senate Bill S6734

2013-2014 Legislative Session

Increases income eligibility levels in the EPIC program

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Archive: Last Bill Status - In Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Senate Actions - UPPERCASE
Mar 04, 2014 referred to aging

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S6734 - Bill Details

Current Committee:
Senate Aging
Law Section:
Elder Law
Laws Affected:
Amd ยงยง241, 242 & 248, Eld L
Versions Introduced in Previous Legislative Sessions:
2011-2012: S984
2009-2010: S1839

S6734 - Bill Texts

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Increases income eligibility levels in the EPIC program from $35,000 to $75,000 for unmarried residents and from $50,000 to $100,000 for married residents.

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BILL NUMBER:S6734

TITLE OF BILL: An act to amend the elder law, in relation to
eligibility levels in the elderly pharmaceutical insurance coverage
program

PURPOSE OR GENERAL IDEA OF BILL:

Increases the income limits in the EPIC program to $75,000 for single
and $100,000 for married couples. Also, excludes social security
income from income threshold determinations.

SUMMARY OF SPECIFIC PROVISIONS:

Section 1: Subdivision 3 of section 241 of the elder law is amended to
exclude social security income from income threshold determinations
under the EPIC program.

Section 2: Subdivision 2 of section 242 of the elder law is amended to
allow for the increase in the limits of income for the elderly covered
under the EPIC program to $75,000 for individual enrollees and
$100,000 for married enrollees.

Section 3 and 4: Amends section 248 of the elder law to reflect the
increase in the limits of income for the elderly covered under the
EPIC program to $75,000 for individual enrollees and $100,000 for
married enrollees.

Section 5: Effective date.

JUSTIFICATION:

In 2012, prescription medication prices rose 3.6%, twice the 1.7%
inflation rate.* Such an increase is extremely problematic considering
the vast majority of seniors in New York are living on fixed incomes.
New York seniors deserve relief from these rising prescription
medication costs. The EPIC program can help combat these rising costs.
However, currently, the eligibility requirements for EPIC are capped
at $35,000 for an individual enrollee and $50,000 for married
enrollees. These eligibility requirements can easily be expanded to
assist even more New York seniors. This legislation will expand the
income threshold to $75,000 for an individual enrollee and $100,000
for married enrollees and exclude social security income from the
income calculations. This legislation is absolutely necessary to help
senior citizens in New York afford their prescription medication
during a time where prices are double the inflation rate.

PRIOR LEGISLATIVE HISTORY:

None

FISCAL IMPLICATIONS:

Based on a recent fiscal analysis prepared by the New York State
Department of Health for the Independent Democratic Conference, this
expansion will help cost $2.07 million in 2014-2015.


EFFECTIVE DATE:

Immediately.

* Dennis Cauchon, "Drug prices jump again while other health costs
decline: The upward trend in the price of prescription drugs is in
sharp contrast to other health costs," USA Today, February 2013,
available at http://www.usatoday.com/story/news/nation/2013/02/13/
price-of-a-prescription-rising-again/1918099/(citing the Bureau of
Economic Analysis).

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                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6734

                            I N  S E N A T E

                              March 4, 2014
                               ___________

Introduced  by  Sens.  VALESKY,  AVELLA, CARLUCCI, KLEIN, SAVINO -- read
  twice and ordered printed, and when printed to  be  committed  to  the
  Committee on Aging

AN  ACT to amend the elder law, in relation to eligibility levels in the
  elderly pharmaceutical insurance coverage program

