NY State Senate Bill 2019-S4578B

Senate Bill S4578B

2019-2020 Legislative Session

Authorizes individuals to participate in the NY State of health marketplace without providing information regarding citizenship or lawful residency or receiving or requesting a subsidy

download bill text pdf

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2020	referred to health
May 10, 2019	print number 4578b
May 10, 2019	amend (t) and recommit to health
Mar 18, 2019	print number 4578a
Mar 18, 2019	amend (t) and recommit to health
Mar 15, 2019	referred to health

Bill Amendments

Original

B (Active)

2019-S4578 - Details

See Assembly Version of this Bill:: A6791
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§268-a, 268-c, 268-g & 206, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S6820, A1968

2019-S4578 - Summary

Authorizes individuals to participate in the NY State of Health marketplace without providing information regarding citizenship or lawful residency or requesting or receiving a state or federal subsidy.

2019-S4578 - Sponsor Memo

                                
 
BILL NUMBER: S4578

SPONSOR: SALAZAR
 
TITLE OF BILL:  An act to amend the public health law, in relation to
authorizing individuals to participate in the state health benefit
exchange without providing information regarding citizenship or lawful
residency in the United States and regardless of eligibility for a
federal subsidy

 
PURPOSE OF THE BILL:

This bill will allow undocumented immigrants who can pay out-of-pocket
premiums and without any state and federal subsidy to participate in the
New. York State Health Benefit Exchange.

 
SUMMARY OF PROVISIONS:

Section 1: Section 206 of the public health law is amended by adding a
new subdivision 31. This section will require the commissioner of health
to establish, in consultation and collaboration with the superintendent
of financial services, eligibility requirements for health care coverage

through the State Health Benefit Exchange stablished pursuant to the
federal Patient Protection and Affordable Care Act. These requirements
shall not include requirements that individuals provide any information
regarding citizenship or lawful residency in the United States. Such
eligibility requirements shall also authorize individuals to participate
in the State Health Benefit Exchange regardless of an individual's
eligibility or need for a federal subsidy.

Section 2: This act shall take effect immediately.

 
JUSTIFICATION:

The federal Patient Protection and Affordable Care Act made it illegal
for an undocumented immigrant to participate in health benefit
exchanges, even if that individual could pay out of pocket and did not
need a federal subsidy to afford the health insurance coverage.  Federal
law went as far as making this action a felony.

New York is in the process of codifying the State health Benefit
Exchange and this development allows the state to allow undocumented
immigrants who can afford to pay the monthly premium out-of-pocket and
without any federal or state subsidy to do so.

Over one million residents of New York are undocumented immigrants.
Many are able to buy into the health benefit exchange without a federal
or state subsidy but are currently unable to do so.

Currently, the NYS Health Benefit Exchange offers a range of health
insurance policy options. The most inexpensive covers a family of three
costs as little as $110 per month for primary and preventive care cover-
age.  This is affordable buy-in coverage for the poorest of immigrants
and their families.

The power of the health benefit exchange is that it uses the power of
economies of scale tolsiakehealth insurance more affordable. By opening
up enrollment, without anMtiVsttdy to undocumented immigrants, we
increase the pool of participants in the exchange that maintain its
affordability for all other participants and future participants.
This simple change in how New York State will operate its health benefit
exchange is nothing short of a life-saver for the tens of thousands of
immigrants who do not have access to health care or preventive health
services. Being able to access preventive health services and wellness
visits will prevent the development of chronic illnesses, which force
many immigrants into emergency rooms for basic care at a huge expense to
New York.

Allowing undocumented immigrants to buy into the health benefit exchange
and without any subsidy is part of a set of solutions New York should
engage immediately as it strives to provide health care for all.

 
FISCAL IMPLICATIONS:

None to the State. In fact, by reducing the extremely expensive behavior
of using emergency rooms for primary care for our uninsured and indi-
gent, New York State would be able to save hundreds of millions of
dollars in the way it funds the indigent care.

