Referred to Committee
April 19, 2013
April 18, 2013(Key vote)
Title: Expands Medicaid Eligibility
Vote Smart's Synopsis:
Vote to pass a bill that expands Medicaid eligibility.
Requires the Department of Health and Human Services to submit a request to the secretary of the U.S. Department of Health and Human Services for a waiver that provides health insurance coverage through private insurance options for “eligible individuals” with a low risk of needing extensive medical services and who meet one of the following conditions (Sec. 10):
They are currently employed or actively seeking employment;
They are primary caregivers for a family member; or
They are the spouse of an adult who is employed or actively seeking employment.
Defines “eligible individual” as an individual who is under 65 years of age, not pregnant, and who has an income that does not exceed 133% of the federal poverty level (Sec. 9).
Requires the department redesign the Medicaid program to meet certain measures including, but not limited to, the following measures (Sec. 15):
Implementing a patient-centered medical home model of care;
Amending access restrictions to emergency departments;
Requiring medical service providers to see Medicaid patients within a specified time frame; and
Providing targeted patient education.
Requires Medicaid service providers and health insurance issuers to pay the department insurance assistance mitigation fees in an amount proportionate to each provider’s or issuer’s services (Secs. 13 & 17).
Requires the department to collect the following amounts from insurance assistance mitigation fees per fiscal year (Secs. 13 & 17):
$20 million from Medicaid service provider fees; and
$10 million form health insurance issuer fees.
Establishes a value-based purchasing system with incentive payments for hospitals, physicians, nurses, long-term care facilities, and home health care agencies that meet established performance standards (Sec. 16).