Relates to the date of enrollment in the child health insurance plan

1 Co-sponsor

• Kathleen A. Marchione

BILL NUMBER:S4745B

Title of bill

An act to amend the public health law, in relation to the date of enrollment in the child health insurance plan

Purpose

To allow families who sign-up and are approved for Child Health Plus prior to or within sixty days of their child's birth, to have coverage take effect the day of birth.

Summary of specific provisions

Section 1 and 2 amends PHL § 2511, to allow coverage under Child Health Plus to take effect on the date of a child's birth, if application is made prior to or within sixty days of the child's birth and such application has been approved by an approved organization.

Section 3: Provides the effective date.

Justification

Current provisions of the Public Health Law establishing the Child Health Plus (CHP) program allow children to be presumed eligible and temporarily enrolled under CHP, if, based on preliminary information they appear to be meet income eligibility standards. Once enrolled, coverage takes place on the first date of the enrollment period following the date of a presumed eligibility determination; this creates a coverage gap from the point of application that can be 30 days. This bill would correct that situation and provide coverage at the point of eligibility determination consistent with other publicly funded coverage programs.

Child Health Plus is a fantastic New York State all-inclusive health insurance program created for MIDDLE CLASS families. The cost of a child's monthly premium is determined by a cross section of the number of people in the family and the family's income. Families can sign-up their children at any point between birth and age eighteen. A family can also complete all the paperwork prior to a child's birth and then simply activate the plan when the child is born.

Current law sets a gap between the date of birth and the beginning date of coverage, through no fault of the enrollee. Let's say Max Jr. is born on August 3, 2014. His family knew they wanted to sign Max up for Child Health Plus and they completed all the paperwork in July, prior to his birth. His family calls on August 5th to activate his account. Because Max does not qualify for Medicaid, there is a loophole in the law that says Max's coverage does not begin until the beginning of the next month, so in his case, September 1, 2014. This means that Max does not have health insurance for the month of August.

There are other situations that occur if you are born after the 15th of the month. If you are born after the middle of the month, you will not being coverage the first of the following month, but rather the first of the next month. Example; Max Jr. was born on August 16, 2014, he now doesn't have health insurance until October 1st, 2014.

Some families know about this gap in coverage and put their newborn on a parent's plan, however not all families have that option.

Prior legislative history

New Bill.

Fiscal implications

Minimal.

Effective date

This act shall take effect January 1, 2016.