To enact section 5111.862 of the Revised Code to require the Director of Job and Family Services to seek federal approval to create a premium assistance component of the Medicaid program.

Section 1. That section 5111.862 of the Revised Code be enacted to read as follows:

Sec. 5111.862.  (A) As used in this section:

"Assistance group" means a group of individuals treated as a unit for purposes of determining eligibility for, and participation in, the premium assistance component of the medicaid program.

"Health benefit plan" has the same meaning as in section 3924.01 of the Revised Code.

"Plan of health coverage" has the same meaning as in section 3923.282 of the Revised Code.

"Federal poverty line" means the official poverty line as established at least annually by the United States office of management and budget pursuant to section 673(2) of the "Community Services Block Grant Act," 95 Stat. 511 (1981), 42 U.S.C. 9902(2), as amended.

(B) The director of job and family services shall submit to the United States secretary of health and human services a request for a medicaid waiver to create a premium assistance component of the medicaid program. If the United States secretary grants the waiver, the director shall establish the premium assistance component in accordance with this section and the terms of the waiver.

(C)(1) For an assistance group to qualify for the premium assistance component, all of the following must apply:

(a) The assistance group must have countable income not exceeding three hundred per cent of the federal poverty line.

(b) Each member of the assistance group, while participating in the premium assistance component, must be enrolled in a health benefit plan or plan of health coverage.

(c) If the health benefit plan or plan of health coverage in which the assistance group is enrolled is sponsored by an employer of a member of the assistance group, the employer must contribute not less than fifty per cent of any premium charged for the assistance group's enrollment.

(d) The assistance group must meet all other eligibility requirements for the premium assistance component established in rules adopted under section 5111.85 of the Revised Code.

(2) No assistance group shall be denied eligibility for the premium assistance component due to either of the following:

(a) The amount of the assistance group's resources;

(b) That no member of the assistance group qualifies for any other component of the medicaid program.

(D) The premium assistance component shall subsidize the premium for enrollment in a health benefit plan or plan of health coverage charged an assistance group participating in the component. The subsidy shall range from twenty to eighty per cent of the premium as determined using a sliding scale established in rules adopted under section 5111.85 of the Revised Code. The sliding scale shall be based on an assistance group's countable income and the number of members of the assistance group. The subsidy shall not cover any portion of the premium for which an employer of a member of the assistance group is responsible. The premium assistance component shall not pay the costs of any deductibles, copayments, or other cost-sharing expenses, other than the premium, for which the assistance group is responsible under the health benefit plan or plan of health coverage.

(E) No member of an assistance group may participate in the premium assistance component and another component of the medicaid program contemporaneously. A member of an assistance group who meets the eligibility requirements for the premium assistance component and one or more other components of the medicaid program shall choose whether to participate in the premium assistance component or the other component or components for which the member is eligible. The medicaid program shall not pay for the costs of any medical assistance, other than the premium subsidy, provided to a member of an assistance group participating in the premium assistance component, including medical assistance that is not covered by the health benefit plan or plan of coverage in which the member is enrolled but is covered by another component of the medicaid program in which the member could participate if not for the member's participation in the premium assistance component.