 
LEGISLATIVE HISTORY:

New Bill.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2019-S4578 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4578
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              March 15, 2019
                                ___________
 
 Introduced  by  Sen. SALAZAR -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in relation to authorizing  indi-
   viduals  to  participate  in the state health benefit exchange without
   providing information regarding citizenship or lawful residency in the
   United States and regardless of eligibility for a federal subsidy
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 206 of the public health law is amended by adding a
 new subdivision 31 to read as follows:
   31.  THE  COMMISSIONER  SHALL REQUIRE, IN CONSULTATION AND COOPERATION
 WITH THE SUPERINTENDENT OF  FINANCIAL  SERVICES,  THAT  THE  ELIGIBILITY
 REQUIREMENTS  FOR  HEALTH CARE COVERAGE THROUGH THE STATE HEALTH BENEFIT
 EXCHANGE ESTABLISHED PURSUANT TO  THE  FEDERAL  PATIENT  PROTECTION  AND
 AFFORDABLE  CARE  ACT  (P.L.  111-148), AS AMENDED BY THE FEDERAL HEALTH
 CARE AND EDUCATION RECONCILIATION ACT OF 2010 (P.L. 111-152), SHALL  NOT
 INCLUDE  REQUIREMENTS THAT INDIVIDUALS PROVIDE ANY INFORMATION REGARDING
 CITIZENSHIP OR LAWFUL RESIDENCY IN THE UNITED STATES.  SUCH  ELIGIBILITY
 REQUIREMENTS  SHALL  ALSO  AUTHORIZE  INDIVIDUALS  TO PARTICIPATE IN THE
 STATE HEALTH BENEFIT EXCHANGE REGARDLESS OF AN INDIVIDUAL'S  ELIGIBILITY
 OR NEED FOR A FEDERAL SUBSIDY.
   § 2. This act shall take effect immediately.
 
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10805-01-9

2019-S4578A - Details

See Assembly Version of this Bill:: A6791
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§268-a, 268-c, 268-g & 206, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S6820, A1968

2019-S4578A - Summary

2019-S4578A - Sponsor Memo

                                
 
BILL NUMBER: S4578A

SPONSOR: SALAZAR
 
TITLE OF BILL:  An act to amend the public health law, in relation to
authorizing individuals to participate in the state health benefit
exchange without providing information regarding citizenship or lawful
residency in the United States or requesting or receiving a state or
federal subsidy

 
PURPOSE OF THE BILL:

This bill will allow undocumented immigrants who can pay out-of-pocket
premiums and without any state and federal subsidy to participate in the
New York State Health Benefit Exchange.

 
SUMMARY OF PROVISIONS:

Section 1: Section 206 of the public health law is amended by adding a
new subdivision 31. This section will require the commissioner of health
to establish, in consultation and collaboration with the superintendent
of financial services, eligibility requirements for health care coverage

through the State Health Benefit Exchange stablished pursuant to the
federal Patient Protection and Affordable Care Act. These requirements
shall not include requirements that individuals provide any information
regarding citizenship or lawful residency in the United States. Such
eligibility requirements shall also authorize any individual who pays
all associated costs, without requesting or receiving a state or federal
subsidy, to participate in the state health benefit exchange.

Section 2: This act shall take effect immediately.

 
JUSTIFICATION:

The federal Patient Protection and Affordable Care Act made it illegal
for an undocumented immigrant to participate in health benefit
exchanges, even if that individual could pay out of pocket and did not
need a federal subsidy to afford the health insurance coverage.  Federal
law went as far as making this action a felony.

New York is in the process of codifying the State health Benefit
Exchange and this development allows the state to allow undocumented
immigrants who can afford to pay the monthly premium out-of-pocket and
without any federal or state subsidy to do so.

Over one million residents of New York are undocumented immigrants.
Many are able to buy into the health benefit exchange without a federal
or state subsidy but are currently unable to do so.

Currently, the NYS Health Benefit Exchange offers a range of health
insurance policy options. The most inexpensive covers a family of three
costs as little as $110 per month for primary and preventive care cover-
age.This is affordable buy-in coverage for the poorest of immigrants and
their families.

