Bill > HB2457

This bill expands MO HealthNet services to include individuals aged 19 to 64 who are not otherwise eligible but meet specific income requirements, specifically those at or below 133% of the federal poverty level plus an additional 5%, as outlined by federal law (42 U.S.C. Section 1396a(a)(10)(A)(i)(VIII) and 42 CFR 435.119 and 435.603). These individuals will receive a comprehensive "health benefits service package," which will be determined by the Department of Social Services to meet federal coverage requirements. Importantly, reimbursement rates for providers serving these newly eligible individuals will be comparable to commercial insurance payment levels, a higher rate than typically paid for MO HealthNet services, and will be set annually. The bill also establishes conditions under which this expanded eligibility could be discontinued, including a decrease in federal funding below 90% or a vote by the General Assembly, with the MO HealthNet oversight committee tasked with providing information on costs, savings, and outcomes to inform such decisions. The oversight committee will also research potential cost-sharing options, expanding coverage for state-financed services, and enrolling individuals in private health plans.