Relating to a hawk-i program purchase option, and including effective date and contingent implementation provisions

The bill directs the director of the department of human services to coordinate the administration of the hawk-i program with the hawk-i program purchase option to maximize efficiencies and improve the continuity of care for eligible children; and to implement mechanisms to ensure the long-term financial sustainability of the hawk-i program and mitigate any adverse financial impacts to the health insurance marketplace. The mechanisms are to address issues related to minimizing adverse selection, the state financial risk and contribution, and negative impacts to premiums in the individual and group insurance market both inside and outside of the health insurance marketplace. At a minimum, the hawk-i purchase option must include: establishment of an annual per enrollee premium rate similar to the average rate paid by the state to managed care plan contractors under the hawk-i program; establishment of a benefit set equal to the benefits covered under the hawk-i program; establishment of annual open enrollment periods consistent with those for the hawk-i program; the ability of the director of the department of human services to adjust the purchase option’s actuarial value to a value no lower than percent; reimbursement mechanisms to address potential reductions in funding for health insurance marketplace operations; and reimbursement mechanisms to address potential increased costs to the hawk-i program. The director of the department of human services in collaboration with the commissioner of insurance shall report to the chairpersons and ranking members of the house and senate human resources committees and the joint appropriations subcommittee on health and human services by September 1, 2021, on the progress of the federal waivers and the results from actuarial and economic analyses that are necessary for a waiver proposal. The report shall also include recommendations regarding any statutory or administrative rule changes necessary to implement the program. The bill takes effect upon enactment. Implementation of any waiver provision that requires a state financial contribution is contingent on further legislative action to approve the state’s contribution.