The power of the health benefit exchange is that it uses the power of
economies of scale to make health insurance more affordable. By opening
up enrollment, without any subsidy to undocumented immigrants, we
increase the pool of participants in the exchange that maintain its
affordability for all other participants and future participants.
This simple change in how New York State will operate its health benefit
exchange is nothing short of a life-saver for the tens of thousands of
immigrants who do not have access to health care or preventive health
services. Being able to access preventive health services and wellness
visits will prevent the development of chronic illnesses, which force
many immigrants into emergency rooms for basic care at a huge expense to
New York.

Allowing undocumented immigrants to buy into the health benefit exchange
and without any subsidy is part of a set of solutions New York should
engage immediately as it strives to provide health care for all

 
FISCAL IMPLICATIONS:

None to the State. In fact, by reducing the extremely expensive behavior
of using emergency rooms for primary care for our uninsured and indi-
gent, New York State would be able to save hundreds of millions of
dollars in the way it funds the indigent care.

 
LEGISLATIVE HISTORY:

New Bill.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2019-S4578A - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4578--A
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              March 15, 2019
                                ___________
 
 Introduced  by  Sen. SALAZAR -- read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Health  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN  ACT to amend the public health law, in relation to authorizing indi-
   viduals to participate in the state health  benefit  exchange  without
   providing information regarding citizenship or lawful residency in the
   United States or requesting or receiving a state or federal subsidy
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 206 of the public health law is amended by adding a
 new subdivision 31 to read as follows:
   31. THE COMMISSIONER SHALL REQUIRE, IN  CONSULTATION  AND  COOPERATION
 WITH  THE  SUPERINTENDENT  OF  FINANCIAL  SERVICES, THAT THE ELIGIBILITY
 REQUIREMENTS FOR HEALTH CARE COVERAGE THROUGH THE STATE  HEALTH  BENEFIT
 EXCHANGE  ESTABLISHED  PURSUANT  TO  THE  FEDERAL PATIENT PROTECTION AND
 AFFORDABLE CARE ACT (P.L. 111-148), AS AMENDED  BY  THE  FEDERAL  HEALTH
 CARE  AND EDUCATION RECONCILIATION ACT OF 2010 (P.L. 111-152), SHALL NOT
 INCLUDE REQUIREMENTS THAT INDIVIDUALS PROVIDE ANY INFORMATION  REGARDING
 CITIZENSHIP  OR  LAWFUL RESIDENCY IN THE UNITED STATES. SUCH ELIGIBILITY
 REQUIREMENTS SHALL ALSO AUTHORIZE ANY INDIVIDUAL WHO PAYS ALL ASSOCIATED
 COSTS, WITHOUT REQUESTING OR RECEIVING A STATE OR  FEDERAL  SUBSIDY,  TO
 PARTICIPATE IN THE STATE HEALTH BENEFIT EXCHANGE.
   § 2. This act shall take effect immediately.
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10805-03-9

2019-S4578B (ACTIVE) - Details

See Assembly Version of this Bill:: A6791
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§268-a, 268-c, 268-g & 206, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S6820, A1968

2019-S4578B (ACTIVE) - Summary

2019-S4578B (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S4578B

SPONSOR: SALAZAR
 
TITLE OF BILL:  An act to amend the public health law, in relation to
authorizing individuals to participate in the NY State of Health, the
official health plan marketplace without providing information regarding
citizenship or lawful residency in the United States or requesting or
receiving a state or federal subsidy

 
PURPOSE OF THE BILL:

This bill will allow undocumented immigrants who can pay out-of-pocket
premiums and without any state and federal subsidy to participate in the
New York State Health Benefit Exchange and to protect the confidentiali-
ty of participants who do not provide a social security number or proof
of legal status in the United States.

 
SUMMARY OF PROVISIONS:

Section 1 amends Subdivision 10 of section 268-a of the public health
law, as added by section 2 of part T of chapter 57 of the laws of 2019,

defining "qualified individual" by deleting the requirement that a
person either be a citizen or national of the United States or an alien
lawfully present in the United States in order to be eligible to partic-
ipate in the NY State of health.

Section 2 amends paragraph (a) of subdivision 1 of section 268-c of the
public health law, as added by section 2 of part T of chapter 57 of the
laws of 2019, to provide that eligibility determinations shall allow any
qualified individual to participate in a qualified health plan who pays
all associated costs without requesting or receiving a state or federal
subsidy.

