99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB2465

 

Introduced 2/17/2015, by Rep. Adam Brown

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 170/20

    Amends the Covering ALL KIDS Health Insurance Act. Provides that a child is not eligible for coverage under the Covering ALL KIDS Health Insurance Program if he or she is an undocumented immigrant.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
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7    (Section scheduled to be repealed on July 1, 2016)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) who (i) effective July 1, 2014, in accordance with
16    42 CFR 457.805 (78 FR 42313, July 15, 2013) or any other
17    federal requirement necessary to obtain federal financial
18    participation for expenditures made under this Act, has
19    been without health insurance coverage for 90 days; (ii) is
20    a newborn whose responsible relative does not have
21    available affordable private or employer-sponsored health
22    insurance; or (iii) within one year of applying for
23    coverage under this Act, lost medical benefits under the

 

 

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1    Illinois Public Aid Code or the Children's Health Insurance
2    Program Act; and
3        (3.5) whose household income, as determined, effective
4    October 1, 2013, by the Department, is at or below 300% of
5    the federal poverty level as determined in compliance with
6    42 U.S.C. 1397bb(b)(1)(B)(v) and applicable federal
7    regulations.
8    An entity that provides health insurance coverage (as
9defined in Section 2 of the Comprehensive Health Insurance Plan
10Act) to Illinois residents shall provide health insurance data
11match to the Department of Healthcare and Family Services as
12provided by and subject to Section 5.5 of the Illinois
13Insurance Code. The Department of Healthcare and Family
14Services may impose an administrative penalty as provided under
15Section 12-4.45 of the Illinois Public Aid Code on entities
16that have established a pattern of failure to provide the
17information required under this Section.
18    The Department of Healthcare and Family Services, in
19collaboration with the Department of Insurance, shall adopt
20rules governing the exchange of information under this Section.
21The rules shall be consistent with all laws relating to the
22confidentiality or privacy of personal information or medical
23records, including provisions under the Federal Health
24Insurance Portability and Accountability Act (HIPAA).
25    (b) The Department shall monitor the availability and
26retention of employer-sponsored dependent health insurance

 

 

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

 

 

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1    an institution for mental diseases; or .
2        (3) the child is an undocumented immigrant.
3    (f) The Department may adopt rules, including, but not
4limited to: rules regarding annual renewals of eligibility for
5the Program in conformance with Section 7 of this Act; rules
6providing for re-enrollment, grace periods, notice
7requirements, and hearing procedures under subdivision (e)(1)
8of this Section; and rules regarding what constitutes
9availability and affordability of private or
10employer-sponsored health insurance, with consideration of
11such factors as the percentage of income needed to purchase
12children or family health insurance, the availability of
13employer subsidies, and other relevant factors.
14    (g) Each child enrolled in the Program as of July 1, 2011
15whose family income, as established by the Department, exceeds
16300% of the federal poverty level may remain enrolled in the
17Program for 12 additional months commencing July 1, 2011.
18Continued enrollment pursuant to this subsection shall be
19available only if the child continues to meet all eligibility
20criteria established under the Program as of the effective date
21of this amendatory Act of the 96th General Assembly without a
22break in coverage. Nothing contained in this subsection shall
23prevent a child from qualifying for any other health benefits
24program operated by the Department.
25(Source: P.A. 98-130, eff. 8-2-13; 98-651, eff. 6-16-14.)