What's happening
This bill limits Medicaid optional services for adults to the minimum benefits required for private health plans, excluding long-term care.
Why it matters
Aligns Medicaid optional benefits for adults with the minimum coverage required by private health plans, which could lead to the elimination or reduction of certain services currently available to Medicaid recipients but not typically covered by basic private insurance.
Intends to create cost savings for the state by reducing Medicaid spending, potentially lowering the state’s overall Medicaid budget and, by extension, addressing concerns about high state taxes that fund these programs.
May impact the incentive structure for low-income adults to transition from public assistance to private employment, as Medicaid would no longer offer more generous coverage than entry-level private plans (excluding long-term care).
Requires the state to seek federal approval for these changes and grants broad authority to state health officials to update regulations, meaning implementation details and exact service reductions may be shaped by future administrative decisions.
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Who cares
Headline styles
Match Medicaid to Private Insurance
Plain English, a few words. Used as the page title.
Sponsors
2 Multi-sponsors
History
- Held for consideration in health
- Referred to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Limit Medicaid Optional Benefits
In Senate Committee · Health · Sponsor Pamela Helming
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
5545
2019-2020 Regular Sessions
IN ASSEMBLY
February 13, 2019
Introduced by M. of A. GOODELL, GIGLIO, HAWLEY, MORINELLO, FRIEND -- Multi-Sponsored by -- M. of A. CROUCH, DiPIETRO -- read once and referred to the Committee on Health
AN ACT to amend the social services law, in relation to aligning Medicaid optional services with private sector health benefits
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. This act shall be known and may be cited as the "Medicaid taxpayer equity act".
§ 2. The legislature hereby finds that it is fundamentally unfair to the taxpayers of the state for Medicaid optional services to exceed the minimum health insurance benefits levels that are required for private sector health insurance plans. Higher benefit levels for Medicaid compared to private insurance create a disincentive for people to leave public assistance and accept private employment and private health coverage. Higher Medicaid benefit levels are also a contributing factor causing the state to have the highest Medicaid costs in the nation and some of the highest property taxes in the nation. The purpose of this act is to ensure that Medicaid optional services for adults do not exceed the minimum health insurance benefit levels that apply to private insurance plans, other than long-term care services.
§ 3. Title 11 of article 5 of the social services law is amended by adding a new section 362 to read as follows:
§ 362. Benefits provided under this title for Medicaid optional services. The state shall not offer to individuals over the age of twenty-one years Medicaid optional services that exceed the minimum benefits required for health care plans under article forty-three of the insurance law. This section shall not apply to Medicaid long-term care services.
§ 4. The commissioner of the department of health shall submit to the federal department of health and human services for approval any amend-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04942-01-9
A. 5545 2
ments to the state plan required by this act. Furthermore, the commissioner of the department of health shall have the authority to promulgate or amend any regulations necessary for the implementation of this act.
§ 5. This act shall take effect on the one hundred twentieth day after 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.