Rep. Bill Mitchell

Filed: 2/16/2011

 

 


 

 


 
09700HB1409ham001LRB097 06852 RPM 50685 a

1
AMENDMENT TO HOUSE BILL 1409

2    AMENDMENT NO. ______. Amend House Bill 1409 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Covering ALL KIDS Health Insurance Act is
5amended by changing Section 20 as follows:
 
6    (215 ILCS 170/20)
7    (Section scheduled to be repealed on July 1, 2016)
8    Sec. 20. Eligibility.
9    (a) To be eligible for the Program, a person must be a
10child:
11        (1) who is a resident of the State of Illinois;
12        (2) who is ineligible for medical assistance under the
13    Illinois Public Aid Code or benefits under the Children's
14    Health Insurance Program Act;
15        (3) either (i) who has been without health insurance
16    coverage for 12 months, (ii) whose parent has lost

 

 

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1    employment that made available affordable dependent health
2    insurance coverage, until such time as affordable
3    employer-sponsored dependent health insurance coverage is
4    again available for the child as set forth by the
5    Department in rules, (iii) who is a newborn whose
6    responsible relative does not have available affordable
7    private or employer-sponsored health insurance, or (iv)
8    who, within one year of applying for coverage under this
9    Act, lost medical benefits under the Illinois Public Aid
10    Code or the Children's Health Insurance Program Act; and
11        (3.5) whose household income, as determined by the
12    Department, is at or below 300% of the federal poverty
13    level. This item (3.5) is effective July 1, 2011.
14    An entity that provides health insurance coverage (as
15defined in Section 2 of the Comprehensive Health Insurance Plan
16Act) to Illinois residents shall provide health insurance data
17match to the Department of Healthcare and Family Services as
18provided by and subject to Section 5.5 of the Illinois
19Insurance Code.
20    The Department of Healthcare and Family Services, in
21collaboration with the Department of Insurance, shall adopt
22rules governing the exchange of information under this Section.
23The rules shall be consistent with all laws relating to the
24confidentiality or privacy of personal information or medical
25records, including provisions under the Federal Health
26Insurance Portability and Accountability Act (HIPAA).

 

 

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1    (b) The Department shall monitor the availability and
2retention of employer-sponsored dependent health insurance
3coverage and shall modify the period described in subdivision
4(a)(3) if necessary to promote retention of private or
5employer-sponsored health insurance and timely access to
6healthcare services, but at no time shall the period described
7in subdivision (a)(3) be less than 6 months.
8    (c) The Department, at its discretion, may take into
9account the affordability of dependent health insurance when
10determining whether employer-sponsored dependent health
11insurance coverage is available upon reemployment of a child's
12parent as provided in subdivision (a)(3).
13    (d) A child who is determined to be eligible for the
14Program shall remain eligible for 12 months, provided that the
15child maintains his or her residence in this State, has not yet
16attained 19 years of age, and is not excluded under subsection
17(e).
18    (e) A child is not eligible for coverage under the Program
19if:
20        (1) the premium required under Section 40 has not been
21    timely paid; if the required premiums are not paid, the
22    liability of the Program shall be limited to benefits
23    incurred under the Program for the time period for which
24    premiums have been paid; re-enrollment shall be completed
25    before the next covered medical visit, and the first
26    month's required premium shall be paid in advance of the

 

 

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1    next covered medical visit; or
2        (2) the child is an inmate of a public institution or
3    an institution for mental diseases; or .
4        (3) the child is an undocumented immigrant.
5    (f) The Department may adopt rules, including, but not
6limited to: rules regarding annual renewals of eligibility for
7the Program in conformance with Section 7 of this Act; rules
8providing for re-enrollment, grace periods, notice
9requirements, and hearing procedures under subdivision (e)(1)
10of this Section; and rules regarding what constitutes
11availability and affordability of private or
12employer-sponsored health insurance, with consideration of
13such factors as the percentage of income needed to purchase
14children or family health insurance, the availability of
15employer subsidies, and other relevant factors.
16    (g) Each child enrolled in the Program as of July 1, 2011
17whose family income, as established by the Department, exceeds
18300% of the federal poverty level may remain enrolled in the
19Program for 12 additional months commencing July 1, 2011.
20Continued enrollment pursuant to this subsection shall be
21available only if the child continues to meet all eligibility
22criteria established under the Program as of the effective date
23of this amendatory Act of the 96th General Assembly without a
24break in coverage. Nothing contained in this subsection shall
25prevent a child from qualifying for any other health benefits
26program operated by the Department.

 

 

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1(Source: P.A. 96-1272, eff. 1-1-11; 96-1501, eff. 1-25-11.)".