The Senate Finance Committee approved an amendment that establishes a premium structure for Medicaid enrollees based on household size and added a requirement for semiannual reporting on implementation and collection outcomes.

The amendment sets premiums by household size (examples discussed in committee included $60 per month for a single-person household and $80 for a two-person household in one illustrative table), with separate parameters for CHIP at 255% of poverty. Committee members raised concerns that premiums based on household size, rather than on services actually used, could impose steep costs on some families and risk reduced access for people needing substance-use or mental-health treatment.

Senator Roosevelt noted that a single parent earning about $26,000 a year could face substantial premium costs and worried parents might drop employer coverage to preserve children’s coverage. A department representative said the intent is to apply for a waiver to implement premiums only and to avoid cost-sharing, because simultaneous premiums and cost-sharing would be administratively burdensome and increase uncompensated care. The department also said most enrollees receive services through managed-care organizations and estimated about 185,000 enrollees are in managed care, with fewer than 2,000 not enrolled in managed care.

Committee members added a friendly amendment requiring a report every six months on collections, enrollment impacts and related outcomes; the committee then voted and passed the item, recording a roll-call vote and the chair’s yes vote. The department and committee members agreed to continue technical work between meetings.