Adopted and Filed

Medicaid for employed people with disabilities program—premium amounts, 75.1(39)“b”

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ARC 5174C

HUMAN SERVICES DEPARTMENT[441]

Adopted and Filed

Rule making related to MEPD program premium amounts

The Human Services Department hereby amends Chapter 75, "Conditions of Eligibility," Iowa Administrative Code.

Legal Authority for Rule Making

This rule making is adopted under the authority provided in Iowa Code section 249A.3.

State or Federal Law Implemented

This rule making implements, in whole or in part, Iowa Code section 249A.3.

Purpose and Summary

This amendment adjusts federal poverty level (FPL) increments used to assess premiums for applicants and recipients with income over 150 percent of the FPL under the Medicaid for Employed People with Disabilities (MEPD) program. Iowa Code section 249A.3(2)"a"(1)(b) requires that the maximum premium payable by an individual whose income exceeds 150 percent of the official poverty guidelines shall be commensurate with the cost of state employees' group health insurance in this state. The average cost to the state for state employees' health insurance for a single person is $829 effective January 1, 2020. Therefore, the maximum premium cannot be above that amount. The new premium scale updates the increase in the maximum premium allowed to reflect the increase in the cost of state employees' health insurance by adding an additional premium tier (1,550 percent of the FPL and above equals the $829 premium). All other amounts are increased a small amount.

Public Comment and Changes to Rule Making

Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on June 17, 2020, as ARC 5049C. No public comments were received. No changes from the Notice have been made.

Adoption of Rule Making

This rule making was adopted by the Council on Human Services on August 11, 2020.

Fiscal Impact

The impact to members from the increase in premiums is expected to be minimal, so the savings to the state from the premium increase also will be minimal. Based on current members, the average monthly premium increase is expected to be approximately $1.20. With approximately 4,200 members paying premiums each month, this equates to an annual revenue increase of approximately $61,000 (total), of which $23,000 is the state share.

Jobs Impact

After analysis and review of this rule making, no impact on jobs has been found.

Waivers

Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).

Review by Administrative Rules Review Committee

The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee's meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

Effective Date

This rule making will become effective on November 1, 2020.

The following rule-making action is adopted:

Amend subparagraph 75.1(39)"b"(3) as follows:

(3)Premiums shall be assessed as follows:

IF THE INCOME OF THE

APPLICANT IS ABOVE:

THE MONTHLY

PREMIUM IS:

150% of Federal Poverty Level

$34 $35

165% of Federal Poverty Level

$47 $48

180% of Federal Poverty Level

$56 $57

200% of Federal Poverty Level

$66 $67

225% of Federal Poverty Level

$77 $79

250% of Federal Poverty Level

$89 $92

300% of Federal Poverty Level

$112 $115

350% of Federal Poverty Level

$137 $140

400% of Federal Poverty Level

$161 $165

450% of Federal Poverty Level

$186 $190

550% of Federal Poverty Level

$232 $237

650% of Federal Poverty Level

$280 $286

750% of Federal Poverty Level

$329 $337

850% of Federal Poverty Level

$389 $398

1000% of Federal Poverty Level

$467 $477

1150% of Federal Poverty Level

$547 $559

1300% of Federal Poverty Level

$631 $644

1480% of Federal Poverty Level

$729 $744

1550% of Federal Poverty Level

$829

[Filed 8/18/20, effective 11/1/20]

[Published 9/9/20]

Editor's Note: For replacement pages for IAC, see IAC Supplement 9/9/20.

Human Services Department

Official Document

  • Medicaid for employed people with disabilities program—premium amounts, 75.1(39)“b”
  • Published on 9/9/2020
  • 97 Views
  • Adopted and Filed

The official published PDF of this document is available from the Iowa General Assembly’s Administrative Rules page.

View Official PDF

View the Iowa Administrative Bulletin for 9/9/2020.

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Related Notices

Administrative Rule References

The following administrative rule references were added to this document. You may click a reference to view related notices.

Rule 441-75.1(39)"b"
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