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 3 of section 241 of the elder law is amended to
read as follows:
  3. "Income" shall mean "household gross income" as defined in the real
property  tax  circuit  breaker credit program, pursuant to subparagraph
(C) of paragraph one of subsection (e) of section six hundred six of the
tax law, [but] EXCLUDING ANY PAYMENTS RECEIVED UNDER THE FEDERAL  SOCIAL
SECURITY  ACT,  AND  only shall include the income of program applicants
and spouses and shall exclude the income of other members of the  house-
hold.
  S  2.  Subdivision  2  of  section  242  of the elder law, as added by
section 5 of part T of chapter 56 of the laws of  2012,  is  amended  to
read as follows:
  2.  Persons  eligible  for  catastrophic  coverage  under  section two
hundred forty-eight of this title shall include:
  (a) any unmarried resident who is at least sixty-five years of age and
whose income for the calendar year immediately preceding  the  effective
date  of the annual coverage period beginning on or after January first,
two thousand one, is more than twenty thousand and less than or equal to
[thirty-five] SEVENTY-FIVE thousand dollars.  After the initial determi-
nation of eligibility, each eligible  individual  must  be  redetermined
eligible at least every twenty-four months; and
  (b)  any  married resident who is at least sixty-five years of age and
whose income for the calendar year immediately preceding  the  effective
date  of the annual coverage period when combined with the income in the
same calendar year of such married person's spouse beginning on or after
January first, two  thousand  one,  is  more  than  twenty-six  thousand
dollars  and less than or equal to [fifty] ONE HUNDRED thousand dollars.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD13205-01-3

S. 6734                             2

After the initial determination of eligibility, each eligible individual
must be redetermined eligible at least every twenty-four months.
  S  3.  Paragraphs  (a)  and (b) of subdivision 2 of section 248 of the
elder law, as added by section 17 of part T of chapter 56 of the laws of
2012, are amended to read as follows:
  (a) Annual personal covered drug expenditures for unmarried individual
eligible program participants:
individual income of $20,001 to [$21,000] $42,000      $530
individual income of [$21,001] $42,001                 $550
to [$22,000] $44,000
individual income of [$22,001] $44,001                 $580
to [$23,000] $46,000
individual income of [$23,001] $46,001                 $720
to [$24,000] $48,000
individual income of [$24,001] $48,001                 $750
to [$25,000] $50,000
individual income of [$25,001] $50,001                 $780
to [$26,000] $52,000
individual income of [$26,001] $52,001                 $810
to [$27,000] $54,000
individual income of [$27,001] $54,001                 $840
to [$28,000] $56,000
individual income of [$28,001] $56,001                 $870
to [$29,000] $58,000
individual income of [$29,001] $58,001                 $900
to [$30,000] $60,000
individual income of [$30,001] $60,001                 $930
to [$31,000] $62,000
individual income of [$31,001] $62,001                 $960
to [$32,000] $64,000
individual income of [$32,001] $64,001                 $1,160
to [$33,000] $66,000
individual income of [$33,001] $66,001                 $1,190
to [$34,000] $68,000
individual income of [$34,001] $68,001                 $1,230
to [$35,000] $75,000
  (b) Annual personal covered drug expenditures for each married
individual eligible program participant:
joint income of $26,001 to [$27,000] $54,000           $650
joint income of [$27,001] $54,001                      $675
to [$28,000] $56,000
joint income of [$28,001] $56,001                      $700
to [$29,000] $58,000
joint income of [$29,001] $58,001                      $725
to [$30,000] $60,000
joint income of [$30,001] $60,001                      $900
to [$31,000] $62,000
joint income of [$31,001] $62,001                      $930
to [$32,000] $64,000
joint income of [$32,001] $64,001                      $960
to [$33,000] $66,000
joint income of [$33,001] $66,001                      $990
to [$34,000] $68,000
joint income of [$34,001] $68,001                      $1,020
to [$35,000] $70,000

