(Doc Name COUNCIL\NBD\3710C011.NBD.AC13.DOCX):
EXPLANATION:
Amend the bill, as and if amended, on page 525, after line 7, by adding a new Part appropriately numbered to read:
Whereas, the Patient Protection And Affordable Care Act of 2010
(ACA), as amended, provides for the expansion of the Medicaid
program to cover adults age nineteen through sixty-four and
families that have income at or below one hundred and
thirty-three percent of the federal poverty level (FPL), which
includes a five percent income disregard, equating to income at
or below one hundred thirty-eight percent of the FPL; and
Whereas, the ACA stipulates that from January 1, 2014 through
December 31, 2016, the federal government will fund one hundred
percent of a state's cost of Medicaid services provided to newly
eligible beneficiaries under the expansion; and
Whereas, the latest data from the Milliman study prepared for the South Carolina Department of Health and Human Services estimates that approximately 351,000 South Carolinians would become newly eligible for Medicaid under the expansion; and
Whereas, according to the Milliman study (April, 2012), opting to participate in the Medicaid expansion for 2014-2016 with a one hundred percent match results in an estimated $4.1 billion in new federal funding, which includes only half of the funding for 2014, and an estimated $81 million in administrative costs, which includes some cost elements that would exist even if South Carolina did not adopt the expansion, resulting in a net benefit to the State of approximately $4 billion; and
Whereas, based on data from the Milliman Study (April, 2012) it
is estimated that more than $236 million in state tax revenue
would be generated during 2014-2016, with only the second half
of 2014 included in the estimate, from the expansion funds and
the resultant job growth, both within and outside the health
care industry, income gains, and additional purchasing, which
replaces, almost three-fold, the $81 million projected to be
expended by the state in administrative costs to implement the
expansion; and
Whereas, an additional requirement of the ACA provides that
beginning in 2014 and continuing through 2020 reimbursement of
Medicaid and Medicare federal Disproportionate Hospital Share
funds will be reduced whether or not a state opts to participate
in the Medicaid expansion; the amount of federal funds the State
is projected to lose from this reduction is $2.6 billion for the
years 2014 through 2020, which, if the state participates in
Medicaid Expansion, these losses would be significantly offset
by the federal expansion funds coming into the state; and
Whereas, as South Carolinians have begun to understand Medicaid
expansion and its ramifications, a constantly growing number of
organizations have voiced their strong support for the
expansion; one of the most recent proponents is the Charleston
Metro Chamber of Commerce, with eighteen hundred plus members,
which has embraced the expansion due to the reduction in
healthcare costs for businesses and the commensurate growth and
expansion of business, industry, and jobs; the South Carolina
Small Business Chamber of Commerce, which for the past decade
has tried to address its members' top priority, 'the cost of
health insurance', vociferously endorses Medicaid expansion and
the reduction in or elimination of health insurance premiums, a
substantial savings for its members; AARP found that fifty-four
percent of older adults in the State support Medicaid expansion,
even though many of them already receive Medicare and would not
directly benefit; the South Carolina Hospital Association, the
South Carolina Primary Care Association, the American Heart
Association, and United Way all have recognized that not only
will many of their members and patients directly benefit from
Medicaid expansion, but also that the expansion will help with a
more efficient and effective use of our health care resources;
and in addition, print and visual media across the state promote
the value of Medicaid expansion for the State, its residents and
businesses, and the overall health and productivity of the
State; and
Whereas, not only does opting into Medicaid expansion
significantly impact and improve the state's economic welfare,
but exercising this option also gives hundreds of thousands of
South Carolinians the opportunity to improve their individual
health and their chances of entering and maintaining a place in
the workforce as a contributing, productive member of their
communities and the State. Now, therefore,
SECTION 1. The Patient Protection and Affordable Care Act of 2010 (ACA), as amended by the Health Care and Education Reconciliation Act, P.L. 111-152 of 2010, provides for Medicaid expansion, which requires the federal government to fund one hundred percent of a state's cost of Medicaid services provided to newly eligible expansion reciepients from January 1, 2014 through December 31, 2016. Federal funds received pursuant to the ACA to expand Medicaid coverage are deemed to be appropriated to the Department of Health and Human Services pursuant to Part IA of this act for fiscal year 2013-2014 beginning January 1, 2014 and are deemed to continue to be so appropriated in suceeding annual general appropriations acts through fiscal year 2016-2017 ending December 31, 2016.
SECTION 2. The Department of Health and Human Services shall make all Medicaid authorizations required to implement the Medicaid expansion provided for in Section 3; however, implementation of Section 3 is dependent upon the federal government providing one hundred percent of the Medicaid funding necessary for expansion in accordance with the Patient Protection and Affordable Care Act, P.L. 111-148 of 2010, as amended by the Health Care and Education Reconciliation Act, P.L. 111-152 of 2010.
SECTION 3. Beginning
January 1, 2014, through December 31, 2016, the following are
eligible for Medicaid pursuant to the provisions of the Patient
Protection and Affordable Care Act, P.L. 111-148 of 2010, as
amended by the Health Care and Education Reconciliation Act, P.
L. 111-152, of 2010:
(1)
a family with income at or below one hundred thirty-three
percent of the federal poverty level, which includes a five
percent income disregard; and
(2)
a childless individual nineteen through sixty-four years
of age with income at or below one hundred thirty-three percent
of the federal poverty level, which includes a five percent
income disregard.
SECTION 4. (A)
There is created the Contingency Fund for Continued
Care in the Office of the State Treasurer, a fund separate and
distinct from the general fund of the state for the purpose of
preserving funds for the continuation of Medicaid expansion if
authorized by the General Assembly pursuant to Section 5. The
following must be deposited into this fund:
(1)
health care savings generated from programs, policies, and
procedures of the Department of Health and Human Services newly
implemented or expanded as an alternative to Medicaid expansion
during 2014 through 2016;
(2)
savings realized from preventive services provided to
newly eligible Medicaid beneficiaries pursuant to the Medicaid
expansion during 2014 through 2016;
(3)
notwithstanding any other provision of law providing for
the disposition of any tax or fee, net state tax revenue
generated from implementation of the Medicaid expansion and the
commensurate growth in jobs and increased income and
purchasing.
(B)(1) To determine the
funds to be deposited in the Contingency Fund for Continued Care
pursuant to subsection (A), the State Budget and Control Board,
Research and Statistics Division, shall work in conjunction with
the Department of Health and Human Services and in consultation
with the South Carolina Primary Care Association and the South
Carolina Hospital Association and shall submit their findings to
the State Budget and Control Board.
(2)
The Department of Revenue, in consultation with the Board
of Economic Advisors and other agencies as needed, shall
determine the funds to be deposited in the Contingency Fund for
Continued Care and shall submit its findings to the Budget and
Control Board.
(3)
The State Budget and Control Board shall certify to the
State Treasurer the transfer of funds pursuant to this
subsection to the Contingency Fund for Continued Care.
SECTION 5. The General Assembly may authorize the continued participation of the State in Medicaid expansion, in accordance with the provisions of the Patient Protection and Affordable Care Act, as amended, if the General Assembly finds that Medicaid expansion, as provided for in Section 3, has substantially achieved its goals of providing Medicaid to newly eligible beneficiaries and generating health care savings and state tax revenue./
Renumber sections to conform.
Amend totals and titles to conform.