Amendment #880 to H.3600

Amendment #880 to H3600

MassHealth Spending Limit

Representatives Lyons of Andover, DeCoste of Norwell and Lombardo of Billerica move to amend the bill by inserting at the end thereof the following new outside section: -

SECTION XXX. (a) MassHealth expenditures from the Executive Office of Health and Human Services and related Commonwealth agencies including the Massachusetts Health Connector shall not exceed 30% of any general appropriations act and supplemental budget appropriations for any fiscal year beginning with fiscal year 2018; provided that any such appropriations shall continue to fund all required MassHealth programs that serve individuals with disabilities, seniors, pregnant mothers, individuals with breast or cervical cancer, individuals who are HIV positive, and all those eligible individuals who are at or below the federal poverty level.

(b) Chapter 118E is hereby amended by adding the following section:-

Section 78. On or before March 30 of each year, the secretary shall apply to the federal Centers for Medicare and Medicaid Services for a waiver or amendment to a current waiver pursuant to section 1115 of the federal Social Security Act, 42 USC Section 1315, to allow the commonwealth to require the following:

(a) no employee who is offered subsidized health insurance coverage by his employer shall be eligible for any healthcare program funded by the commonwealth; and

(b) to institute a work requirement for all able-bodied adults receiving any health care services funded by the commonwealth. The work requirement shall:

(1) require an eligible person to:

(i) become employed,

(ii) actively seek employment, which would be verified by the division, or (iii) attend a job training program;

(2) require an eligible person to verify on a monthly basis compliance with requirements of subdivision (1) of this paragraph and any change in family income;

(3) require the administration to confirm an eligible person's change in family income as reported pursuant to subdivision (2) of this paragraph and determine the person's eligibility under this article;

(4) allow the administration to ban an eligible person from enrollment for 1 year if the eligible person failed to report a change in family income or made a false statement regarding compliance with the requirements of subdivision (1) of this paragraph.; and

(5) allow for an exemption if a person meets any of the following conditions:

(i) is at least 18 years of age but is still attending high school as a full-time student;

(ii) is the sole caregiver of a family member who is under 5 years of age; or

(iii) is currently receiving temporary or permanent long-term disability benefits from a private insurer or the government.

Upon the approval of such waiver pursuant to section 1115 of the federal Social Security Act, 42 USC Section 1315, for any of the requirements of this section, the secretary shall take all actions necessary to implement the requirements of this section.

Section 19. On or before March 30 of each year, the board shall apply to the federal Centers for Medicare and Medicaid Services for a waiver or amendment to a current waiver pursuant to section 1115 of the federal Social Security Act, 42 USC Section 1315,to allow the commonwealth to require that no employee who is offered subsidized health insurance coverage by an employer shall be eligible for a healthcare program funded by the commonwealth.

Upon the approval of such waiver pursuant to section 1115 of the federal Social Security Act, 42 USC Section 1315, the board shall take all necessary actions to implement subsection (a).