HSB 581

Topics:Health care Families & human services

Same legislation: HF 2492

Official bill page Lobbyist declarations One-pager to print

Where it is now

Done: IntroducedFebruary 21, 2020
Done: SubcommitteeJanuary 28, 2020
Done: House committeeFebruary 19, 2020
Done: Passes the HouseMarch 5, 202056–39
Stopped: Senate committeeDied when the General Assembly ended
Next: Passes the Senate
Next: To the Governor
Next: Signed into law

Died when the session ended The 2020 session adjourned on June 14, 2020, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?

What’s in it

AI summary People who lose their spot in Iowa's health or dental wellness plans because they didn't pay their monthly fees may have to pay an extra administrative fee to sign up again. This rule applies to members who did not complete required healthy behaviors and were not exempt from making payments. The department of human services will create the specific rules for these fees.¹

Read the official explanation

This bill provides that membership in the Iowa health and wellness plan or the dental wellness plan shall require that an Iowa health and wellness plan member or a dental wellness plan member who does not complete required healthy behaviors and is not otherwise exempt from payment of a monthly contribution, and whose eligibility is terminated due to nonpayment of monthly contributions, in addition to any other requirements for reenrollment, shall be subject to payment of an administrative fee as established by rule of the department upon the member’s application for reenrollment in either plan. The bill directs the department of human services to adopt administrative rules in accordance with the bill, subject to federal approval.

Changed since by amendments H-8080, H-8043; see Amendments.

Full bill text²

House subcommittee

Named January 28, 2020. On February 17, 2020 it recommended amendment and passage.

Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part

Fiscal note

AI summary This bill requires the Department of Human Services to seek approval to make certain Iowa Health and Wellness Plan members repay missed monthly contributions before they can reenroll after a second disenrollment. The bill is estimated to have one-time costs to the Department of Human Services of $216,000 in fiscal year 2021 for system changes. The fiscal impact regarding the repayment of contributions and changes in enrollment numbers cannot be determined but is likely to be minimal.³

Read the fiscal note

Description

House File 2492 requires the Department of Human Services (DHS) to seek approval of an amendment to the section 1115 demonstration waiver for the Iowa Health and Wellness Plan (IHAWP) from the Centers for Medicare and Medicaid Services (CMS). The amendment would require IHAWP members who are subject to monthly contributions, and who have been disenrolled for failure to pay those contributions, to repay those before reenrolling after their second disenrollment. Members would not be required to repay monthly contributions after being disenrolled the first time for failure to pay.

Background

The IHAWP covers individuals below 133.0% of the federal poverty level (FPL). Members are not required to pay monthly contributions in the first year on the program or in subsequent years if their income is below 50.0% of FPL or if they complete what are known as “Healthy Behaviors.” Healthy Behaviors are health risk assessments and dental or medical wellness exams. Members subject to monthly contributions are required to pay either $5 or $10 based on their income and may be disenrolled for nonpayment of contributions after 90 days. Members may contact the DHS and claim financial hardship to avoid payment of monthly contributions, but they must do so before the payment is due.

Assumptions

Significant system work would be necessary for the Eligibility Integrated Application Solution (ELIAS), data warehouse, and medical systems to provide notification to members and allow for additional system interfaces for DHS field staff.
The match rate for the IHAWP is 88.30% federal and 11.70% State, and for systems changes is 75.55% federal and 24.45% State.
An average of 749 individuals were disenrolled per month in FY 2019 for failure to pay monthly contributions and not all those individuals will choose to reenroll.
Revenues from repayment of monthly contributions will be minimal with an estimated average debt of $30 and with the 88.30% federal share returned to the federal government.
Requiring repayment of monthly contributions to regain eligibility would likely result in fewer members being enrolled in IHAWP, but the number of members who would choose not to reenroll cannot be estimated. The savings is not expected to be significant because it is assumed that members needing coverage are likely to reapply or go to a hospital for care, and the hospital will assist them in reenrolling.

Fiscal Impact

House File 2492 is estimated to have one-time costs to the DHS of $216,000 in FY 2021 for systems changes. The impact for repayment of monthly contributions and fewer IHAWP members cannot be determined but is likely to be minimal due to the State match rate and because it is assumed individuals will reenroll when they need coverage.