Section 3 amends section 268-g of the public health law by adding two
new subdivisions 4 and 5 as follows: (4) to authorize the commissioner
to seek a federal waiver allowing qualified individuals who pay all
associated costs to participate and (5) directing the commissioner
utilize a defined formula to avoid the use of any federal funds for such
qualified individuals.

Section 4 amends section 206 of the public health law by adding a new
subdivision 31 which provides that the commissioner shall promulgate
rules and regulations to protect and maintain the confidentiality of
participants in the NY State of health who do not provide a social secu-
rity number or proof of legal status in the United States.

Section 5: This act shall take effect immediately.

 
JUSTIFICATION:

The federal Patient Protection and Affordable Care Act made it illegal
for an undocumented immigrant to participate in health benefit
exchanges, even if that individual could pay out of pocket and did not
need a federal subsidy to afford the health insurance coverage.  Federal
law went as far as making this action a felony.

New York is in the process of codifying the State Health Benefit
Exchange and this development allows the state to allow undocumented

immigrants who can afford to pay the monthly premium out-of-pocket and
without any federal or state subsidy to do so.

Over one million residents of New York are undocumented immigrants.
Many are able to buy into the health benefit exchange without a federal
or state subsidy but are currently unable to do so due to the
restrictions in the federal law.

Currently, the NYS Health Benefit Exchange offers a range of health
insurance policy options. The most inexpensive covers a family of three
costs as little as $110 per month for primary and preventive care cover-
age. This is affordable buy-in coverage for the poorest of immigrants
and their families.

The power of the health benefit exchange is that it uses the power of
economies of scale to make health insurance more affordable. By opening
up enrollment, without any subsidy to undocumented immigrants, we
increase the pool of participants in the exchange that maintain its
affordability for all other participants and future participants. This
simple change in how New York State will operate its health benefit
exchange is nothing short of a life-saver for the tens of thousands of
immigrants who do not have access to health care or preventive health
services. Being able to access preventive health services and wellness
visits will prevent the development of chronic illnesses, which force
many immigrants into emergency rooms for basic care at a huge expense to
New York.

Allowing undocumented immigrants to buy into the health benefit exchange
and without any subsidy is part of a set of solutions New York should
engage in immediately as it strives to provide health care for all.

 
FISCAL IMPLICATIONS:

None to the State. In fact, by reducing the extremely expensive behavior
of using emergency rooms for primary care for our uninsured and indi-
gent, New York State would be able to save hundreds of millions of
dollars in the way it funds the indigent care.

 
LEGISLATIVE HISTORY:

New Bill.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2019-S4578B (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4578--B
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              March 15, 2019
                                ___________
 
 Introduced  by  Sen. SALAZAR -- read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Health  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to  said  committee  --  committee  discharged,  bill amended, ordered
   reprinted as amended and recommitted to said committee

 AN ACT to amend the public health law, in relation to authorizing  indi-
   viduals  to participate in the NY State of Health, the official health
   plan marketplace without providing information  regarding  citizenship
   or  lawful residency in the United States or requesting or receiving a
   state or federal subsidy
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subdivision 10 of section 268-a of the public health law,
 as added by section 2 of part T of chapter 57 of the laws  of  2019,  is
 amended to read as follows:
   10.  "Qualified  individual"  means,  with respect to qualified health
 plans, an individual, including a minor, who:
   (a) is eligible to enroll in a qualified health plan offered to  indi-
 viduals through the Marketplace;
   (b) resides in this state; AND
   (c)  at the time of enrollment, is not incarcerated, other than incar-
 ceration pending the disposition of charges[; and
   (d) is, and is reasonably expected to be, for the  entire  period  for
 which  enrollment  is sought, a citizen or national of the United States
 or an alien lawfully present in the United States].
   § 2. Paragraph (a) of subdivision 1 of section  268-c  of  the  public
 health law, as added by section 2 of part T of chapter 57 of the laws of
 2019, is amended to read as follows:
   (a) Perform eligibility determinations for federal and state insurance
 affordability  programs  including medical assistance in accordance with
 section three hundred sixty-six of the social services law, child health