S. 6734                             3

joint income of [$35,001] $70,001                      $1,050
to [$36,000] $72,000
joint income of [$36,001] $72,001                      $1,080
to [$37,000] $74,000
joint income of [$37,001] $74,001                      $1,110
to [$38,000] $76,000
joint income of [$38,001] $76,001                      $1,140
to [$39,000] $78,000
joint income of [$39,001] $78,001                      $1,170
to [$40,000] $80,000
joint income of [$40,001] $80,001                      $1,200
to [$41,000] $82,000
joint income of [$41,001] $82,001                      $1,230
to [$42,000] $84,000
joint income of [$42,001] $84,001                      $1,260
to [$43,000] $86,000
joint income of [$43,001] $86,001                      $1,290
to [$44,000] $88,000
joint income of [$44,001] $88,001                      $1,320
to [$45,000] $90,000
joint income of [$45,001] $90,001                      $1,575
to [$46,000] $92,000
joint income of [$46,001] $92,001                      $1,610
to [$47,000] $94,000
joint income of [$47,001] $94,001                      $1,645
to [$48,000] $96,000
joint income of [$48,001] $96,001                      $1,680
to [$49,000] $98,000
joint income of [$49,001] $98,001                      $1,715
to [$50,000] $100,000
  S  4.  Paragraphs  (a)  and (b) of subdivision 4 of section 248 of the
elder law, as added by section 17 of part T of chapter 56 of the laws of
2012, are amended to read as follows:
  (a) Limits on co-payments by  unmarried  individual  eligible  program
participants:
individual income of $20,001
to [$21,000] $42,000                              no more than $1,050
individual income of [$21,001] $42,001
to [$22,000] $44,000                              no more than $1,100
individual income of [$22,001] $44,001
to [$23,000] $46,000                              no more than $1,150
individual income of [$23,001] $46,001
to [$24,000] $48,000                              no more than $1,200
individual income of [$24,001] $48,001
to [$25,000] $50,000                              no more than $1,250
individual income of [$25,001] $50,001
to [$26,000] $52,000                              no more than $1,300
individual income of [$26,001] $52,001
to [$27,000] $54,000                              no more than $1,350
individual income of [$27,001] $54,001
to [$28,000] $56,000                              no more than $1,400
individual income of [$28,001] $56,001
to [$29,000] $58,000                              no more than $1,450
individual income of [$29,001] $58,001
to [$30,000] $60,000                              no more than $1,500
individual income of [$30,001] $60,001

S. 6734                             4

to [$31,000] $62,000                              no more than $1,550
individual income of [$31,001] $62,001
to [$32,000] $64,000                              no more than $1,600
individual income of [$32,001] $64,001
to [$33,000] $66,000                              no more than $1,650
individual income of [$33,001] $66,001
to [$34,000] $68,000                              no more than $1,700
individual income of [$34,001] $68,001
to [$35,000] $75,000                              no more than $1,750
  (b)  Limits on co-payments by each married individual eligible program
participant:
joint income of $26,001
to [$27,000] $54,000                              no more than $1,08
joint income of [$27,001] $54,001
to [$28,000] $56,000                              no more than $1,120
joint income of [$28,001] $56,001
to [$29,000] $58,000                              no more than $1,160
joint income of [$29,001] $58,001
to [$30,000] $60,000                              no more than $1,200
joint income of [$30,001] $60,001
to [$31,000] $62,000                              no more than $1,240
joint income of [$31,001] $62,001
to [$32,000] $64,000                              no more than $1,280
joint income of [$32,001] $64,001
to [$33,000] $66,000                              no more than $1,320
joint income of [$33,001] $66,001
to [$34,000] $68,000                              no more than $1,360
joint income of [$34,001] $68,001
to [$35,000] $70,000                              no more than $1,400
joint income of [$35,001] $70,001
to [$36,000] $72,000                              no more than $1,440
joint income of [$36,001] $72,001
to [$37,000] $74,000                              no more than $1,480
joint income of [$37,001] $74,001
to [$38,000] $76,000                              no more than $1,520
joint income of [$38,001] $76,001
to [$39,000] $78,000                              no more than $1,560
joint income of [$39,001] $78,001
to [$40,000] $80,000                              no more than $1,600
joint income of [$40,001] $80,001
to [$41,000] $82,000                              no more than $1,640
joint income of [$41,001] $82,001
to [$42,000] $84,000                              no more than $1,680
joint income of [$42,001] $84,001
to [$43,000] $86,000                              no more than $1,720
joint income of [$43,001] $86,001
to [$44,000] $88,000                              no more than $1,760
joint income of [$44,001] $88,001
to [$45,000] $90,000                              no more than $1,800
joint income of [$45,001] $90,001
to [$46,000] $92,000                              no more than $1,840
joint income of [$46,001] $92,001
to [$47,000] $94,000                              no more than $1,880
joint income of [$47,001] $94,001
to [$48,000] $96,000                              no more than $1,920
joint income of [$48,001] $96,001

S. 6734                             5

to [$49,000] $98,000                              no more than $1,960
joint income of [$49,001] $98,001
to [$50,000] $100,000                             no more than $2,000
  S 5. This act shall take effect immediately.

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