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2018 HB 5463: An Act Concerning The Study Of Health Insurance Options For Individuals Ineligible For Medicaid.


  • Logan, George S.
  • Adams, Terry B.
  • Hall, Joshua Malik
  • Fleischmann, Andrew M.
  • Winkler, Michael
  • Rovero, Daniel S.
  • McGee, Brandon L.
  • Tercyak, Peter A.
  • Rose, Kim
  • Santiago, Hilda E.
  • Lemar, Roland J.
  • Looney, Martin M.


2018-03-07 lower
2018-03-09 lower
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2018-03-28 lower
2018-04-04 lower
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2018-04-04 lower
2018-04-04 lower
2018-05-01 lower
2018-05-01 lower
2018-05-03 lower
2018-05-03 lower
2018-05-03 lower

Bill Text

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (Effective from passage) (a) For purposes of this section, "Medicaid public option" means a health insurance plan that allows persons otherwise ineligible for Medicaid to purchase coverage under such health insurance plan. The executive director of the Office of Health Strategy, appointed pursuant to section 19a-754a of the general statutes, in consultation with the study group established pursuant to subsection (b) of this section, shall study whether and how the state should create a Medicaid public option.

(b) The executive director of the Office of Health Strategy shall convene a study group that shall include: (1) Three consumer advocates, one each appointed by the speaker, the majority leader and the minority leader of the House of Representatives; (2) three providers, including at least one private insurance provider and two Medicaid-enrolled health care providers, one each appointed by the president pro tempore, the majority leader and the minority leader of the Senate; (3) the Commissioner of Social Services, or the commissioner's designee; (4) the chairman of the Health Care Cabinet established pursuant to section 19a-725 of the general statutes, or the chairman's designee; and (5) the Healthcare Advocate appointed pursuant to section 38a-1042 of the general statutes, or the Healthcare Advocate's designee.

(c) The study shall include, but need not be limited to:

(1) The total amount of premiums that should be assessed to Medicaid public option enrollees after an actuarial analysis to ensure maximum access to coverage and minimal impact on state resources;

(2) Coverage that should be included in a Medicaid public option, including whether benefits should be limited to the ten essential health benefits required pursuant to 42 USC 18022;

(3) Scheduling of enrollment periods and whether such enrollment periods should be aligned with enrollment periods adopted pursuant to section 38a-1084 of the general statutes;

(4) The level of reimbursement rates to providers needed to ensure that the provider pool meets demand;

(5) Whether the state should apply for an innovation waiver under 42 USC 18052 to allow eligible persons who enroll in a Medicaid public option to use tax credits and cost-sharing subsidies toward their premiums;

(6) Whether to charge enrollees copayments and deductibles and, if so, in what amounts;

(7) How to ensure the sustainability of the Medicaid program if the program is expanded to include a Medicaid public option;

(8) Whether to sell Medicaid public option coverage on the Connecticut Health Insurance Exchange as a qualified health plan pursuant to 42 USC 18021; and

(9) What name should be given to any Medicaid public option created as a result of the study.

(d) Within available appropriations, the executive director of the Office of Health Strategy may appoint consultants to assist with the study.

(e) Not later than December 31, 2018, the executive director of the Office of Health Strategy shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, on the results of the study to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies, human services and insurance. The study group shall terminate on the date that it submits such report or December 31, 2018, whichever is later.

Behind the Bill