SB 1925 — MEDICAID-ELIGIBILITY-INCOME

*LRB09515591DRJ41591b* SB1925 95THEngrossed GENERALLRB095 ASSEMBLY15591 StateDRJ of41591 Illinoisb andAN 2008ACT SB1925concerning Introducedpublic 1/16/2008,aid. by Sen.

Jeffrey M.

Schoenberg SYNOPSIS AS INTRODUCED:

ILCS 5/5-2 from Ch.

23, par.

5-2 Amends the Illinois Public Aid Code.

Provides for Medicaid eligibility for all persons who are not otherwise eligible for medical assistance under any other provision and who have income, as determined by the Department of Healthcare and Family Services, that is equal to or less than 100% of the Federal Poverty Level, or is equal to or less than 100% of the Federal Poverty Level by disregarding the maximum earned income as determined by the Department.

Provides that the medical assistance for which such persons are eligible shall be no less than the covered benefits available to basic maintenance under the AABD or TANF programs but who fail to qualifyr thereunder on the basis of need, and who have insufficient income and resources to meet the costs of necessary medical care.

LRB095 15591 DRJ 41591 b FISCAL NOTE ACT MAY APPLY A BILL FOR SB1925 LRB095 15591 DRJ 41591 b AN ACT concerning public aid.

(i) their income, as determined by the SB1925 Engrossed - 2 - LRB095 15591 DRJ 41591 b Illinois Department in accordance with any federal requirements, is equal to or less than 70% in fiscal year 2001, equal to or less than 85% in fiscal year 2002 and until a date to be determined by the Department by rule, and equal to or less than 100% beginning on the date determined by the Department by rule, of the nonfarm income official poverty line, as defined by the federal Office of Management and Budget and revised annually in accordance with Section 673(2) of the Omnibus Budget Reconciliation Act of 1981, applicable to families of the same size;

SB1925 Engrossed - 3 - LRB095 15591 DRJ 41591 b 3.

Such plan shall provide ambulatory prenatal care to pregnant women during a presumptive eligibility period and establish an income eligibility standard that is equal to 133% of the nonfarm income official poverty line, as defined by the federal Office of Management and Budget and revised annually in accordance with Section 673(2) of the Omnibus Budget Reconciliation Act of 1981, applicable to families of the same size, provided that costs incurred for medical care SB1925 Engrossed - 4 - LRB095 15591 DRJ 41591 b are not taken into account in determining such income eligibility.

(a) the person requires a level of care provided by SB1925 Engrossed - 5 - LRB095 15591 DRJ 41591 b a hospital, skilled nursing facility, or intermediate care facility, as determined by a physician licensed to practice medicine in all its branches;

(i) such coverage shall be pursuant to SB1925 Engrossed - 6 - LRB095 15591 DRJ 41591 b provisions of the federal Social Security Act;

Participants in the long-term care insurance partnership program established under the PartnershipIllinois for Long-Term Care ActPartnership whoProgram meetAct thePartnership qualifications for SB1925 Engrossed - 7 - LRB095 15591 DRJ 41591 b Long-Term Care Act who meet the qualifications for protection of resources described in Section 15 25 of that Act.

Subject to federal approval, persons who are eligible for medical assistance coverage under applicable provisions of the federal Social Security Act and the federal Breast and Cervical Cancer Prevention and SB1925 Engrossed - 8 - LRB095 15591 DRJ 41591 b Treatment Act of 2000.

Those eligible persons are defined SB1925 - 8 - LRB095 15591 DRJ 41591 b to include, but not be limited to, the following persons:

SB1925 Engrossed - 9 - LRB095 15591 DRJ 41591 b 14.

Subject to the availability of funds for this SB1925 - 9 - LRB095 15591 DRJ 41591 b purpose, the Department may provide coverage under this Article to persons who reside in Illinois who are not eligible under any of the preceding paragraphs and who meet the income guidelines of paragraph 2(a) of this Section and (i) have an application for asylum pending before the federal Department of Homeland Security or on appeal before a court of competent jurisdiction and are represented either by counsel or by an advocate accredited by the federal Department of Homeland Security and employed by a not-for-profit organization in regard to that application or appeal, or (ii) are receiving services through a federally funded torture treatment center.

AllPersons persons who are not otherwise eligible for medical assistance under any other paragraph of this Section and who havemeet income, as determined by the Illinoisfollowing Department,requirements: that is equal to or less than 100% of the Federal Poverty Level, or is equal to or less than 100% of SB1925 - 10 - LRB095 15591 DRJ 41591 b the Federal Poverty Level by disregarding the maximum earned income as determined by the Illinois Department, are eligible to receive medical assistance that is no less than the covered benefits available to persons eligible under paragraph 2 of this Section.

(a) They are at least 19 years of age and younger SB1925 Engrossed - 10 - LRB095 15591 DRJ 41591 b than 65 years of age.

(b) They are uninsured at the time they apply for medical assistance.

(c) They have income that is equal to or less than 100% of the federal poverty income guidelines.

A person’s income shall be determined using the methodology used to determine income under paragraph 2(a)(i) of this Section.

Notwithstanding any other provision of this Code, eligible non-citizens as defined under Section 1-11 of this Code may qualify regardless of when they entered the United States.

The Department may require that persons enrolled under this paragraph 15 choose a medical home and a primary care provider.

Covered services shall include all services covered for persons enrolled under paragraph 2(a)(i) of this Section except that long-term care services shall not be covered.

For services provided to persons for whom federal matching funds are not available, the Department may establish rates of reimbursement for and make payments to providers that are owned or operated by a State agency, a State university, or a county with a population of 3,000,000 or more that differ from rates otherwise established under this Code.

SB1925 Engrossed - 11 - LRB095 15591 DRJ 41591 b The eligibility of any such person for medical assistance under this Article is not affected by the payment of any grant under the Senior Citizens and Disabled Persons Property Tax Relief and Pharmaceutical Assistance Act or any distributions or items of income described under subparagraph (X) of paragraph (2) of subsection (a) of Section 203 of the Illinois Income Tax Act.

SB1925 - 11 - LRB095 15591 DRJ 41591 b The eligibility of any person for medical assistance under this Article shall not be affected by the receipt by the person of donations or benefits from fundraisers held for the person in cases of serious illness, as long as neither the person nor members of the person’s family have actual control over the donations or benefits or the disbursement of the donations or benefits.

SB1925 Engrossed - 12 - LRB095 15591 DRJ 41591 b 95-546, eff.

8-29-07.)8-29-07;

revised 1-22-08.)