A BILL TO BE ENTITLED
AN ACT to provide Health insurance premium assistance for lower‑income, uninsured pregnant women.
The General Assembly of North Carolina enacts:
SECTION 1.  Article 2 of Chapter 108A is amended by adding a new Part to read as follows:
"Part 10. Insurance Premium Assistance for Pregnancy.
"§ 108A‑70.35.  Definitions.
In this Part, the following definitions apply:
(1)	Federal poverty level. – The federal poverty guidelines established by the United States Department of Health and Human Services, as periodically revised.
(2)	Household income. – As defined under 26 U.S.C. § 5000A(c)(4)(B).
(3)	Medicaid. – The State Medical Assistance Program established under Part 6 of this Article.
(4)	Minimum essential coverage. – As defined under 26 U.S.C. § 5000A(f)(1).
(5)	Program. – The Insurance Premium Assistance for Pregnancy program established in this Part.
(6)	Uninsured. – Without minimum essential coverage.
"§ 108A‑70.36.  Purpose; no entitlement.
The purpose of this Part is to help uninsured lower‑income pregnant women who are residents of this State acquire health insurance through premium assistance. Premium assistance shall be paid from State funds appropriated. Nothing in this Part shall be construed as obligating the General Assembly to appropriate funds for this purpose or as entitling any person to receive premium assistance under this Part.
"§ 108A‑70.37.  Program established.
The Insurance Premium Assistance for Pregnancy program is established. The program shall be administered by the Department of Health and Human Services in accordance with this Part.
"§ 108A‑70.38.  Program eligibility.
In order to participate in the program, an individual must meet all of the following requirements:
(1)	Be a resident of the State.
(2)	Be lawfully present in the United States.
(3)	Not be on active punishment, as that term is defined under G.S. 15A‑1340.11.
(4)	Have a medically verified pregnancy.
(5)	Not have minimum essential coverage.
(6)	Have household income of no more than one hundred eighty-five percent (185%) of the federal poverty level.
"§ 108A‑70.39. Program benefits.
(a)	An individual who qualifies under G.S. 108A‑70.38 shall be eligible for premium assistance from the State to help the individual purchase coverage under a health benefit plan during the period of the pregnancy through the end of the second calendar month following the pregnancy.
(b)	The amount of the premium assistance shall be the amount necessary to purchase insurance coverage up to the amount provided in 26 U.S.C. § 36B(b)(2)(B)(ii).
(c)	The Department of Health and Human Services shall remit the amount of the premium assistance to a qualified individual's insurer on behalf of the qualified individual.
(d)	A qualified individual who participates in the program shall remain responsible for the other costs of the health benefit plan in which they are enrolled, including any cost sharing."
SECTION 2.  Without regard to resources, pregnant women with household income, as that term is used in 26 U.S.C. § 5000A(c)(4)(B), that is equal to or less than one hundred thirty‑three percent (133%) of the federal poverty level are eligible for services related only to pregnancy and those other conditions determined by the Department of Health and Human Services as conditions that may complicate pregnancy.
SECTION 3.  The Department of Health and Human Services shall timely submit any State plan amendments necessary or take other appropriate actions so that the programmatic changes provided in Sections 1 and 2 of this act may take effect on January 1, 2014.
SECTION 4.  Sections 1 and 2 of this act become effective January 1, 2014, and apply to pregnancies medically verified on or after that date. The remainder of this act is effective when it becomes law.