HB122 SD1 SSCR1118

STAND. COM. REP. NO.1118

Honolulu, Hawaii

, 2003

RE: H.B. No. 122

S.D. 1

Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2003

State of Hawaii

Sir:

Your Committees on Human Services and Health, to which was referred H.B. No. 122 entitled:

"A BILL FOR AN ACT RELATING TO PRESUMPTIVE MEDICAID ELIGIBILITY FOR PREGNANT WOMEN,"

beg leave to report as follows:

The purpose of this measure is to ensure early and continuous prenatal care by requiring the Department of Human Services to grant presumptive eligibility to pregnant women who apply for Medicaid or QUEST coverage for prenatal care or other medical services related to the pregnancy.

Testimony in support of this measure was submitted by the Hawaii State Commission on the Status of Women; Hawaii Primary Care Association; Healthy Mother, Healthy Babies Coalition of Hawaii; HMSA; March of Dimes, Hawaii Chapter; Mothers Care for Tomorrow's Children; Big Island Malama A Hoopili Pono Perinatal Consortia; Kokua Council; and two concerned individuals. The Department of Human Services opposed this measure.

Your Committees find that early and continuous prenatal care for pregnant women is a nationally recognized and recommended standard of care to address both low birth-weight and poor birth outcomes in infants. The State Department of Health in January 2002 reported that key indicators for maternal and child health in Hawaii had worsened since 1995, after the MOMI program providing presumptive eligibility for Medicaid coverage for pregnant women was abolished. Significantly, the Department of Health documented increases in infant mortality and low birth-weight infants, and a decrease in the number of women seeking early prenatal care.

Your Committees further find that promoting early and continuous prenatal care is in the best interests of the child and the mother, as well as the State. Hawaii Medicaid now pays the costs of 25% of all births, 38% of all births with complications costing $50,000 or more, and 75% of all births costing $1 million or more. By contrast, prenatal care is relatively inexpensive, averaging $1,800 for the entire pregnancy, and provides medical supervision that is crucial if either mother or infant develop pregnancy-related complications.

Your Committees further find that the Department of Human Services has been working on a simplified application form and other changes to its existing rules and procedures to expedite the processing of applications for Medicaid or QUEST coverage from pregnant women. Despite over eight years of effort, this issue has yet to resolved satisfactorily. Accordingly, your Committees believe that the best way to ensure that pregnant women are able to access early prenatal care is by statutorily mandating the Department of Human Services to grant presumptive eligibility to pregnant applicants.

Your Committees have amended this measure by:

(1) Requiring pregnant women to submit proof of income and confirmation of pregnancy with the application, in order to be deemed presumptively eligible for Medicaid or QUEST coverage;

(2) Providing that infants of pregnant women granted presumptive eligibility shall also be deemed eligible for services and processed for coverage under the State Children's Health Insurance Program (SCHIP);

(3) Providing that if a pregnant woman is later determined to be ineligible for medical assistance, the plan shall be notified and reimbursed by the Department of Human Services for the months in which the pregnant woman was enrolled; and

(4) Providing that reimbursement payments to providers shall be calculated on the basis of reimbursement standards for prenatal care established by the Department of Human Services, based on the recommended guidelines of the American College of Obstetrics and Gynecology for prenatal and postnatal care.

As affirmed by the records of votes of the members of your Committees on Human Services and Health that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 122, as amended herein, and recommend that it pass Second Reading in the form attached hereto as H.B. No. 122, S.D. 1, and be referred to the Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committees on Human Services and Health,

____________________________ ROSALYN H. BAKER, Chair		____________________________ SUZANNE CHUN OAKLAND, Chair