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HB 2375

Counties and county officers; Counties and County Officers Act of 2025; effective date.

2025 Regular Session Introduced by Kyle Hilbert

Expands Medicaid to nonpregnant adults under 65 with income ≤138% FPL, funded by a 90% FMAP, with implementation starting Jan 1, 2026 (CMS approval required).

Second Reading referred to Rules
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Bill Summary · HB 2375

Summary — HB 2375 (Healthcare Access for Working Kansans — “HAWK” Act)

Status: Introduced Feb 3, 2025. (Per docket: Withdrawn from House Committee on Health & Human Services and rereferred to Committee on Interstate Cooperation.)
Primary purpose: expand Medicaid eligibility for working-age adults in Kansas and establish implementation, administrative, reporting and fiscal guardrails for that expansion.

Main purpose

Authorize Medicaid (Kansas Program of Medical Assistance) eligibility for non‑pregnant adults under age 65 with modified adjusted gross income (MAGI) at or below 138% of the federal poverty level (including the 5% MAGI disregard) — subject to federal approval and a 90% enhanced federal medical assistance percentage (FMAP). The program is called the Healthcare Access for Working Kansans (HAWK) Act.

Key provisions

  • Eligibility: Coverage for adults <65 (non‑pregnant) with income ≤138% FPL, effective for eligibility determinations on/after Jan 1, 2026 (subject to CMS approval).
  • Enrollment condition: Applicants must provide employment verification at initial and renewal application, with enumerated exemptions (students, parents/guardians of dependents, those unfit for employment or with pending SSI/SSDI claims, certain veterans, foster youth up to age 22, homelessness, volunteer workers ≥20 hours/week, hardship determinations).
  • Managed care: KDHE to administer benefits through managed care organizations (MCOs), preferably those subject to the state “privilege fee” (KSA 40‑3213). Contracting rules include non‑discrimination on tax status, preference for entities on the state insurance exchange, and requirement for tiered benefit plans with incentives for healthy behaviors (full implementation by July 1, 2027).
  • Federal approvals: Secretary must submit necessary state plan amendments/waivers to CMS; submit such applications to the State Finance Council at least 10 calendar days before CMS submission.
  • FMAP trigger / nonseverability: If the FMAP for the expansion population falls below 90%, coverage must be terminated on a 12‑month phase‑out; that FMAP provision is declared nonseverable — failure of CMS to approve it voids the entire act.
  • Incarceration rules: Prohibits suspension of benefits for incarcerations under 30 days; allows suspension (not termination) for incarcerations over 30 days. Requires coordination between KDHE, Department of Corrections and county jails to facilitate coverage prior to release.
  • Reporting and oversight: Annual cost/revenue/savings reporting to the Legislature. Establishes a 15‑member Rural Health Advisory Committee. Adds extra meeting days for the Robert G. (Bob) Bethell Joint Committee to monitor implementation.
  • Coverage exclusions: No abortion coverage except where required by federal law.
  • Rulemaking: Secretary to adopt necessary rules; act effective upon publication in the Kansas Register.

Fiscal impact (KDHE fiscal note highlights)

  • Implementation prep (FY2025): $400,000 total ($200,000 State General Fund).
  • FY2026 (half‑year implementation assumed; 150,000 new enrollees assumed):
    • Total expenditures: ~$797.8 million (≈$757.8M direct assistance + $40.0M admin).
    • State share of capitation (after 90% FMAP): ~$75.8 million.
    • State administrative share: ~$16.4 million.
    • Offsets/revenues: ~$876.0 million total offsets (including ~$830.2M federal match, ~$43.7M additional privilege fee revenue, ~$2.2M additional drug rebate revenue).
    • Net State General Fund savings after offsets: estimated $78.3 million for FY2026.
  • FY2027 (full year):
    • Total expenditures: ~$1.7 billion (~$1.6B direct assistance + $82.4M admin).
    • State share of direct assistance: ~$157.7 million; state admin share: ~$34.1M.
    • Expected offsets/revenues: ~$1.8 billion (including ~$1.7B federal match, ~$91.0M privilege fee revenue).
    • Net State General Fund savings after offsets: estimated $152.9 million for FY2027.
  • Note: KDHE projects 2.5% annual member growth and anticipates some savings from moving existing Medicaid subpopulations (e.g., MediKan, certain incarcerated individuals) into the expansion group. Final cost allocations between KDHE and KDADS will be determined before implementation.

Who is affected

  • Primary beneficiaries: Low‑income working‑age adults in Kansas earning ≤138% FPL who meet program rules.
  • State: KDHE and KDADS will incur administrative and program costs/oversight responsibilities; potential net State General Fund savings per fiscal note assumptions due to federal match and privilege fee revenues.
  • Managed care organizations and providers: Contracting, capitation rate changes, privilege fee collection implications.
  • Counties/corrections: New coordination obligations for pre‑release enrollment.

Procedural/timeline notes

  • Effective date for eligibility determinations intended: Jan 1, 2026 (subject to CMS approvals).
  • Secretary must submit state plan amendments/waivers to CMS and notify State Finance Council 10 days prior.
  • The FMAP 90% requirement is treated as a condition precedent; if CMS will not approve it, the whole act may be nullified per nonseverability language.

If you want, I can produce a one‑page fact sheet or timeline for stakeholder briefings (implementation steps, CMS approvals, data systems changes, and likely legislative oversight milestones).

Compiled from official sources — confirm details with the bill’s official record.

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