(a) For the purposes of this section:
(1) “Affordable Care Act” has the same meaning as provided in section 38a-1080;
(2) “Covered Connecticut program” means the program established under subsection (b) of this section;
(3) “Exchange” has the same meaning as provided in section 38a-1080;
(4) “Health carrier” has the same meaning as provided in section 38a-1080;
(5) “Individual market” has the same meaning as provided in 42 USC 18024(a), as amended from time to time;
(6) “Office of Health Strategy” means the Office of Health Strategy established under section 19a-754a; and
(7) “Silver level” has the same meaning as provided in 42 USC 18022(d), as amended from time to time.
(b) There is established within the Office of Health Strategy the Covered Connecticut program for the purpose of reducing the state's uninsured rate. The Office of Health Strategy shall administer said program in consultation with the Commissioner of Social Services, Insurance Commissioner and exchange, and, as part of said program, the Office of Health Strategy shall:
(1) Provide premium and cost-sharing subsidies that are sufficient to ensure fully subsidized coverage:
(A) On and after July 1, 2021, for parents and needy caretaker relatives, and their tax dependents not older than twenty-six years of age, who (i) are eligible for premium and cost-sharing subsidies for a qualified health plan, (ii) are ineligible for Medicaid because their income exceeds the Medicaid income limits under chapter 319v, (iii) have household income up to one hundred seventy-five per cent of the federal poverty level, and (iv) are receiving coverage under the benchmark qualified health plan offered through the exchange in the individual market at a silver level of coverage; and
(B) On and after July 1, 2022, for all parents, needy caretaker relatives and nonpregnant low-income adults who (i) are between eighteen and sixty-four years of age, (ii) are eligible for premium and cost-sharing subsidies for a qualified health plan, (iii) are ineligible for Medicaid because their income exceeds the Medicaid income limits under chapter 319v, (iv) have household income up to one hundred seventy-five per cent of the federal poverty level, and (v) are receiving coverage under the benchmark qualified health plan offered through the exchange in the individual market at a silver level of coverage;
(2) Not earlier than July 1, 2022, provide dental and nonemergency medical transportation services, as provided under chapter 319v, to all parents, needy caretaker relatives and nonpregnant low-income adults who (A) are between eighteen and sixty-four years of age, (B) are eligible for premium and cost-sharing subsidies for a qualified health plan, (C) are ineligible for Medicaid because their income exceeds the Medicaid income limits under chapter 319v, (D) have household income up to one hundred seventy-five per cent of the federal poverty level, and (E) are receiving coverage under the benchmark qualified health plan offered through the exchange in the individual market at a silver level of coverage;
(3) Establish procedures to, on a quarterly basis, pay in reimbursement to each health carrier offering the qualified health plan described in subparagraph (A) or (B) of subdivision (1) of this subsection, as applicable, the premium and cost-sharing subsidies required under subdivision (1) of this subsection to ensure fully subsidized coverage; and
(4) Consult with the Commissioner of Social Services and Insurance Commissioner for the purposes set forth in section 17b-312.
(c) (1) The Office of Health Strategy may, subject to the approval required under subdivision (3) of this subsection, seek a waiver pursuant to Section 1332 of the Affordable Care Act, as amended from time to time, to advance the purpose of the Covered Connecticut program. The Office of Health Strategy shall implement such waiver if the federal government issues such waiver.
(2) The Office of Health Strategy shall submit a report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations, human services and insurance containing any proposed waiver described in subdivision (1) of this subsection before seeking such waiver from the federal government.
(3) Not later than thirty days after the Office of Health Strategy submits a report under subdivision (2) of this subsection, the joint standing committees of the General Assembly having cognizance of matters relating to appropriations, human services and insurance shall convene a joint public hearing on the proposed waiver contained in the report submitted pursuant to subdivision (2) of this subsection, separately vote to approve or reject such proposed waiver and advise the Office of Health Strategy of their approval or rejection of such proposed waiver. If any committee takes no action on such proposed waiver within the thirty-day period, the proposed waiver shall be deemed rejected.
(d) The benefits and subsidies provided for individuals as part of the Covered Connecticut program shall not be considered income for such individuals for the purposes of chapter 229.
(e) Not later than January 1, 2022, and every six months thereafter, the Office of Health Strategy shall submit a report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations, human services and insurance. Such report shall contain a description of the operations and finances of, and progress made by, the Covered Connecticut program for the immediately preceding six-month period.
(June Sp. Sess. P.A. 21-2, S. 16.)
History: June Sp. Sess. P.A. 21-2 effective June 23, 2021.
Structure Connecticut General Statutes
Title 19a - Public Health and Well-Being
Chapter 368dd - Office of Health Strategy
Section 19a-754a. - Office of Health Strategy established.
Section 19a-754c. - Covered Connecticut program. Waivers. Prior approval. Reports.
Section 19a-754e. - Health care expansion study. Report.
Section 19a-754f. - Definitions.
Section 19a-754h. - Payer reporting requirements. Publication of reports.