5/26/22,
10:41 PM
The Daily Bulletin: 2022-05-26 | Legislative Reporting Service
UNC
SCHOOL OF GOVERNMENT
The Daily Bulletin: 2022-05-26
PUBLIC/HOUSE BILLS
H 149 (2021) EXPANDING ACCESS TO HEALTHCARE. (NEW) Filed Feb 24 2021, AN ACT EXPANDING ACCESS TO
HEALTHCARE IN NORTH CAROLINA.
Senate committee substitute to the 2nd edition replaces the content of the 2nd edition with the following.
Parti.
Provides for the following provisions to become effective upon the later of six months after the date the act becomes law. or on
the date the work requirements developed under Part 1 1. of the act becomes law. Repeals Section 3, SL 2013-5, which bars the
State from expanding the State's Medicaid eligibility under the Medicaid expansion provided in the Affordable Care Act, PL
1 1 1-148, as amended, for which the enforcement was ruled unconstitutional by the U.S. Supreme Court, and bars State entities
from attempting to expand the Medicaid eligibility standards provided in SL 20 1 1-145. as amended, or elsewhere in State law,
unless directed by the NCGA. Amends GS 108A-54.3 to enact new subdivision (24), requiring the Department of Health and
Human Services (DHHS) to provide Medicaid coverage to individuals described in section 1 902(a)( 1 0)( A)(i)(VIIl ) of the
Social Security Act who are in compliance with work requirements established in the State Plan and in rule. Section 1902(a)
( 1 0)( A )(i)( VII I ) of the Social Security Act includes individuals who beginning January 1. 2014. who are under 65 years of age,
not pregnant, not entitled to. or enrolled for, benefits under part A of title XVIII. or enrolled for benefits under part
В
of title
XVIII. and are not described in a another subclause, and whose income does not exceed 133% of the poverty line applicable to
a family of the size involved. Makes coverage available through an Alternative Benefit Plan established by DHHS consistent
with federal requirements, unless the individual is exempt from mandatory enrollment in the Plan under 42 CFR 440.31 5.
Enacts GS 108A-54.3B. States legislative intent to fully fund the nonfederal share of the cost of NC Health Works, meaning
the provision of Medicaid coverage to the individuals described in new GS 108A-54.3A(24), through a combination of ( 1)
increases in revenue from the gross premium tax due to NC Health Works; (2) increases in intergovernmental transfers dur to
NC Health Works; (3) the hospital health assessment under Part 3. Article 7B. GS Chapter 108A, excluding State retention;
and (4) savings to the State attributable to the NC Health Works corresponding to General Fund budget reductions to other
State programs. Directs DHHS to annually report, beginning in 2024, to the specified NCGA committee, division, and the
Office of State Budget and Management (OSBM). as specified. Requires expeditiously discontinuing coverage for the
individuals described in new GS 108A-54.3A(24) if the nonfederal share of the cost cannot be fully funded through the
described sources. Requires the DHHS Secretary to notify the specified NCGA committee, division, and OSBM of such a
determination, and post notice to its website including the proposed effective date of the discontinuation of coverage. Also
requires the DHHS Secretary to submit necessary documentation to the Centers for Medicare and Medicaid Sendees (CMS).
Enacts GS 108A-54.3C to require expeditious discontinuation of Medicaid coverage if the federal medical assistance
percentage for Medicaid coverage provided to the individuals described in new GS 108A-54.3A(24) falls below 90%. Requires
the DHHS Secretary fulfill identical requirements as those for a discontinuation due to insufficient funds from identified
sources in GS 108A-54.3B.
Establishes the ARPA Temporary Savings Fund as a nonreverting special fund in the Division of Health Benefits (DHB)
consisting of any savings realized as a result of federal receipts arising from the enhanced federal medical assistance
percentage (FMAP) available to the State under section 9814 of the American Rescue Plan Act (ARPA). Requires legislative
allocation or expenditure of the funds.
Effective October 1. 2022. through December 31. 2022, subjects licensed hospitals to a 0.044% hospital health advancement
assessment of its hospital costs, excluding critical access hospitals and State owned or operated hospitals, for the fiscal quarter
beginning October 1 . 2022. Raises the hospital health assessment rate to 0.539% for the State fiscal quarter beginning January
1 . 2023, and the State fiscal quarter beginning April 1. 2023, effective the later of January 1, 2023, or the effective date of the
Medicaid coverage under new GS 108A-54.3A(24). through June 30. 2023; provides that no assessment can be imposed for
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