HSB 509

Topics:Health care Families & human services

Same legislation: SSB 3012, HF 2135, SF 2163

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Official bill page Lobbyist declarations One-pager to print

Where it is now

Done: IntroducedJanuary 9, 2024
Done: SubcommitteeJanuary 9, 2024
Done: House committeeJanuary 23, 2024
Skipped: Passes the HouseContinued as HF 2135
Next: Senate committee
Next: Passes the Senate
Next: To the Governor
Next: Signed into law

Became HF 2135 → Its progress continues under the new number. Go to HF 2135 What’s a funnel?

What’s in it

AI summary People with low monthly incomes can now use up to $50 each month for necessary trust expenses without needing permission from a court. For people with higher monthly incomes, the amount they can spend without court approval stays at $10. This change affects people who receive medical income assistance.¹

Read the official explanation

This bill relates to medical income assistance trust fees. The bill increases the amount that may be paid or set aside each month for necessary trust expenses without court approval for beneficiaries whose total monthly income is less than 125 percent of the average statewide charge for nursing facility services to a private-pay resident of a nursing facility from $10 to $50. If a beneficiary’s total monthly income is at or above 125 percent of such charge, the limit remains $10.

Full bill text²

House subcommittee

Named January 9, 2024. Meeting: Wednesday, January 17 · 12:00 PM · House Lounge 2.

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 increases the maximum monthly amount that can be set aside for the administration of a Medical Income Assistance Trust. It is estimated to increase costs to the state's General Fund Medicaid appropriation by approximately $365,000 in fiscal year 2025 and $290,000 annually beginning in fiscal year 2026.³

Read the fiscal note

Description

Senate File 2163 increases the amount to be paid or set aside each month for administration of a Medical Income Assistance Trust, from no more than $10 per month to no more than $50 per month without court approval.

Background

Iowa Code section 633C.3 currently allows for a maximum of $10 per month to be set aside for the expenses of a Medical Income Assistance Trust for Medicaid beneficiaries. A Medical Income Assistance Trust, or Miller Trust, allows a beneficiary to qualify for Medicaid who would otherwise have too much in assets or income to qualify for Medicaid, provided that a certain amount of pension or Social Security income is placed into the Trust. A spouse may be eligible to receive funds from the Trust. If the beneficiary does not have a spouse, the balance of the Trust, beyond a monthly allowance for the beneficiary and the cost of administering the Trust, is paid to a nursing facility to cover the costs of nursing care. Any payments to nursing facilities to cover the cost of care for a beneficiary decrease the amount of State and federal dollars paid by Medicaid.

Assumptions

Any decreases in the amount of income available from a qualified beneficiary for the cost of nursing care are costs borne by Medicaid.
According to the Iowa Department of Health and Human Services (HHS), the Bill affects 1,642 beneficiaries annually.
An increase of $40 monthly due to increasing the maximum allowable administrative cost in the Bill will increase annual Medicaid costs for nursing facilities by approximately $788,000 beginning in FY 2025.
The State will pay 36.75% of Medicaid costs for nursing facilities, while the federal government will pay 63.25%, the same as Iowa’s FY 2025 Federal Medicaid Assistance Percentage (FMAP). The FMAP rate in FY 2026 is assumed to equal the FY 2025 rate.
According to the HHS, a one-time information technology (IT) implementation will be necessary at a cost of $310,000 in FY 2025. The State will pay 25.0% of costs for IT implementation, while the federal government will pay 75.0%.
Any increase in State costs is expected to be funded from the HHS’s General Fund Medicaid appropriation.