REPORT TITLE:
Medical Assistance
DESCRIPTION:
Requires the state to cover medical assistance according to a
statutory formula. (HB3016 CD1)
3016
HOUSE OF REPRESENTATIVES H.B. NO. H.D. 1
TWENTIETH LEGISLATURE, 2000 S.D. 1
STATE OF HAWAII C.D. 1
________________________________________________________________
________________________________________________________________
A BILL FOR AN ACT
RELATING TO MEDICAL ASSISTANCE TO LOW-INCOME PERSONS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
1 SECTION 1. The legislature finds that a number of
2 individuals in the State are unable to receive necessary health
3 care services due to overly restrictive federal regulations.
4 These individuals, many who derive their income solely or largely
5 from Social Security, have terminal or life-threatening
6 illnesses. Due to these unwieldy regulations, persons must
7 either spend nearly half of their monthly income to qualify for
8 medicaid, or they avoid a "spend-down" and therefore do without
9 critical health care, including necessary treatment and services
10 for sexually transmitted diseases, AIDS, and family health
11 services.
12 The legislature recognizes that the concept of spend-down is
13 related to eligibility for medicaid's medically needy program.
14 However, federal requirements do not allow states to defer spend-
15 down requirements. To do so would cause a state to be in
16 noncompliance with federal requirements resulting in the
17 withholding of federal funding. In fact, the medicaid spend-down
18 requirements apply to all persons who are eligible under the
19 medically needy program, and under federal provisions, exceptions
20 are not allowed for any group of individuals.
Page 2 3016
H.B. NO. H.D. 1
S.D. 1
C.D. 1
1 The medicaid program allows a state to expand coverage to
2 select groups of individuals who are above the medicaid income
3 level but are low income, provided the state bears the full cost
4 of the selective assistance. The legislature finds that health
5 care services should be expanded to assist those who are deemed
6 financially needy and who have terminal or life-threatening
7 illnesses.
8 SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended
9 by adding a new section to be appropriately designated and to
10 read as follows:
11 "ยง321- Medical assistance to people on limited incomes
12 with terminal or life-threatening illnesses. The State shall
13 provide state only funds per individual per month to cover
14 medical expenses not to exceed an amount equal to the difference
15 between the medically needy income standard and one hundred per
16 cent of the federal poverty level for a household of one, to
17 people who derive their income solely or not less than eighty per
18 cent from social security, if they have a terminal or life
19 threatening illness.
20 For the purposes of this section:
21 "Terminal illness" means that a licensed physician
22 (preferably the patient's own physician) has attested in writing
23 that due to the nature of the patient's condition, the patient's
24 life expectancy is expected to be six months or less.
Page 3 3016
H.B. NO. H.D. 1
S.D. 1
C.D. 1
1 "Life threatening illness" means that a licensed physician
2 (preferably the patient's own physician) has attested in writing
3 that the patient has a condition held in abeyance due to
4 condition-specific medication or treatment which, if withheld
5 from the patient, would eventually lead to death."
6 SECTION 3. New statutory material is underscored.
7 SECTION 4. This Act shall take effect upon its approval.