96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB2777


 
Introduced 2/24/2009, by Rep. Tom Cross
 
SYNOPSIS AS INTRODUCED:








  



305 ILCS 5/5-2
 from Ch. 23, par. 5-2








 Amends the Illinois Public Aid Code. Makes a technical change
in a Section concerning the classes of persons eligible for Medicaid.
















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A BILL FOR









 











HB2777

LRB096 09222 DRJ 19374 b






1
 AN ACT concerning public aid.


2
 Be it enacted by the People of the State of Illinois, 
3
represented in the General Assembly: 


4
 Section 5. The Illinois Public Aid Code is amended by 
5
changing Section 5-2 as follows:




6
 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)



7
 Sec. 5-2. Classes of Persons Eligible. Medical assistance 
8
under this
Article shall be available to any of the
the 
9
following classes of persons in
respect to whom a plan for 
10
coverage has been submitted to the Governor
by the Illinois 
11
Department and approved by him:
12
  1. Recipients of basic maintenance grants under 
13
 Articles III and IV.

14
  2. Persons otherwise eligible for basic maintenance 
15
 under Articles
III and IV but who fail to qualify 
16
 thereunder on the basis of need, and
who have insufficient 
17
 income and resources to meet the costs of
necessary medical 
18
 care, including but not limited to the following:


19
   (a) All persons otherwise eligible for basic 
20
 maintenance under Article
III but who fail to qualify 
21
 under that Article on the basis of need and who
meet 
22
 either of the following requirements:


23
    (i) their income, as determined by the 
 


 






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1
 Illinois Department in
accordance with any federal 
2
 requirements, is equal to or less than 70% in

3
 fiscal year 2001, equal to or less than 85% in 
4
 fiscal year 2002 and until
a date to be determined 
5
 by the Department by rule, and equal to or less

6
 than 100% beginning on the date determined by the 
7
 Department by rule, of the nonfarm income official 
8
 poverty
line, as defined by the federal Office of 
9
 Management and Budget and revised
annually in 
10
 accordance with Section 673(2) of the Omnibus 
11
 Budget Reconciliation
Act of 1981, applicable to 
12
 families of the same size; or


13
    (ii) their income, after the deduction of 
14
 costs incurred for medical
care and for other types 
15
 of remedial care, is equal to or less than 70% in

16
 fiscal year 2001, equal to or less than 85% in 
17
 fiscal year 2002 and until
a date to be determined 
18
 by the Department by rule, and equal to or less

19
 than 100% beginning on the date determined by the 
20
 Department by rule, of the nonfarm income official 
21
 poverty
line, as defined in item (i) of this 
22
 subparagraph (a).


23
   (b) All persons who would be determined eligible 
24
 for such basic
maintenance under Article IV by 
25
 disregarding the maximum earned income
permitted by 
26
 federal law.

 


 






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1
  3. Persons who would otherwise qualify for Aid to the 
2
 Medically
Indigent under Article VII.

3
  4. Persons not eligible under any of the preceding 
4
 paragraphs who fall
sick, are injured, or die, not having 
5
 sufficient money, property or other
resources to meet the 
6
 costs of necessary medical care or funeral and burial

7
 expenses.


8
  5.(a) Women during pregnancy, after the fact
of 
9
 pregnancy has been determined by medical diagnosis, and 
10
 during the
60-day period beginning on the last day of the 
11
 pregnancy, together with
their infants and children born 
12
 after September 30, 1983,
whose income and
resources are 
13
 insufficient to meet the costs of necessary medical care to

14
 the maximum extent possible under Title XIX of the
Federal 
15
 Social Security Act.


16
  (b) The Illinois Department and the Governor shall 
17
 provide a plan for
coverage of the persons eligible under 
18
 paragraph 5(a) by April 1, 1990. Such
plan shall provide 
19
 ambulatory prenatal care to pregnant women during a

20
 presumptive eligibility period and establish an income 
21
 eligibility standard
that is equal to 133%
of the nonfarm 
22
 income official poverty line, as defined by
the federal 
23
 Office of Management and Budget and revised annually in

24
 accordance with Section 673(2) of the Omnibus Budget 
25
 Reconciliation Act of
1981, applicable to families of the 
26
 same size, provided that costs incurred
for medical care 
 


 






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1
 are not taken into account in determining such income

2
 eligibility.


