26B-3-112.  Maximizing use of premium assistance programs — Utah’s Premium Partnership for Health Insurance.

(1) 

Terms Used In Utah Code 26B-3-112

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Month: means a calendar month, unless otherwise expressed. See Utah Code 68-3-12.5
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • PPACA: means the same as that term is defined in Section 31A-1-301. See Utah Code 26B-3-101
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(a)  The department shall seek to maximize the use of Medicaid and Children’s Health Insurance Program funds for assistance in the purchase of private health insurance coverage for Medicaid-eligible and non-Medicaid-eligible individuals.

(b)  The department’s efforts to expand the use of premium assistance shall:

(i)  include, as necessary, seeking federal approval under all Medicaid and Children’s Health Insurance Program premium assistance provisions of federal law, including provisions of PPACA;

(ii)  give priority to, but not be limited to, expanding the state‘s Utah Premium Partnership for Health Insurance Program, including as required under Subsection (2); and

(iii)  encourage the enrollment of all individuals within a household in the same plan, where possible, including enrollment in a plan that allows individuals within the household transitioning out of Medicaid to retain the same network and benefits they had while enrolled in Medicaid.

(2)  The department shall seek federal approval of an amendment to the state’s Utah Premium Partnership for Health Insurance program to adjust the eligibility determination for single adults and parents who have an offer of employer sponsored insurance. The amendment shall:

(a)  be within existing appropriations for the Utah Premium Partnership for Health Insurance program; and

(b)  provide that adults who are up to 200% of the federal poverty level are eligible for premium subsidies in the Utah Premium Partnership for Health Insurance program.

(3)  For the fiscal year 2020-21, the department shall seek authority to increase the maximum premium subsidy per month for adults under the Utah Premium Partnership for Health Insurance program to $300.

(4)  Beginning with the fiscal year 2021-22, and in each subsequent fiscal year, the department may increase premium subsidies for single adults and parents who have an offer of employer-sponsored insurance to keep pace with the increase in insurance premium costs, subject to appropriation of additional funding.

Renumbered and Amended by Chapter 306, 2023 General Session