Full Text of SB1527 97th General Assembly
SB1527sam001 97TH GENERAL ASSEMBLY | Sen. Carole Pankau Filed: 3/29/2011
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| 1 | | AMENDMENT TO SENATE BILL 1527
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1527 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 10. The Children's Health Insurance Program Act is | 5 | | amended by changing Sections 20 and 40 as follows:
| 6 | | (215 ILCS 106/20)
| 7 | | Sec. 20. Eligibility.
| 8 | | (a) To be eligible for this Program, a person must be a | 9 | | person who
has a child eligible under this Act and who is | 10 | | eligible under a waiver
of federal requirements pursuant to an | 11 | | application made pursuant to
subdivision (a)(1) of Section 40 | 12 | | of this Act or who is a child who:
| 13 | | (1) is a child who is not eligible for medical | 14 | | assistance;
| 15 | | (2) is a child whose annual household income, as | 16 | | determined by the
Department, is above 133% of the federal |
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| 1 | | poverty level and at or below
200%
of the federal poverty | 2 | | level;
| 3 | | (2.5) is a child whose household assets do not exceed | 4 | | $10,000, excluding (i) the value of the residence in which | 5 | | the child lives and (ii) the value of a vehicle used by the | 6 | | household for transportation purposes; for purposes of | 7 | | this paragraph (2.5), "vehicle" does not include a | 8 | | recreational vehicle as defined in the Campground | 9 | | Licensing and Recreational Area Act;
| 10 | | (3) is a resident of the State of Illinois; and
| 11 | | (4) is a child who is either a United States citizen or | 12 | | included in one
of the following categories of | 13 | | non-citizens:
| 14 | | (A) unmarried dependent children of either a | 15 | | United States Veteran
honorably discharged or a person | 16 | | on active military duty;
| 17 | | (B) refugees under Section 207 of the Immigration | 18 | | and
Nationality Act;
| 19 | | (C) asylees under Section 208 of the Immigration | 20 | | and
Nationality Act;
| 21 | | (D) persons for whom deportation has been withheld | 22 | | under
Section 243(h) of the Immigration and | 23 | | Nationality Act;
| 24 | | (E) persons granted conditional entry under | 25 | | Section 203(a)(7) of the
Immigration and Nationality | 26 | | Act as in effect prior to April 1, 1980;
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| 1 | | (F) persons lawfully admitted for permanent | 2 | | residence under
the Immigration and Nationality Act; | 3 | | and
| 4 | | (G) parolees, for at least one year, under Section | 5 | | 212(d)(5)
of the Immigration and Nationality Act.
| 6 | | Those children who are in the categories set forth in | 7 | | subdivisions
(4)(F) and (4)(G) of this subsection, who enter | 8 | | the United States on or
after August 22, 1996, shall not be | 9 | | eligible for 5 years beginning on the
date the child entered | 10 | | the United States.
| 11 | | (b) A child who is determined to be eligible for assistance | 12 | | may remain
eligible for 12 months, provided the child maintains | 13 | | his or
her residence in the State, has not yet attained 19 | 14 | | years of age, and is not
excluded pursuant to subsection (c). A | 15 | | child who has been determined to
be eligible for assistance | 16 | | must reapply or otherwise establish eligibility
at least | 17 | | annually.
An eligible child shall be required , as determined by | 18 | | the
Department by rule, to report promptly those changes in | 19 | | income and other
circumstances that affect eligibility within | 20 | | 30 days after the occurrence of the change . The eligibility of | 21 | | a child may be
redetermined based on the information reported | 22 | | or may be terminated based on
the failure to report or failure | 23 | | to report accurately. A child's responsible
relative or | 24 | | caretaker may also be held liable to the Department for any
| 25 | | payments made by the Department on such child's behalf that | 26 | | were inappropriate.
An applicant shall be provided with notice |
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| 1 | | of these obligations.
| 2 | | (c) A child shall not be eligible for coverage under this | 3 | | Program if:
| 4 | | (1) the premium required pursuant to
Section 30 of this | 5 | | Act has not been paid. If the
required premiums are not | 6 | | paid the liability of the Program
shall be limited to | 7 | | benefits incurred under the
Program for the time period for | 8 | | which premiums had been paid. Re-enrollment shall be
| 9 | | completed prior to the next covered medical visit and the | 10 | | first month's
required premium shall be paid in advance of | 11 | | the next covered medical visit.