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

                                                            LBD10805-06-9

 S. 4578--B                          2
 
 plus in accordance with section twenty-five hundred eleven of this chap-
 ter, the basic health program in accordance with section  three  hundred
 sixty-nine-gg  of the social services law, premium tax credits and cost-
 sharing  reductions and qualified health plans in accordance with appli-
 cable law and other health  insurance  programs  as  determined  by  the
 commissioner.  SUCH ELIGIBILITY DETERMINATIONS SHALL ALLOW ANY QUALIFIED
 INDIVIDUAL TO PARTICIPATE IN A QUALIFIED HEALTH PLAN WHO PAYS ALL  ASSO-
 CIATED COSTS WITHOUT REQUESTING OR RECEIVING A STATE OR FEDERAL SUBSIDY;
   §  3.  Section 268-g of the public health law is amended by adding two
 new subdivisions 4 and 5 to read as follows:
   4. THE COMMISSIONER IS AUTHORIZED AND DIRECTED TO SEEK A FEDERAL WAIV-
 ER ALLOWING QUALIFIED  INDIVIDUALS  WHO  PAY  ALL  ASSOCIATED  COSTS  OF
 PARTICIPATING  IN  A  QUALIFIED  HEALTH  PLAN WITHOUT A STATE OR FEDERAL
 SUBSIDY.
   5. (A) THE COMMISSIONER SHALL UTILIZE THE FOLLOWING FORMULA  TO  AVOID
 THE USE OF ANY FEDERAL FUNDS FOR QUALIFIED INDIVIDUALS WHO PAY ALL ASSO-
 CIATED COSTS OF PARTICIPATING IN A QUALIFIED HEALTH PLAN WITHOUT A STATE
 OR FEDERAL SUBSIDY:
   (I)  THE  AVERAGE TOTAL AMOUNT EXPENDED PER MEMBER SHALL BE DETERMINED
 BY DIVIDING THE FEDERAL ADMINISTRATIVE FUNDING AMOUNT  PROVIDED  TO  THE
 STATE  FOR  THE  MARKETPLACE  AS  A HEALTH BENEFIT EXCHANGE BY THE TOTAL
 NUMBER OF ENROLLEES IN THE MARKETPLACE;
   (II) THE AVERAGE TOTAL AMOUNT EXPENDED PER MEMBER DETERMINED  PURSUANT
 TO  SUBPARAGRAPH (I) OF THIS PARAGRAPH SHALL BE MULTIPLIED BY THE NUMBER
 OF QUALIFIED INDIVIDUALS WHO PAY ALL ASSOCIATED COSTS  OF  PARTICIPATING
 IN  A QUALIFIED HEALTH PLAN WITHOUT A STATE OR FEDERAL SUBSIDY TO DETER-
 MINE THE TOTAL REIMBURSEMENT AMOUNT;
   (III) THE STATE SHALL REIMBURSE THE FEDERAL GOVERNMENT ANNUALLY BY THE
 TOTAL REIMBURSEMENT AMOUNT DETERMINED PURSUANT TO SUBPARAGRAPH  (II)  OF
 THIS PARAGRAPH.
   (B) THE TOTAL REIMBURSEMENT AMOUNT DETERMINED PURSUANT TO SUBPARAGRAPH
 (II)  OF  PARAGRAPH  (A)  OF  THIS  SUBDIVISION SHALL BE PROVIDED TO THE
 MARKETPLACE BY AN ANNUAL ALLOCATION TO THE INDIGENT CARE  FUNDS  IN  THE
 ANNUAL STATE BUDGET.
   §  4.  Section 206 of the public health law is amended by adding a new
 subdivision 31 to read as follows:
   31. THE COMMISSIONER SHALL PROMULGATE RULES AND REGULATIONS TO PROTECT
 AND MAINTAIN THE CONFIDENTIALITY OF PARTICIPANTS  IN  THE  NY  STATE  OF
 HEALTH, THE OFFICIAL HEALTH PLAN MARKETPLACE WHO DO NOT PROVIDE A SOCIAL
 SECURITY NUMBER OR PROOF OF LEGAL STATUS IN THE UNITED STATES.
   § 5. This act shall take effect immediately.

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