OH HB13

Director of Job and Family Services must submit a request to the U.S. Secretary of Health and Human Services for a Medicaid waiver to create a premium assistance component.

Assistance groups with countable income up to 300% of the federal poverty line may qualify if all members are enrolled in a health benefit plan and employers contribute at least 50% of premiums for employer-sponsored coverage.

Premium subsidy ranges from 20% to 80% of the premium using a sliding scale based on countable income and number of assistance group members, but does not cover deductibles, copayments, or other cost-sharing expenses.

Assistance groups cannot be denied eligibility based on their resources or lack of qualification for other Medicaid components.

Members participating in the premium assistance component cannot simultaneously participate in other Medicaid components and the program will not pay for medical assistance beyond the premium subsidy.