The Department shall | 12 | | promulgate rules regarding grace periods, notice
| 13 | | requirements, and hearing procedures pursuant to this | 14 | | subsection;
| 15 | | (2) the child is an inmate of a public institution or a | 16 | | patient in an
institution for mental diseases; or
| 17 | | (3) the child is a member of a family that is eligible | 18 | | for health benefits
covered under the State of Illinois | 19 | | health benefits plan on the basis of a
member's employment | 20 | | with a public agency.
| 21 | | (d) The Department shall seek a waiver of federal | 22 | | requirements under the Patient Protection and Affordable Care | 23 | | Act in order to allow the Department to immediately implement | 24 | | the changes made to this Section by this amendatory Act of the | 25 | | 97th General Assembly. Upon federal waiver approval, the | 26 | | Department
shall promulgate rules necessary to implement the |
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| 1 | | changes made to this Section by this amendatory Act of the 97th | 2 | | General Assembly. | 3 | | (Source: P.A. 96-1272, eff. 1-1-11.)
| 4 | | (215 ILCS 106/40)
| 5 | | Sec. 40. Waivers.
| 6 | | (a) The Department shall request any necessary waivers of | 7 | | federal
requirements in order to allow receipt of federal | 8 | | funding for:
| 9 | | (1) the coverage of families with eligible children | 10 | | under this Act; and
| 11 | | (2) the coverage of
children who would otherwise be | 12 | | eligible under this Act, but who have health
insurance.
| 13 | | (b) The failure of the responsible federal agency to | 14 | | approve a
waiver for children who would otherwise be eligible | 15 | | under this Act but who have
health insurance shall not prevent | 16 | | the implementation of any Section of this
Act provided that | 17 | | there are sufficient appropriated funds.
| 18 | | (c) Eligibility of a person under an approved waiver due to | 19 | | the
relationship with a child pursuant to Article V of the | 20 | | Illinois Public Aid
Code or this Act shall be limited to such a | 21 | | person whose countable income is
determined by the Department | 22 | | to be at or below such income eligibility
standard as the | 23 | | Department by rule shall establish. The income level
| 24 | | established by the Department shall not be below 90% of the | 25 | | federal
poverty
level. Such persons who are determined to be |
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| 1 | | eligible must reapply, or
otherwise establish eligibility, at | 2 | | least annually. An eligible person shall
be required , as | 3 | | determined by the Department by rule, to report promptly those
| 4 | | changes in income and other circumstances that affect | 5 | | eligibility to the Department within 30 days after the | 6 | | occurrence of the change . The
eligibility of a person may be
| 7 | | redetermined based on the information reported or may be | 8 | | terminated based on
the failure to report or failure to report | 9 | | accurately. A person may also be
held liable to the Department | 10 | | for any payments made by the Department on such
person's behalf | 11 | | that were inappropriate. An applicant shall be provided with
| 12 | | notice of these obligations.
| 13 | | (d) The Department
shall promulgate rules necessary to | 14 | | implement the changes made to this Section by this amendatory | 15 | | Act of the 97th General Assembly. | 16 | | (Source: P.A. 96-328, eff. 8-11-09.)
| 17 | | Section 15. The Covering ALL KIDS Health Insurance Act is | 18 | | amended by changing Section 20 as follows: | 19 | | (215 ILCS 170/20) | 20 | | (Section scheduled to be repealed on July 1, 2016)
| 21 | | Sec. 20. Eligibility. | 22 | | (a) To be eligible for the Program, a person must be a | 23 | | child:
| 24 | | (1) who is a resident of the State of Illinois; |
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| 1 | | (2) who is ineligible for medical assistance under the | 2 | | Illinois Public Aid Code or benefits under the Children's | 3 | | Health Insurance Program Act;
| 4 | | (3) either (i) who has been without health insurance | 5 | | coverage for 12 months, (ii) whose parent has lost | 6 | | employment that made available affordable dependent health | 7 | | insurance coverage, until such time as affordable | 8 | | employer-sponsored dependent health insurance coverage is | 9 | | again available for the child as set forth by the | 10 | | Department in rules, (iii) who is a newborn whose | 11 | | responsible relative does not have available affordable | 12 | | private or employer-sponsored health insurance, or (iv) | 13 | | who, within one year of applying for coverage under this | 14 | | Act, lost medical benefits under the Illinois Public Aid | 15 | | Code or the Children's Health Insurance Program Act; and | 16 | | (3.5) whose household income, as determined by the | 17 | | Department, is at or below 300% of the federal poverty | 18 | | level. This item (3.5) is effective July 1, 2011 ; and . | 19 | | (4) whose household assets do not exceed $10,000, | 20 | | excluding (i) the value of the residence in which the child | 21 | | lives and (ii) the value of a vehicle used by the household | 22 | | for transportation purposes; for purposes of this | 23 | | paragraph (4), "vehicle" does not include a recreational | 24 | | vehicle as defined in the Campground Licensing and | 25 | | Recreational Area Act. | 26 | | An entity that provides health insurance coverage (as |