3
  (c) The Illinois Department may conduct a 
4
 demonstration in at least one
county that will provide 
5
 medical assistance to pregnant women, together
with their 
6
 infants and children up to one year of age,
where the 
7
 income
eligibility standard is set up to 185% of the 
8
 nonfarm income official
poverty line, as defined by the 
9
 federal Office of Management and Budget.
The Illinois 
10
 Department shall seek and obtain necessary authorization

11
 provided under federal law to implement such a 
12
 demonstration. Such
demonstration may establish resource 
13
 standards that are not more
restrictive than those 
14
 established under Article IV of this Code.

15
  6. Persons under the age of 18 who fail to qualify as 
16
 dependent under
Article IV and who have insufficient income 
17
 and resources to meet the costs
of necessary medical care 
18
 to the maximum extent permitted under Title XIX
of the 
19
 Federal Social Security Act.

20
  7. Persons who are under 21 years of age and would

21
 qualify as
disabled as defined under the Federal 
22
 Supplemental Security Income Program,
provided medical 
23
 service for such persons would be eligible for Federal

24
 Financial Participation, and provided the Illinois 
25
 Department determines that:


26
   (a) the person requires a level of care provided by 
 


 






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1
 a hospital, skilled
nursing facility, or intermediate 
2
 care facility, as determined by a physician
licensed to 
3
 practice medicine in all its branches;


4
   (b) it is appropriate to provide such care outside 
5
 of an institution, as
determined by a physician 
6
 licensed to practice medicine in all its branches;


7
   (c) the estimated amount which would be expended 
8
 for care outside the
institution is not greater than 
9
 the estimated amount which would be
expended in an 
10
 institution.

11
  8. Persons who become ineligible for basic maintenance 
12
 assistance
under Article IV of this Code in programs 
13
 administered by the Illinois
Department due to employment 
14
 earnings and persons in
assistance units comprised of 
15
 adults and children who become ineligible for
basic 
16
 maintenance assistance under Article VI of this Code due to

17
 employment earnings. The plan for coverage for this class 
18
 of persons shall:


19
   (a) extend the medical assistance coverage for up 
20
 to 12 months following
termination of basic 
21
 maintenance assistance; and


22
   (b) offer persons who have initially received 6 
23
 months of the
coverage provided in paragraph (a) above, 
24
 the option of receiving an
additional 6 months of 
25
 coverage, subject to the following:


26
    (i) such coverage shall be pursuant to 
 


 






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1
 provisions of the federal
Social Security Act;


2
    (ii) such coverage shall include all services 
3
 covered while the person
was eligible for basic 
4
 maintenance assistance;


5
    (iii) no premium shall be charged for such 
6
 coverage; and


7
    (iv) such coverage shall be suspended in the 
8
 event of a person's
failure without good cause to 
9
 file in a timely fashion reports required for
this 
10
 coverage under the Social Security Act and 
11
 coverage shall be reinstated
upon the filing of 
12
 such reports if the person remains otherwise 
13
 eligible.

14
  9. Persons with acquired immunodeficiency syndrome 
15
 (AIDS) or with
AIDS-related conditions with respect to whom 
16
 there has been a determination
that but for home or 
17
 community-based services such individuals would
require 
18
 the level of care provided in an inpatient hospital, 
19
 skilled
nursing facility or intermediate care facility the 
20
 cost of which is
reimbursed under this Article. Assistance 
21
 shall be provided to such
persons to the maximum extent 
22
 permitted under Title
XIX of the Federal Social Security 
23
 Act.

24
  10. Participants in the long-term care insurance 
25
 partnership program
established under the Illinois 
26
 Long-Term Care Partnership Program Act
Partnership for 
 


 






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1
 Long-Term Care Act who meet the
qualifications for 
2
 protection of resources described in Section 15
25 of that

3
 Act.

4
  11. Persons with disabilities who are employed and 
5
 eligible for Medicaid,
pursuant to Section 
6
 1902(a)(10)(A)(ii)(xv) of the Social Security Act, as

7
 provided by the Illinois Department by rule. In 
8
 establishing eligibility standards under this paragraph 
9
 11, the Department shall, subject to federal approval:
10
   (a) set the income eligibility standard at not 
11
 lower than 350% of the federal poverty level;
12
   (b) exempt retirement accounts that the person 
13
 cannot access without penalty before the age
of 59 1/2, 
14
 and medical savings accounts established pursuant to 
15
 26 U.S.C. 220;
16
   (c) allow non-exempt assets up to $25,000 as to 
17
 those assets accumulated during periods of eligibility 
18
 under this paragraph 11; and

19
   (d) continue to apply subparagraphs (b) and (c) in 
20
 determining the eligibility of the person under this 
21
 Article even if the person loses eligibility under this 
22
 paragraph 11.

