HB0606 Dougherty, Patrick

P R E F I L E D

HB 606 -- Health Insurance for Children

The bill requires insurers and similar entities to cover uninsured children who are not eligible for Medicaid and whose household income is below 250% of the federal poverty level. The Director of Health assigns children to particular insurers based on the child's geographic location or to the parent's insurer, if any. The assignment process must fairly distribute risk among insurers. The director decides what benefits are covered except that abortion is not covered. Benefits are required to be at least equal to Medicaid benefits. The director decides premiums based on ability to pay. Premiums cannot exceed 30% of the average premium for insured children. Insurers are allowed to discount payments to health care providers. The director is required to set the discount rate at 50% of the cost of covering uninsured children, except the discount rate cannot exceed 1% of the payment to providers.

The bill also requires the Director of Health, after consulting with the Division of Medical Services, to develop cooperative arrangements between insurers and schools which receive direct Medicaid services.