- 2025 69th Legislature 2025 HB0185.2 - 1 - Authorized Print Version – HB 185 1 HOUSE BILL NO. 185 2 INTRODUCED BY E. STAFMAN, R. MARSHALL, T. RUNNING WOLF, M. YAKAWICH, S. HOWELL, G. 3 NIKOLAKAKOS 4 5 A BILL FOR AN ACT ENTITLED: “AN ACT DIRECTING THE DEPARTMENT OF PUBLIC HEALTH AND 6 HUMAN SERVICES TO APPLY FOR AND IMPLEMENT CONTINUOUS ELIGIBILITY FOR CHILDREN 7 UNDER 6 YEARS OF AGE IN THE HEALTHY MONTANA KIDS PLAN; REQUIRING REPORTS TO THE 8 LEGISLATURE; AND PROVIDING AN IMMEDIATE EFFECTIVE DATE.” 9 10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA: 11 12 NEW SECTION. Section 1. 13 (1) The legislature finds that Montana voters 14 approved a ballot initiative in 2008 to create the healthy Montana kids plan, which coordinated access to health 15 coverage for children enrolled in the Montana medicaid program and the children's health insurance program 16 and increased eligibility standards for those programs. 17 (2) The legislature further finds that fluctuations in family income can result in a child being 18 disenrolled and subsequently reenrolled in the programs making up the healthy Montana kids plan multiple 19 times before the child reaches 19 years of age. 20 (3) The legislature further finds that Montana experienced one of the largest percentage increases 21 of children losing coverage under the medicaid program and children's health insurance program during the 22 recent eligibility unwinding, and, as a result, large numbers of uninsured children are eligible but not enrolled in 23 the medicaid program and the children's health insurance program. 24 (4) The legislature further finds that pediatrician-recommended checkups are more frequent in the 25 earliest months and years of a child's life to monitor developmental milestones and address small complications 26 before they become complex conditions. 27 (5) The legislature further finds that 3 YEARS OF continuous eligibility FROM THE DATE OF 28 OR SUBSEQUENT for healthy Montana kids plan enrollees under 6 years of age: - 2025 69th Legislature 2025 HB0185.2 - 2 - Authorized Print Version – HB 185 1 (a) will provide consistent, predictable access to health care services at a time of critical early 2 childhood development; 3 (b) will improve health outcomes by providing children with ongoing preventive care and by 4 preventing gaps in care that can occur when a family loses coverage and cannot afford necessary health care 5 services, including medications; 6 (c) may reduce the costs of health care services by allowing children to receive the right level of 7 care at the right time in the right setting and by lessening the chances that they will need emergency care or 8 treatment for conditions that have worsened because of a lack of care; and 9 (d) may improve a child's readiness for school because regular, preventive care may identify 10 physical, behavioral, and developmental concerns that can be addressed before the conditions affect school 11 performance. 12 (6) The legislature further finds that providing 3 YEARS OF continuous eligibility until the child 13 reaches FROM THE DATE OF ENROLLMENT OR REENROLLMENT FOR A CHILD UNDER 6 years of age will reduce 14 administrative costs for the department of public health and human services by reducing the need to 15 redetermine a child's eligibility for renewed or continued coverage under the healthy Montana kids plan. 16 (7) It is the purpose of the legislature to allow a child UNDER 6 YEARS OF AGE enrolled in the healthy 17 Montana kids plan to remain enrolled in the program until 6 years of age FOR 3 YEARS FROM THE 18 INITIAL ENROLLMENT OR REENROLLMENT, 6 YEARS OF AGE, WHICHEVER OCCURS 19, even if a change in family circumstances occurs that would otherwise make the child ineligible for the 20 program. 21 (8) The department of public health and human services may conduct audits to ensure compliance 22 with this section. 23 (9) The legislature directs the department of public health and human services to apply to the 24 centers for medicare and medicaid services for the necessary waivers and state plan amendments to allow for 25 3 YEARS OF continuous eligibility as provided in this section for children enrolled in the programs making up the 26 healthy Montana kids plan through the end of the month in which a child attains 6 years of age. Among other 27 elements, the department's research and demonstration waiver applications must include but are not limited to 28 testing of the following hypotheses: - 2025 69th Legislature 2025 HB0185.2 - 3 - Authorized Print Version – HB 185 1 (a) whether ongoing enrollment will: 2 (i) reduce the percentage of children under 6 years of age who are disenrolled and reenrolled in 3 the programs making up the healthy Montana kids plan; 4 (ii) increase the number of enrollees participating in well-baby and well-child visits, including 5 developmental assessments to the extent those assessments can be quantified; and 6 (iii) increase access to early intervention or other services that can prevent or lessen 7 developmental delays before kindergarten; and 8 (b) whether continuous eligibility will reduce administrative costs for the department. 9 (10) The department shall: 10 (a) submit requests for the necessary waivers and amendments required under subsection (9) no 11 later than July 1, 2025; 12 (b) notify the appropriate interim or standing committees of the legislature when the department 13 has received a decision from the centers for medicare and medicaid services on a waiver or amendment 14 request and include a copy of the decision with the certification. The department shall submit the notification 15 within 30 days from the date the decision is received and shall submit a copy of the notification to the code 16 commissioner. 17 (c) if the necessary waiver and amendment requests are approved, implement 3 YEARS OF 18 continuous eligibility for eligible children no later than 6 months from the date the approval from the centers for 19 medicare and medicaid services is received by the department. 20 21 NEW SECTION. Section 2. [This act] is effective on passage and approval. 22 - END -