Iowa

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IOWA LEGISLATIVE UPDATE - 2008

H.F. 2539 - Health Care Bill

It is the intent to the General Assembly that all Iowans have health care coverage, with the initial priority of providing health care coverage for all children.

The legislation lays out plans to gradually cover every uninsured child in the state, reaching universal coverage for children by 2011. The law will achieve this partly by expanding its SCHIP, hawk-i, to include children from families earning up to 300 percent of the federal poverty level.  Prior to this law, eligibility levels for hawk-i were set at 200 percent of FPL.

Children between 200 to 300 percent of FPL will receive coverage under hawk-i, but will likely be subject to higher-cost sharing than lower income beneficiaries.  The law requires the hawk-i board establish premium amounts based on a sliding scale. 

For uninsured children under 19 not eligible for public assistance expansion, HF 2539 mandates that an advisory council develop a plan by December 2008 to ensure access to private coverage for which the contribution requirement for all cost sharing expenses is no more than two percent of family income per child covered, up to a maximum of six and one half percent of family income per family.

In addition to increasing health coverage, the law extends private insurance coverage for children on their parent's plan until they reach age 25, marry or move out of the state.  Prior to the law, children were allowed to remain on their parents' plan if they were under the age of 18 or a full-time student.

Private insurers are also barred from excluding or limiting coverage based on preexisting conditions when a consumer switches from a group plan to an individual plan. This provision applies to policies starting on or after July 1, 2008.

The measure includes provisions for aggressive outreach to promote children's coverage. The law requires, that beginning with 2008 tax returns, taxpayers will be given the opportunity to note on their returns whether or not their children are insured.  If a taxpayer indicates their child is uninsured and the family's income suggests the child might be eligible for a medical assistance program, the state will notify the family of the child's eligibility for selected programs.

The reform law also paves the way to an even larger goal: providing Iowans with access to coverage by 2013.  Although the legislation does not detail how this goal will be met, it does charge two task forces with recommending affordable coverage options for uninsured adults by December 2008. A cost-sharing cap of six and one half percent (as a percent of family income) for such coverage is one guideline written into the law.

The measure also includes provisions for a public private partnership to develop and implement an interoperable electronic health record system; medical and dental homes; end-of-life care decision making, long-term care options; assistance to small employers with implementing reimbursement accounts; tax credit for small businesses offering wellness programs; state initiative for prevention and chronic care management; health care transparency and institutes a Direct Care Workers Advisory Council.

H.F. 2539  Bill Summary

H.F. 2539 Bill

 

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