Bill > AB374

Introduced Session

Legislative Counsel's Digest: The Patient Protection and Affordable Care Act (Public Law 111-148, as amended) provides a refundable federal income tax credit and cost-sharing reductions to certain eligible persons who earn not more than 400 percent of the federally designated poverty level in order to offset the cost of certain health care plan premiums. (26 U.S.C. 36B, 42 U.S.C. 18071; 45 C.F.R. 155.305) The Act further requires that such credits and cost-sharing reductions only be made available to purchase health insurance which is offered on a state health insurance exchange, which includes, without limitation, the Silver State Health Insurance Exchange established by this State in 2011. (26 U.S.C. 36B, 42 U.S.C. 18071; NRS 695I.200) Existing federal law authorizes the Secretary of the United States Department of Health and Human Services to waive certain Medicaid requirements or provisions of the Act to promote state health care innovation. (42 U.S.C. 1315, 18052) Existing federal law states that the purpose of the Medicaid program is to promote access to health insurance for certain low-income persons. (42 U.S.C. 1396) Existing law authorizes this State to enroll Medicaid recipients in a managed care program provided by a health maintenance organization pursuant to a contract with the Nevada Department of Health and Human Services. (42 U.S.C. 1396u-2; NRS 422.273) Existing federal law also authorizes a state to receive its Federal Medical Assistance Percentage (FMAP) allotment of money from the Federal Government to reimburse providers of health care for medical services which are provided as part of a managed care program. (42 U.S.C. 1396d, 1396u-2) Existing law requires this State to develop a State Plan for Medicaid which includes, without limitation, a list of the medical services provided to Medicaid recipients. (42 U.S.C. 1396a; NRS 422.063) Existing law also prohibits a state from using FMAP or other federal Medicaid money to reimburse a provider of health care for medical services which are provided to a person who earns more than 138 percent of the federally designated poverty level or for other expenses which are unrelated to the administration of Medicaid. (42 U.S.C. 1396a, 1396b(a)(7); 42 C.F.R. 433.15(b)) Section 2 of this bill requires the Director of the Nevada Department of Health and Human Services to seek any necessary waiver of certain provisions of federal law to allow a Medicaid managed care program to be offered for purchase through the Silver State Health Insurance Exchange to persons who are otherwise ineligible for Medicaid. Additionally, section 2 of this bill requires the Director to seek any necessary federal waiver to allow persons to use the federal income tax credits and cost-sharing reductions authorized by the Act to purchase coverage through a Medicaid managed care program which is made available for purchase from the Department or on the Silver State Health Insurance Exchange. Section 5 of this bill revises the definition of qualified health plan to include the Medicaid managed care program so that it may be offered for purchase in the same manner as other health plans through the Silver State Health Insurance Exchange. Section 3 of this bill requires the Department, to the extent allowed by federal law, to make coverage through the Medicaid managed care program available for purchase to any person who is not otherwise eligible for Medicaid. To purchase such coverage, the person must apply to the Division or may purchase coverage through the Silver State Health Insurance Exchange if the waiver has been obtained from the Secretary of the United States Department of Health and Human Services. Section 3 requires the annual premium charged for such coverage to be set at an amount which represents 150 percent of the median expenditure paid on behalf of a Medicaid recipient during the immediately preceding fiscal year. Section 3 further requires the benefits offered in such a managed care program to be the same as those provided to other Medicaid recipients. Finally, section 3 prohibits the Nevada Department of Health and Human Services from using any federal money to carry out the provisions of that section.

AI Summary

Nelson Araujo (D)*,  Maggie Carlton (D)*,  Lesley Cohen (D)*,  Jason Frierson (D)*,  Michael Sprinkle (D)*,  Elliot Anderson (D),  Teresa Benitez-Thompson (D),  Shannon Bilbray-Axelrod (D),  Christopher Brooks (D),  Irene Bustamante Adams (D),  Richard Carrillo (D),  Skip Daly (D),  Olivia Diaz (D),  Edgar Flores (D),  Osvaldo Fumo (D),  Sandra Jauregui (D),  Amber Joiner (D),  William McCurdy (D),  Brittney Miller (D),  Dina Neal (D),  James Ohrenschall (D),  Ellen Spiegel (D),  Heidi Swank (D),  Tyrone Thompson (D),  Justin Watkins (D),  Steve Yeager (D), 

Vetoed by the Governor. (on 06/16/2017)

Official Document