House bill NO. 230

INTRODUCED BY E. Stafman, J. Cohenour, J. Windy Boy, T. Running Wolf, D. Hawk, E. Kerr-Carpenter, M. Stromswold, A. Buckley, M. Marler, K. Kortum, T. France, M. Caferro, F. Smith, W. Curdy, D. Hayman, E. McClafferty, S. Morigeau, J. Lynch, K. Abbott, P. Tuss, J. Karlen, B. Carter, M. Romano, L. Smith, D. Baum

By Request of the ****

A BILL FOR AN ACT ENTITLED: "AN ACT directing the department of public health and human services to apply for and implement continuous eligibility for children under the age of 6 in the healthy montana kids plan; establishing legislative findings and purpose; requiring reports to the legislature; and PROVIDING AN IMMEDIATE EFFECTIVE DATE."

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:

NEW SECTION. Section 1. Continuous eligibility for young children enrolled in healthy Montana kids plan programs -- legislative findings and purpose -- direction to department of public health and human services. (1) The legislature finds that Montana voters approved a ballot initiative in 2008 to create the healthy Montana kids plan, which coordinated access to health coverage for children enrolled in the Montana medicaid program and the children's health insurance program and increased eligibility standards for those programs.

(2)        The legislature further finds that fluctuations in family income can result in a child being disenrolled and subsequently reenrolled in the programs making up the healthy Montana kids plan multiple times before the child reaches 19 years of age.

(3)        The legislature further finds that continuous eligibility for healthy Montana kids plan enrollees during the first 5 years of life:

(a)        will provide consistent, predictable access to health care services at a time of critical early childhood development;

(b)        will improve health outcomes by providing children with ongoing preventive care and by preventing gaps in care that can occur when a family loses coverage and cannot afford necessary health care services, including medications;

(c)        may reduce the costs of health care services by allowing children to receive the right level of care at the right time in the right setting and by lessening the chances that they will need emergency care or treatment for conditions that have worsened because of a lack of care; and

(d)        may improve a child's readiness for school because regular, preventive care may identify physical, behavioral, and developmental concerns that can be addressed before the conditions affect school performance.

(4)        The legislature further finds that 5-year continuous eligibility will reduce administrative costs for the department of public health and human services by reducing the need to redetermine a child's eligibility for renewed or continued coverage under the healthy Montana kids plan.

(5)        It is the purpose of the legislature to allow children enrolled in both the medicaid-funded and children's health insurance program-funded portions of the healthy Montana kids plan to remain enrolled in those programs for the first 5 years of life even if a change in family circumstances occurs that would otherwise make the children ineligible for the programs.

(6)        The legislature directs the department of public health and human services to apply to the centers for medicare and medicaid services for the necessary waivers to allow for continuous eligibility for children enrolled in the programs making up the healthy Montana kids plan through the end of the month in which a child attains 6 years of age. Among other things, the department's research and demonstration waiver applications must include but are not limited to testing of the following hypotheses:

(a)        whether ongoing enrollment will:

(i)         reduce the percentage of children disenrolled and reenrolled in the programs making up the healthy Montana kids plan during the first 5 years of life;

(ii)         increase the number of enrollees participating in well-baby and well-child visits, including developmental assessments to the extent those assessments can be quantified; and

(iii)        reduce the average monthly cost of services provided to enrollees under 6 years of age; and

(b)        whether continuous eligibility will reduce administrative costs for the department.

(7)        The department shall:

(a)        notify the appropriate interim or standing committees of the legislature of the center for medicare and medicaid services' decisions on the waivers within 30 days of the date the decisions are made; and

(b)        if a waiver request is approved, implement continuous eligibility for children covered by the waiver decision no later than January 1, 2024.

NEW SECTION. Section 2. Effective date. [This act] is effective on passage and approval.