Authorizes individuals to participate in the NY State of Health marketplace without providing information regarding citizenship or lawful residency or requesting or receiving a state or federal subsidy.
STATE OF NEW YORK
________________________________________________________________________
6791--A
2019-2020 Regular Sessions
IN ASSEMBLY
March 20, 2019
___________
Introduced by M. of A. CRUZ, ORTIZ, AUBRY, ARROYO, ROZIC, SIMON, COLTON,
DICKENS, BLAKE, HEVESI, MOSLEY, REYES, JAFFEE, FALL, EPSTEIN, CARROLL,
RAMOS, COOK, D'URSO, D. ROSENTHAL, RIVERA, GLICK, FERNANDEZ -- read
once and referred to the Committee on Health -- committee discharged,
bill amended, ordered reprinted as amended and recommitted to said
committee
AN ACT to amend the public health law, in relation to authorizing indi-
viduals to participate in the NY State of Health, the official health
plan marketplace without providing information regarding citizenship
or lawful residency in the United States or requesting or receiving a
state or federal subsidy
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 10 of section 268-a of the public health law,
2 as added by section 2 of part T of chapter 57 of the laws of 2019, is
3 amended to read as follows:
4 10. "Qualified individual" means, with respect to qualified health
5 plans, an individual, including a minor, who:
6 (a) is eligible to enroll in a qualified health plan offered to indi-
7 viduals through the Marketplace;
8 (b) resides in this state; and
9 (c) at the time of enrollment, is not incarcerated, other than incar-
10 ceration pending the disposition of charges[; and
11 (d) is, and is reasonably expected to be, for the entire period for
12 which enrollment is sought, a citizen or national of the United States
13 or an alien lawfully present in the United States].
14 § 2. Paragraph (a) of subdivision 1 of section 268-c of the public
15 health law, as added by section 2 of part T of chapter 57 of the laws of
16 2019, is amended to read as follows:
17 (a) Perform eligibility determinations for federal and state insurance
18 affordability programs including medical assistance in accordance with
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10805-07-9
A. 6791--A 2
1 section three hundred sixty-six of the social services law, child health
2 plus in accordance with section twenty-five hundred eleven of this chap-
3 ter, the basic health program in accordance with section three hundred
4 sixty-nine-gg of the social services law, premium tax credits and cost-
5 sharing reductions and qualified health plans in accordance with appli-
6 cable law and other health insurance programs as determined by the
7 commissioner. Such eligibility determinations shall allow any qualified
8 individual to participate in a qualified health plan who pays all asso-
9 ciated costs without requesting or receiving a state or federal subsidy;
10 § 3. Section 268-g of the public health law is amended by adding two
11 new subdivisions 4 and 5 to read as follows:
12 4. The commissioner is authorized and directed to seek a federal waiv-
13 er allowing qualified individuals who pay all associated costs of
14 participating in a qualified health plan without a state or federal
15 subsidy.
16 5. (a) The commissioner shall utilize the following formula to avoid
17 the use of any federal funds for qualified individuals who pay all asso-
18 ciated costs of participating in a qualified health plan without a state
19 or federal subsidy:
20 (i) The average total amount expended per member shall be determined
21 by dividing the federal administrative funding amount provided to the
22 state for the marketplace as a health benefit exchange by the total
23 number of enrollees in the marketplace;
24 (ii) The average total amount expended per member determined pursuant
25 to subparagraph (i) of this paragraph shall be multiplied by the number
26 of qualified individuals who pay all associated costs of participating
27 in a qualified health plan without a state or federal subsidy to deter-
28 mine the total reimbursement amount;
29 (iii) The state shall reimburse the federal government annually by the
30 total reimbursement amount determined pursuant to subparagraph (ii) of
31 this paragraph.
32 (b) The total reimbursement amount determined pursuant to subparagraph
33 (ii) of paragraph (a) of this subdivision shall be provided to the
34 marketplace by an annual allocation to the indigent care funds in the
35 annual state budget.
36 § 4. Section 206 of the public health law is amended by adding a new
37 subdivision 31 to read as follows:
38 31. The commissioner shall promulgate rules and regulations to protect
39 and maintain the confidentiality of participants in the NY State of
40 Health, The official health plan Marketplace who do not provide a social
41 security number or proof of legal status in the United States.
42 § 5. This act shall take effect immediately.
