What's happening
This bill requires adjustments to New York's Elderly Pharmaceutical Insurance Coverage (EPIC) program to eliminate the marriage penalty and update eligibility based on cost of living.
Why it matters
Removes financial disincentives for married seniors. By redefining "joint income" for married couples as their combined income divided by two, the bill ensures that married seniors are not penalized with stricter eligibility or higher costs compared to unmarried individuals with the same per-person income.
Aligns fees and drug cost limits between married and unmarried participants. The legislation requires that registration fees, co-payments, and drug expenditure thresholds for each married participant match those for an unmarried person with equivalent income, leveling the playing field and potentially lowering out-of-pocket costs for married seniors.
Ensures EPIC program eligibility keeps pace with inflation. Mandating regular cost-of-living adjustments means that income limits for eligibility and benefit calculations will better reflect real-world economic conditions, helping more seniors retain or gain access to EPIC as living costs rise.
Implements changes on a predictable schedule. The required adjustments to eliminate the marriage penalty and update cost-of-living standards must happen every four years, providing clarity and predictability for seniors planning their health care expenses.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Fix Marriage Penalty for Seniors
Plain English, a few words. Used as the page title.
Sponsors
1 Multi-sponsor
History
- Referred to aging
- Referred to aging
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2065
2019-2020 Regular Sessions
IN ASSEMBLY
January 22, 2019
Introduced by M. of A. ENGLEBRIGHT -- Multi-Sponsored by -- M. of A. COLTON -- read once and referred to the Committee on Aging
AN ACT to amend the elder law, in relation to cost of living and marriage penalty adjustments to eligibility standards for the program for elderly pharmaceutical insurance coverage
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 254 of the elder law, as amended by section 19 of part T of chapter 56 of the laws of 2012, is amended to read as follows:
§ 254. Adjustments. 1. Cost of living adjustment. [1.] (a) Within amounts appropriated, the commissioner of health shall adjust the program eligibility standards set forth in subdivision two of section two hundred forty-two of this title to account for increases in the cost of living.
[2.] (b) The commissioner shall further adjust individual and joint income categories set forth in subdivisions two and four of section two hundred forty-eight of this title to conform to the adjustments made pursuant to this subdivision [one of this section].
2. Marriage penalty adjustment. The commissioner shall further adjust income, registration fees, deductibles, and other program components to eliminate the EPIC marriage penalty, as follows:
(a) For purposes of subdivisions two and four of sections two hundred forty-seven and two hundred forty-eight of this title, joint income shall be defined as income, as such term is defined in section two hundred forty-one of this title and as adjusted pursuant to subdivision one of this section, divided by two.
(b) The quarterly registration fee established pursuant to section two hundred forty-seven of this title, and the limits on point of sale co-payments established pursuant to subdivision four of such section, as such items may be or have been adjusted by the commissioner pursuant to subdivision one of this section and other sections of this chapter, for
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05074-01-9
A. 2065 2
each married individual program participant shall be set at a level that is not greater than the quarterly registration fee and the limit on point of sale co-payments for unmarried individual program participants whose income equals joint income as defined in paragraph (a) of this subdivision.
(c) The annual personal covered drug expenditures for each married individual eligible program participant established pursuant to section two hundred forty-eight of this title as adjusted by the commissioner pursuant to subdivision one of this section and other sections of this chapter, shall be set by the commissioner at a level which is no greater than the personal covered drug expenditures for unmarried individual eligible program participants whose income, as adjusted pursuant to subdivision one of this section, equals joint income as adjusted pursuant to paragraph (a) of this subdivision.
(d) The limits on point of sale co-payments established pursuant to subdivision four of sections two hundred forty-seven and two hundred forty-eight of this title, as adjusted by the commissioner pursuant to subdivision one of this section and other sections of this chapter, for each married individual program participant shall be set at a level that is no greater than the limit on point of sale co-payments for unmarried individual program participants whose income equals joint income as defined in paragraph (a) of this subdivision.
(e) The commissioner shall make the adjustments required by this subdivision on a four-year schedule which he or she shall adopt after consultation with the division of the budget beginning with the fiscal year next succeeding the date on which this subdivision shall have become effective.
§ 2. This act shall take effect on the first of April next succeeding the date on which it shall have become a law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.