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| 1 | | defined in Section 2 of the Comprehensive Health Insurance Plan | 2 | | Act) to Illinois residents shall provide health insurance data | 3 | | match to the Department of Healthcare and Family Services as | 4 | | provided by and subject to Section 5.5 of the Illinois | 5 | | Insurance Code. | 6 | | The Department of Healthcare and Family Services, in | 7 | | collaboration with the Department of Insurance, shall adopt | 8 | | rules governing the exchange of information under this Section. | 9 | | The rules shall be consistent with all laws relating to the | 10 | | confidentiality or privacy of personal information or medical | 11 | | records, including provisions under the Federal Health | 12 | | Insurance Portability and Accountability Act (HIPAA). | 13 | | (b) The Department shall monitor the availability and | 14 | | retention of employer-sponsored dependent health insurance | 15 | | coverage and shall modify the period described in subdivision | 16 | | (a)(3) if necessary to promote retention of private or | 17 | | employer-sponsored health insurance and timely access to | 18 | | healthcare services, but at no time shall the period described | 19 | | in subdivision (a)(3) be less than 6 months.
| 20 | | (c) The Department, at its discretion, may take into | 21 | | account the affordability of dependent health insurance when | 22 | | determining whether employer-sponsored dependent health | 23 | | insurance coverage is available upon reemployment of a child's | 24 | | parent as provided in subdivision (a)(3). | 25 | | (d) A child who is determined to be eligible for the | 26 | | Program shall remain eligible for 12 months, provided that the |
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| 1 | | child maintains his or her residence in this State, has not yet | 2 | | attained 19 years of age, and is not excluded under subsection | 3 | | (e). | 4 | | (e) A child is not eligible for coverage under the Program | 5 | | if: | 6 | | (1) the premium required under Section 40 has not been | 7 | | timely paid; if the required premiums are not paid, the | 8 | | liability of the Program shall be limited to benefits | 9 | | incurred under the Program for the time period for which | 10 | | premiums have been paid; re-enrollment shall be completed | 11 | | before the next covered medical visit, and the first | 12 | | month's required premium shall be paid in advance of the | 13 | | next covered medical visit; or | 14 | | (2) the child is an inmate of a public institution or | 15 | | an institution for mental diseases.
| 16 | | (f) The Department may adopt rules, including, but not | 17 | | limited to: rules regarding annual renewals of eligibility for | 18 | | the Program in conformance with Section 7 of this Act; rules | 19 | | providing for re-enrollment, grace periods, notice | 20 | | requirements, and hearing procedures under subdivision (e)(1) | 21 | | of this Section; and rules regarding what constitutes | 22 | | availability and affordability of private or | 23 | | employer-sponsored health insurance, with consideration of | 24 | | such factors as the percentage of income needed to purchase | 25 | | children or family health insurance, the availability of | 26 | | employer subsidies, and other relevant factors.
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| 1 | | (g) Each child enrolled in the Program as of July 1, 2011 | 2 | | whose family income, as established by the Department, exceeds | 3 | | 300% of the federal poverty level may remain enrolled in the | 4 | | Program for 12 additional months commencing July 1, 2011. | 5 | | Continued enrollment pursuant to this subsection shall be | 6 | | available only if the child continues to meet all eligibility | 7 | | criteria established under the Program as of the effective date | 8 | | of this amendatory Act of the 96th General Assembly without a | 9 | | break in coverage. Nothing contained in this subsection shall | 10 | | prevent a child from qualifying for any other health benefits | 11 | | program operated by the Department. | 12 | | (d) The Department shall seek a waiver of federal | 13 | | requirements under the Patient Protection and Affordable Care | 14 | | Act in order to allow the Department to immediately implement | 15 | | the changes made to this Section by this amendatory Act of the | 16 | | 97th General Assembly. Upon federal waiver approval, the | 17 | | Department
shall promulgate rules necessary to implement the | 18 | | changes made to this Section by this amendatory Act of the 97th | 19 | | General Assembly. | 20 | | (Source: P.A. 96-1272, eff. 1-1-11; 96-1501, eff. 1-25-11.)
| 21 | | Section 99. Effective date. This Act takes effect upon | 22 | | becoming law.".
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