Senate Bill 69 History
Senate Bill No. 69
(By Senator Hunter)
[Introduced February 9, 2005; referred to the Committee
on Banking and Insurance; and then to the Committee on Finance.]
A BILL to amend and reenact §5-16B-1 of the Code of West Virginia,
1931, as amended, relating to expansion of health coverage to
children; and providing exceptions to application and waiting
period if existing coverage is excessively expensive for
families with private health insurance.
Be it enacted by the Legislature of West Virginia:
That §5-16B-1 of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 16B. WEST VIRGINIA CHILDREN'S HEALTH PROGRAM.
§5-16B-1. Expansion of health care coverage to children; creation
of program; legislative directives.
(a) It is the intent of the Legislature to expand access to
health services for eligible children and to pay for this coverage
by using private, state and federal funds to purchase those
services or purchase insurance coverage for those services. To achieve this intention, the West Virginia children's health
insurance program is hereby created. The program shall be
administered by the children's health insurance agency within the
department of administration in accordance with the provisions of
this article and the applicable provisions of Title XXI of the
Social Security Act of 1997. Participation in the program may be
made available to families of eligible children, subject to
eligibility criteria and processes to be established, which
does not create an entitlement to coverage in any person:
Provided, That the criteria must include that if it is determined
that families with private health insurance cannot afford the cost
of full family health coverage and are income eligible under this
article, then they may make application for benefits under the West
Virginia children's health insurance program without any additional
waiting period. Nothing in this article may be construed to
require any appropriation of state general revenue funds for the
payment of any benefit provided for in this article. In the event
that If this article conflicts with the requirements of federal
law, federal law governs.
(b) In developing a children's health insurance program that
operates with the highest degree of simplicity and governmental
efficiency, the board shall avoid duplicating functions available
in existing agencies and may enter into interagency agreements for
the performance of specific tasks or duties at a specific or maximum contract price.
(c) In developing benefit plans, the board may consider any
cost savings, administrative efficiency or other benefit to be
gained by considering existing contracts for services with state
health plans and negotiating modifications of those contracts to
meet the needs of the program.
(d) Upon the transfer of the functions of the children's
health insurance program from the department of health and human
resources to the children's health insurance agency within the
department of administration, the secretary of the department of
health and human resources and the secretary of the department of
administration, acting jointly, are empowered to authorize and
shall authorize such transfers of program funds including, but not
limited to, the West Virginia children's health fund created in
section seven of this article and associated investment accounts;
and transfers of children's health insurance program personnel and
equipment, as are necessary, to facilitate an orderly transfer of
the functions of the children's health insurance program.
Authority to make transfers pursuant to this subsection expires on
the thirty-first day of December, two thousand.
(e) In order to enroll as many eligible children as possible
in the program created by this article and to expedite the
effective date of their health insurance coverage, the board shall
develop and implement a plan whereby applications for enrollment may be taken at any primary care center or other health care
provider, as determined by the director, and transmitted
electronically to the program's offices for eligibility screening
and other necessary processing. The board may use any funds
available to it in the development and implementation of the plan,
including grant funds or other private or public moneys.
NOTE: The purpose of this bill is to provide exceptions to
application and waiting period for the Children's Health Insurance
when existing family coverage is determined to be excessively
expensive for families with private health insurance.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would