HLS 14RS-939 ORIGINAL Page 1 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Regular Session, 2014 HOUSE BILL NO. 759 BY REPRESENTATIVE NORTON 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. 46:979.11 through 979.13, relative to the medical assistance program; to3 prescribe medical assistance program eligibility criteria; to require state participation4 in the expansion of medical assistance program eligibility provided in federal law;5 to provide for definitions; to provide for legislative findings and intent; and to6 provide for related matters.7 Be it enacted by the Legislature of Louisiana:8 Section 1. Chapter 8-B of Title 46 of the Louisiana Revised Statutes of 1950,9 comprised of R.S. 46:979.11 through 979.13, is hereby enacted to read as follows: 10 CHAPTER 8-B. FEDERALLY PROVIDED11 MEDICAL ASSISTANCE PROGRAM EXPANSI ON12 §979.11. Definitions13 As used in this Chapter, the following terms have the meaning ascribed to14 them in this Section:15 (1) "ACA" and "Affordable Care Act" mean the following acts of congress,16 collectively:17 (a) The Patient Protection and Affordable Care Act, which originated as H.R.18 3590 in the One Hundred Eleventh United States Congress and became Public Law19 111-148.20 HLS 14RS-939 ORIGINAL HB NO. 759 Page 2 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (b) The Health Care and Education Reconciliation Act, which originated as1 H.R. 4872 in the One Hundred Eleventh United States Congress and became Public2 Law 111-152.3 (2) "Centers for Medicare and Medicaid Services" means the division of the4 United States Department of Health and Human Services which administers and5 regulates the Medicaid program.6 (3) "Department" means the Department of Health and Hospitals.7 (4) "Medicaid" and "medical assistance program" mean the medical8 assistance program provided for in Title XIX of the Social Security Act.9 (5) "Secretary" means the secretary of the Department of Health and10 Hospitals.11 §979.12. Legislative findings; purpose12 A. The Legislature of Louisiana hereby finds and declares the following:13 (1) The Affordable Care Act, referred to hereafter in this Chapter as the14 "ACA", sets forth health policy reforms that reshape the way virtually all Americans15 will receive and finance their health care.16 (2) In a decision announced on June 28, 2012, the Supreme Court of the17 United States in National Federation of Independent Business Et Al. v. Sebelius,18 Secretary of Health and Human Services, Et Al. upheld the overall constitutionality19 of the ACA; but in the same ruling, a majority of the court held that the mandatory20 expansion of Medicaid eligibility as provided in the ACA is unconstitutionally21 coercive of states, thereby making participation in the Medicaid expansion a22 voluntary proposition for each state.23 (3) The Legislative Fiscal Office estimated in 2013 that had Louisiana24 implemented Medicaid expansion beginning January 1, 2014, the State General Fund25 savings to result from the expansion would have been one hundred six million to one26 hundred eleven million dollars per year from 2014 through 2018, totaling five27 hundred thirty-two million to five hundred fifty-four million dollars in State General28 Fund savings for the period.29 HLS 14RS-939 ORIGINAL HB NO. 759 Page 3 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (4) The legislature declares that due to compelling moral and economic1 reasons, participation in the expansion of Medicaid eligibility is in the best interest2 of this state.3 B. The purposes of this state in expanding Medicaid eligibility to conform4 to the standards established by the ACA, as provided in this Chapter, are as follows:5 (1) To maximize the number of Louisianians who are covered by some form6 of health insurance.7 (2) To provide basic health coverage to the working poor of the state who8 are not offered insurance through their employer and do not earn enough money to9 meet basic family needs and pay for private health insurance.10 (3) To assure health care providers who serve low- to moderate-income11 persons of some amount of compensation for the care they provide, as the ACA12 provides for a dramatic reduction in funding to federal programs which currently13 finance care for the uninsured as a means of financing the Medicaid expansion.14 (4) To avert the economic and human costs of crises in both access to health15 care and health services financing which are likely to result from not participating16 in the expansion of Medicaid while other federal sources of financing for medical17 care for the uninsured and the indigent are being drastically reduced or eliminated.18 §979.13. Expansion of Medicaid eligibility; duties of the secretary of the19 Department of Health and Hospitals20 On or before October 1, 2014, the secretary of the department shall take all21 of the following actions in order to expand Medicaid eligibility:22 (1) File a Medicaid state plan amendment with the Centers for Medicare and23 Medicaid Services to provide that eligibility standards for medical assistance24 program benefits in Louisiana conform to the minimum eligibility standards as25 provided in the Patient Protection and Affordable Care Act (P.L. 111-148) and26 codified in federal regulations relative to medical assistance program coverage (4227 CFR 435.119).28 HLS 14RS-939 ORIGINAL HB NO. 759 Page 4 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (2) Promulgate all rules and regulations in accordance with the1 Administrative Procedure Act as are necessary to implement the provisions of this2 Chapter.3 Section 2. This Act shall become effective upon signature by the governor or, if not4 signed by the governor, upon expiration of the time for bills to become law without signature5 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If6 vetoed by the governor and subsequently approved by the legislature, this Act shall become7 effective on the day following such approval.8 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. 759 Abstract: Requires that La. Medicaid eligibility standards conform to those established by the Affordable Care Act. Proposed law requires the secretary of the Dept. of Health and Hospitals to take actions on or before Oct. 1, 2014, as are necessary to cause this state's participation in the expansion of Medicaid eligibility as provided by the Affordable Care Act (ACA). Provides that such actions shall include: (1)Filing the Medicaid state plan amendment necessary to expand eligibility in accordance with proposed law. (2)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 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 the expansion of Medicaid while other federal sources of financing for medical care for the uninsured and the indigent are being drastically reduced or eliminated. HLS 14RS-939 ORIGINAL HB NO. 759 Page 5 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Effective upon signature of governor or lapse of time for gubernatorial action. (Adds R.S. 46:979.11-979.13)