Signed by Governor Phil Murphy

Vote Smart's Synopsis:

Vote to pass a bill that amends Medicaid coverage for family planning services to individuals with incomes up to 200 percent of the federal poverty level.

Highlights:

• Requires the following services be provided to eligible medically needy individuals, including but not limited to, the following (Sec. 2):

• Pregnant women, who will be provided prenatal care, delivery services, and postpartum care, including nursing facility services;

• Dependent children, who  will be provided with medical services; 

• Individuals who are 65 years of age or older, who will be provided with medical services, excluding prescribed drugs; 

• Individuals who are blind and disabled, who will be provided with medical services, excluding prescribed drugs; and 

• Inpatient hospital services, who will only be provided to eligible medically needy individuals, other than pregnant women, if the US Department of Health and Human Services (HHS) discontinues the state’s waiver to establish inpatient hospital reimbursement rates for the Medicare and Medicaid programs.

• Requires the following resource standard be used to determine medically needy eligibility (Sec. 1):

• For one-person households, the resource standard will be 200 percent of the resource standard for recipients of Supplemental Security Income;

• For two-person households, the resource standard will be 200 percent of the resource standard for recipients of Supplemental Security Income; and

• For households of 3 or more persons, the resource standard in the previous sub-highlight will be increased by $100 for each additional person.

• Specifies that the resource standards established in the above sub-highlights are subject to federal approval and the resource standard may be lower if required by HHS.

• Defines “qualified applicant” means a person who is a resident of the state, is either a US citizen or an eligible immigrant, and is determined to need medical care and services, with respect to who the period for which eligibility to be a recipient is determined to be the maximum period permitted under law and who is an individual that (Sec. 1):

• Has an income that does not exceed the highest income eligibility level for pregnant women established under Title XIX or Title XXI of the federal Social Security Act;

• Is not pregnant; and

• Is eligible to receive planning services under the Medicaid program.

• Defines “recipient” as any qualified applicant receiving benefits under this act (Sec. 1).

Full Bill Text