec. 31,
2016.
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 assure health care providers who serve low- to moderate-income persons of some
amount of compensation for the care they provide, as the ACA provides for a
dramatic reduction in funding to federal programs which currently finance care for
the uninsured as a means of financing the Medicaid expansion.
(4)To avail the state of an expanding resource for medical care for its neediest citizens
while other sources of financing for such care are being drastically diminished.
Proposed law provides that proposed law shall terminate on Dec. 31, 2016. Further,
authorizes the secretary of DHH to revise the Medicaid income eligibility threshold to any
level allowed by federal law other than that required by preceding provisions of proposed
law, and to cause such revised income eligibility threshold to take effect no sooner than Jan.
1, 2017.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 46:979.1-979.5)