23
  12. Subject to federal approval, persons who are 
24
 eligible for medical
assistance coverage under applicable 
25
 provisions of the federal Social Security
Act and the 
26
 federal Breast and Cervical Cancer Prevention and 
 


 






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1
 Treatment Act of
2000. Those eligible persons are defined 
2
 to include, but not be limited to,
the following persons:


3
   (1) persons who have been screened for breast or 
4
 cervical cancer under
the U.S. Centers for Disease 
5
 Control and Prevention Breast and Cervical Cancer

6
 Program established under Title XV of the federal 
7
 Public Health Services Act in
accordance with the 
8
 requirements of Section 1504 of that Act as 
9
 administered by
the Illinois Department of Public 
10
 Health; and


11
   (2) persons whose screenings under the above 
12
 program were funded in whole
or in part by funds 
13
 appropriated to the Illinois Department of Public 
14
 Health
for breast or cervical cancer screening.

15
  "Medical assistance" under this paragraph 12 shall be 
16
 identical to the benefits
provided under the State's 
17
 approved plan under Title XIX of the Social Security
Act. 
18
 The Department must request federal approval of the 
19
 coverage under this
paragraph 12 within 30 days after the 
20
 effective date of this amendatory Act of
the 92nd General 
21
 Assembly.

22
  13. Subject to appropriation and to federal approval, 
23
 persons living with HIV/AIDS who are not otherwise eligible 
24
 under this Article and who qualify for services covered 
25
 under Section 5-5.04 as provided by the Illinois Department 
26
 by rule.

 


 






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1
  14. Subject to the availability of funds for this 
2
 purpose, the Department may provide coverage under this 
3
 Article to persons who reside in Illinois who are not 
4
 eligible under any of the preceding paragraphs and who meet 
5
 the income guidelines of paragraph 2(a) of this Section and 
6
 (i) have an application for asylum pending before the 
7
 federal Department of Homeland Security or on appeal before 
8
 a court of competent jurisdiction and are represented 
9
 either by counsel or by an advocate accredited by the 
10
 federal Department of Homeland Security and employed by a 
11
 not-for-profit organization in regard to that application 
12
 or appeal, or (ii) are receiving services through a 
13
 federally funded torture treatment center. Medical 
14
 coverage under this paragraph 14 may be provided for up to 
15
 24 continuous months from the initial eligibility date so 
16
 long as an individual continues to satisfy the criteria of 
17
 this paragraph 14. If an individual has an appeal pending 
18
 regarding an application for asylum before the Department 
19
 of Homeland Security, eligibility under this paragraph 14 
20
 may be extended until a final decision is rendered on the 
21
 appeal. The Department may adopt rules governing the 
22
 implementation of this paragraph 14.

23
 The Illinois Department and the Governor shall provide a 
24
plan for
coverage of the persons eligible under paragraph 7 as 
25
soon as possible after
July 1, 1984.

26
 The eligibility of any such person for medical assistance 
 


 






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1
under this
Article is not affected by the payment of any grant 
2
under the Senior
Citizens and Disabled Persons Property Tax 
3
Relief and Pharmaceutical
Assistance Act or any distributions 
4
or items of income described under
subparagraph (X) of

5
paragraph (2) of subsection (a) of Section 203 of the Illinois 
6
Income Tax
Act. The Department shall by rule establish the 
7
amounts of
assets to be disregarded in determining eligibility 
8
for medical assistance,
which shall at a minimum equal the 
9
amounts to be disregarded under the
Federal Supplemental 
10
Security Income Program. The amount of assets of a
single 
11
person to be disregarded
shall not be less than $2,000, and the 
12
amount of assets of a married couple
to be disregarded shall 
13
not be less than $3,000.

14
 To the extent permitted under federal law, any person found 
15
guilty of a
second violation of Article VIIIA
shall be 
16
ineligible for medical assistance under this Article, as 
17
provided
in Section 8A-8.

18
 The eligibility of any person for medical assistance under 
19
this Article
shall not be affected by the receipt by the person 
20
of donations or benefits
from fundraisers held for the person 
21
in cases of serious illness,
as long as neither the person nor 
22
members of the person's family
have actual control over the 
23
donations or benefits or the disbursement
of the donations or 
24
benefits.

25
(Source: P.A. 94-629, eff. 1-1-06; 94-1043, eff. 7-24-06; 
26
95-546, eff. 8-29-07; revised 1-22-08.)