Relating to Medicaid coverage for individuals lawfully residing in the state in accordance with the compacts of free association, and providing effective and applicability provisions

This bill requires the department of human services (DHS), in accordance with federal law, to provide Medicaid coverage to individuals lawfully residing in the state in accordance with the compacts of free association (COFA) between the government of the United States and the governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. DHS shall seek federal financial participation for Medicaid coverage provided under the bill retroactively to December 27, 2020. The bill takes effect upon enactment and is retroactively applicable to December 27, 2020. The federal Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 did not include COFA migrants as “qualified non-citizens” for the purposes of Medicaid coverage, resulting in COFA migrants who had previously been eligible for Medicaid coverage no longer being eligible. The federal Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009 provided an option to states to cover lawfully residing children under age and pregnant women, including COFA migrants, under the Medicaid or Children’s Health Insurance Program (CHIP). The state elected to provide coverage to COFA migrants under age 21. The federal Consolidated Appropriations Act, 2021, effective December 27, 2020, requires all states to provide full Medicaid coverage to all COFA migrants who are otherwise eligible for Medicaid. Additionally, the five-year limitation on benefits imposed on some categories of immigrants does not apply to the COFA migrants under the federal law.