H.F. No. 815 Summary

• Establishes a Family Medical Account (FMA) program by January 1, 2022, administered by the Commissioner of Human Services, providing medical assistance benefits to eligible individuals through individual medical accounts funded by the state.

• Eligibility limited to persons with income at or below 138% of federal poverty level, excluding individuals with disabilities or age 65 and older; enrollment effective for 12-month periods with FMA funds vesting after one year.

• State contributes annual amounts to participant FMAs ($1,500 for children, $2,500 for adults with children, $4,000 for adults without children in first year), adjusted annually to meet 50% of CMS annual enrollee costs; funds remain available for medical expenses even after medical assistance eligibility ends.

• Participants receive coverage after meeting annual deductible equal to 100% of annualized contributions; preventive services, certain prescription drugs, lifesaving devices, and respiratory equipment exempt from deductible; outpatient services limited to $300 co-pay per occurrence.

• Requires electronic transactions, monthly participant reports, streamlined renewal processes, annual legislative progress reports beginning October 1, 2023, and federal approval for program implementation.