SPONSOR:

Sen. Henry & Rep. Baumbach

Sens. Marshall, Townsend; Reps. Bentz, Keeley, Kowalko, Osienski

DELAWARE STATE SENATE

149th GENERAL ASSEMBLY

SENATE CONCURRENT RESOLUTION NO. 70

CREATING A MEDICAID BUY-IN STUDY GROUP.

WHEREAS, access to quality, affordable health care is a cornerstone not only of a healthy life, but of a healthy economy and middle-class; and

WHEREAS, more than 24,000 Delawareans are enrolled in Marketplace plans via ChooseHealthDE.com or Healthcare.gov; and

WHEREAS, only one commercial insurer currently sells health plans on Delaware’s Marketplace; and

WHEREAS, health insurance premiums on an average “Silver” level Marketplace plan in Delaware increased by 25% last year; and

WHEREAS, consumers would benefit from greater competition in the individual insurance marketplace; and

WHEREAS, research from the Urban Institute shows that per-enrollee health care spending is 22% less under Medicaid than under private insurance; and

WHEREAS, health care spending in Delaware grew by 7.2% between 1991 and 2014, the fourth highest rate in the nation, according to the Kaiser Family Foundation; and

WHEREAS, from 1987 to 2015, Medicaid spending grew by 4.1% annually versus 6.9% annual growth for private insurance, according to the Centers for Medicare and Medicaid Services; and

WHEREAS, Delaware has taken steps to rein in the growth of health care spending, including establishing a health care benchmark; and

WHEREAS, under Medicaid expansion, Delawareans making 138% or less of the Federal Poverty Level (“FPL”) are eligible for Medicaid; and

WHEREAS, Marketplace consumers over 138% of FPL are limited to commercial insurers; and

WHEREAS, Congress enacted the Medicaid Buy-In option for states in the Balanced Budget Act of 1997 (§ 4733) and enhanced the option in the Ticket to Work and Work Incentive Improvement Act of 1999 (P.L. 106-170, 42 USC 1396 et seq.); and

WHEREAS, Delaware has a Medicaid Buy-In program known as “Medicaid for Workers with Disabilities (MWD)” which is available to current and new Medicaid beneficiaries with disabilities who meet MWD eligibility requirements; and

WHEREAS, creating a Medicaid Buy-In program that allows Delawareans above 138% FPL the ability to purchase Medicaid coverage would provide an affordable, high-quality coverage alternative with premiums set by the State; and

WHEREAS, Delaware’s small size gives it a unique opportunity for innovation in public policy, including health care policy; and

WHEREAS, every American deserves affordable health care.

NOW, THEREFORE:

BE IT RESOLVED by the Senate of the 149 th General Assembly of the State of Delaware, the House of Representatives concurring therein, that a Medicaid Buy-In Study Group (“Study Group”) is hereby created.

BE IT FURTHER RESOLVED that the Study Group is composed of the following voting members serving by virtue of position, or a designee appointed by the member:

(1) A State Senator from the majority caucus, appointed by the President Pro Tem of the Senate, who serves as Co-Chair.

(2) A State Representative from the majority caucus, appointed by the Speaker of the House of Representatives, who serves as Co-Chair.

(3) A State Senator from the minority caucus, appointed by the President Pro Tem.

(4) A State Representative from the minority caucus, appointed by the Speaker of the House.

(5) The Insurance Commissioner.

(6) The Secretary of the Department of Health and Social Services.

(7) The Director of the Office of Management and Budget.

(8) The Controller General.

(9) The Director of the Division of Medicaid and Medical Assistance.

(10) The Chair of the Delaware Health Care Commission.

(11) Two representatives from the insurance industry, 1 appointed by the President Pro Tem and 1 appointed by the Speaker of the House.

(12) Two physicians, appointed by the Medical Society of Delaware.

(13) Two representatives from hospitals, appointed by the Delaware Healthcare Association.

(14) Three members of the public representing consumers, appointed by the Governor.

BE IT FURTHER RESOLVED that the Study Group shall study the adoption of an expanded Medicaid Buy-In program in Delaware, including federal requirements and approvals, eligibility criteria for individuals, potential premiums and levels of coverage, and potential positive and negative consequences of creating an expanded Medicaid Buy-In Program.

BE IT FURTHER RESOLVED that the Governor and the Secretary of Health and Social Services may apply to the Secretary of the U.S. Department of Health and Human Services for a waiver for state innovation under Section 1332 of the Patient Protection and Affordable Care Act (42 USCS § 18052), and if approved, may implement a state plan of innovation that meets the waiver requirements established under federal law and as approved by the United States Secretary of Health and Human Services.

BE IT FURTHER RESOLVED that quorum of the Study Group is a majority of its members.

BE IT FURTHER RESOLVED that:

(1) Official action by the Study Group, including making findings and recommendations, requires the approval of a quorum of the Study Group.

(2) The Study Group may adopt rules necessary for its operation.

BE IT FURTHER RESOLVED that the Co-Chairs of this Study Group are responsible for guiding the administration of the Study Group by doing, at a minimum, all of the following:

(1) Setting a date, time, and place for the initial organizational meeting.

(2) Notifying the individuals listed in lines 43 through 53 of the formation of the Study Group and the need to appoint a member.

(2) Supervising the preparation and distribution of meeting notices, agendas, minutes, correspondence, and reports of the Study Group.

(3) Sending to the President Pro Tempore of the Senate, the Speaker of the House of Representatives, and the Director of the Division of Research of Legislative Council, after the first meeting of the Study Group, a list of the members of the Study Group and the person who appointed them.

(4) Providing meeting notices, agendas, and minutes to the Director of the Division of Research of Legislative Council.

(5) Ensuring that the final report of the Study Group is submitted to the President Pro Tempore of the Senate and the Speaker of the House of Representatives, with copies to all members of the General Assembly, the Governor, the Director and the Librarian of the Division of Research of Legislative Council, and the Delaware Public Archives.

BE IT FURTHER RESOLVED that the Study Group shall hold its first meeting no later than September 10, 2018.

BE IT FURTHER RESOLVED that the General Assembly is responsible for providing reasonable and necessary support staff, including a legislative attorney, and materials for the Study Group to carry out its mission.

BE IT FURTHER RESOLVED that the General Assembly will appropriate funding to the Department of Health and Social Services for the Study Group to use to hire experts to assist in this research.

BE IT FURTHER RESOLVED that the Co-chairs of the Study Group shall compile a report containing a summary of the Study Group’s work regarding the issues assigned to it in lines 54 through 57 of this resolution, including any findings and recommendations, and submit the report to all members of the General Assembly and the Governor no later than January 31, 2019.

SYNOPSIS

This Senate Concurrent Resolution creates a Medicaid Buy-In Study Group to study the adoption of an expanded Medicaid Buy-In program that would allow Delawareans with incomes above 138% of the Federal Poverty Level to purchase insurance coverage through the Medicaid program.

Author: Senator Henry