REPORT TITLE:
Medical assistance


DESCRIPTION:
Covers all children under the State's children's health insurance
program up to three hundred per cent of the federal poverty level
for Hawaii.  Provides health insurance to all permanent legal
immigrant residents, permanent residents under color of law, and
persons from countries of the Compact of Fall Association. (SD1)


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        540
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 2000                                S.D. 1
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO HUMAN SERVICES.



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

 1      SECTION 1.  The legislature finds that with the enactment of
 
 2 the Personal Responsibility and Work Opportunity Responsibility
 
 3 Act of 1996, Congress stripped away medical assistance and other
 
 4 benefits from income qualified immigrants.  A citizen's right to
 
 5 access these benefits were, however, untouched.  Despite the fact
 
 6 that scholars, courts, and attorney generals have declared these
 
 7 discriminatory provisions illegal, Hawaii has failed to accord
 
 8 immigrants the equal protections they are entitled.
 
 9      The legislature further finds that the State's children's
 
10 health insurance program is expected, upon approval by the
 
11 federal health care financing administration, to enroll all
 
12 uninsured children under nineteen whose family's income does not
 
13 exceed two hundred per cent of the federal poverty level for
 
14 Hawaii.  The 1999 legislature appropriated up to ten per cent
 
15 from the Hawaii tobacco master settlement agreement to implement
 
16 the State's children's health insurance program.  Should the
 
17 legislature appropriate additional funds, the department of human
 
18 services would be able to amend the State's plan and enroll
 
19 uninsured children whose family's income does not exceed three
 

 
Page 2                                                     540
                                     H.B. NO.           H.D. 2
                                                        S.D. 1
                                                        

 
 1 hundred per cent of the federal poverty level for Hawaii.  This
 
 2 would help an additional three thousand three hundred uninsured
 
 3 children, and would cost the State $1,260,000 at the thirty-five
 
 4 per cent share and would cost the federal government $2,340,000
 
 5 at the sixty-five per cent share.  The legislature finds that
 
 6 there are compelling economic arguments in favor of this
 
 7 expansion.
 
 8      The legislature believes that it has an opportunity to not
 
 9 only increase the numbers of uninsured children receiving health
 
10 insurance, but to provide health insurance to all permanent legal
 
11 immigrant residents as well.
 
12      The purpose of this Act is to:
 
13      (1)  Cover all children under the State's children's health
 
14           insurance program up to three hundred per cent of the
 
15           federal poverty level for Hawaii; and
 
16      (2)  Provide health insurance to all permanent legal
 
17           immigrant residents.
 
18      SECTION 2.  Chapter 346, Hawaii Revised Statutes, is amended
 
19 by adding a new section to be appropriately designated and to
 
20 read as follows:
 
21      "§346-    Medical assistance to legal immigrants and
 
22 migrants.  The department shall provide state-funded medical
 
23 assistance for:
 

 
Page 3                                                     540
                                     H.B. NO.           H.D. 2
                                                        S.D. 1
                                                        

 
 1      (1)  Legal permanent residents who arrived in the United
 
 2           States after August 22, 1996;
 
 3      (2)  Persons who are permanently residing in the United
 
 4           States under color of law; or
 
 5      (3)  Persons from member countries of the Compact of Free
 
 6           Association,
 
 7 who are otherwise eligible for benefits under the State's
 
 8 medicaid programs, including QUEST and the State's children
 
 9 health insurance program, but are ineligible due to restricted
 
10 eligibility rules imposed by Title XXI of the Social Security Act
 
11 in the federal Balanced Budget Act of 1997 or the Personal
 
12 Responsibility and Work Reconciliation Act of 1996."
 
13      SECTION 3.  Section 328L-4, Hawaii Revised Statutes, is
 
14 amended to read as follows:
 
15      "[[]§328L-4[]]  Use of funds appropriated to the department.
 
16 The department, immediately upon receipt of the thirty-five per
 
17 cent of moneys appropriated pursuant to section 328L-2(b)(2)
 
18 shall:
 
19      (1)  Transfer up to [ten]     per cent of the total moneys
 
20           received by the State from tobacco settlement moneys to
 
21           the department of human services for the children's
 
22           health insurance program; and
 
23      (2)  Expend the remainder of the moneys received by the
 

 
Page 4                                                     540
                                     H.B. NO.           H.D. 2
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 1           department for health promotion and disease prevention
 
 2           programs, including but not limited to, maternal child
 
 3           health and child development programs, promotion of
 
 4           healthy lifestyles (including fitness, nutrition, and
 
 5           tobacco control), and prevention oriented public health
 
 6           programs.
 
 7      For purposes of paragraph (2), the director shall convene an
 
 8 advisory group that shall be separate from the tobacco prevention
 
 9 and control advisory board, to strategically plan the development
 
10 and implementation of preventive systems to achieve measurable
 
11 outcomes and to make recommendations for the expenditure of these
 
12 moneys.  The advisory group shall be composed of nine members
 
13 with expertise in the programs under paragraph (2), and shall be
 
14 selected at the discretion of the director."
 
15      SECTION 4.  There is appropriated out of the general
 
16 revenues of the State of Hawaii the sum of $         , or so much
 
17 thereof as may be necessary for fiscal year 2000-2001, to provide
 
18 state-funded medical assistance for:
 
19      (1)  Legal permanent residents who arrived in the United
 
20           States after August 22, 1996;
 
21      (2)  Persons who are permanently residing in the United
 
22           States under color of law; or
 
23      (3)  Persons from member countries of the Compact of Free
 

 
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                                     H.B. NO.           H.D. 2
                                                        S.D. 1
                                                        

 
 1           Association,
 
 2 who are otherwise eligible for benefits under the State's
 
 3 medicaid programs, including QUEST and the State's children's
 
 4 health insurance program, but are ineligible due to restricted
 
 5 eligibility rules imposed by Title XXI of the Social Security Act
 
 6 in the federal Balanced Budget Act of 1997 or the Personal
 
 7 Responsibility and Work Reconciliation Act of 1996.
 
 8      The sum appropriated shall be expended by the department of
 
 9 human services for the purposes of this Act.
 
10      SECTION 5.  There is appropriated out of the Hawaii tobacco
 
11 settlement special fund the sum of $        , or so much thereof
 
12 as may be necessary for fiscal year 2000-2001 to provide medical
 
13 assistance for all children under the State's children's health
 
14 insurance program up to three hundred per cent of the federal
 
15 poverty level for Hawaii.
 
16      The sum appropriated shall be expended by the department of
 
17 human services for the purposes of this Act.
 
18      SECTION 6.  Statutory material to be repealed is bracketed.
 
19 New statutory material is underscored.
 
20      SECTION 7.  This Act shall take effect upon its approval;
 
21 provided that sections 4 and 5 shall take effect on July 1, 2000.