2020 Colorado Revised Statutes
Title 25.5 - Health Care Policy And Financing
Article 8. Children's Basic Health Plan
Section 25.5-8-103. Definitions.

As used in this article 8, unless the context otherwise requires:

1. "Child" means a person who is less than nineteen years of age.

2. "Children's basic health plan" or "plan" means the subsidized health insurance product designed by the department of health care policy and financing and provided to enrollees, as defined in this section.

3. "Department" means the department of health care policy and financing created insection 25.5-1-104.

4. "Eligible person" means:

(a) (I) A person who is less than nineteen years of age, whose family income does not exceed two hundred fifty percent of the federal poverty line, adjusted for family size.

2. Notwithstanding the provisions of subsection (4)(a)(I) of this section, if the money inthe healthcare affordability and sustainability fee cash fund established pursuant to section 25.54-402.4 (5), together with the corresponding federal matching funds, is insufficient to fully fund all of the purposes described in section 25.5-4-402.4 (5)(b), after receiving recommendations from the Colorado healthcare affordability and sustainability enterprise established pursuant to section 25.5-4-402.4 (3), for persons less than nineteen years of age, the state board may by rule adopted pursuant to the provisions of section 25.5-4-402.4 (6)(b)(III) reduce the percentage of the federal poverty line to below two hundred fifty percent, but the percentage shall not be reduced to below two hundred five percent.

3. Repealed.

(b) (I) A pregnant woman whose family income does not exceed two hundred fifty percent of the federal poverty line, adjusted for family size, and who is not eligible for medicaid.

2. Notwithstanding the provisions of subsection (4)(b)(I) of this section, if the moneyin the healthcare affordability and sustainability fee cash fund established pursuant to section 25.5-4-402.4 (5), together with the corresponding federal matching funds, is insufficient to fully fund all of the purposes described in section 25.5-4-402.4 (5)(b), after receiving recommendations from the Colorado healthcare affordability and sustainability enterprise established pursuant to section 25.5-4-402.4 (3), for pregnant women, the state board by rule adopted pursuant to the provisions of section 25.5-4-402.4 (6)(b)(III) may reduce the percentage of the federal poverty line to below two hundred fifty percent, but the percentage shall not be reduced to below two hundred five percent.

3. Repealed.

5. "Enrollee" means any eligible person that has enrolled in the plan.

6. "Essential community provider" means a health care provider that:

1. Has historically served medically needy or medically indigent patients and demonstrates a commitment to serve low-income and medically indigent populations who make up a significant portion of its patient population, or in the case of a sole community provider, serves the medically indigent patients within its medical capability; and

2. Waives charges or charges for services on a sliding scale based on income and doesnot restrict access or services because of a client's financial limitations.

7. "Health care program" means any health care program in the state that is supportedwith state general fund or federal dollars.

8. "Master settlement agreement" means the master settlement agreement, the smokeless tobacco master settlement agreement, and the consent decree approved and entered by the court in the case denominated State of Colorado, ex rel. Gale A. Norton, Attorney General v. R.J. Reynolds Tobacco Co.; American Tobacco Co., Inc.; Brown & Williamson Tobacco Corp.; Liggett & Myers, Inc.; Lorillard Tobacco Co., Inc.; Philip Morris, Inc.; United States Tobacco Co.; B.A.T. Industries, P.L.C.; The Council For Tobacco Research--U.S.A., Inc.; and Tobacco Institute, Inc., Case No. 97 CV 3432, in the district court for the city and county of Denver.

9. "Medical services board" means the medical services board created in section 25.5-1301.

10. "Subsidized enrollee" means an eligible person who receives a subsidy from thedepartment to purchase coverage under the plan or a comparable health insurance.

11. "Subsidy" means the amount paid by the department to assist an eligible person inpurchasing coverage under the plan or a comparable health insurance product available to the eligible person through another coverage entity.

12. "Trust" means the children's basic health plan trust created in section 25.5-8-105.

Source: L. 2006: Entire article added with relocations, p. 1975, § 7, effective July 1. L. 2007: (4) amended, p. 149, § 10, effective March 22. L. 2008: (4)(a) amended, p. 2019, § 1, effective March 1, 2009; (4)(b) amended, p. 2019, § 2, effective October 1, 2009. L. 2009: (4)(a) and (4)(b) amended, (SB 09-211), ch. 2, pp. 3, 4, § § 1, 2, 3, effective February 26; (4) amended, (HB 09-1293), ch. 152, p. 650, § 8, effective July 1; (4)(b) amended, (SB 09-292), ch. 369, p. 1985, § 130, effective August 5. L. 2010: (4)(a)(I), (4)(a)(II), (4)(a)(III)(A), (4)(a)(III)(B), (4)(b)(I), (4)(b)(II), (4)(b)(III)(A), and (4)(b)(III)(B) amended, (HB 10-1422), ch. 419, p. 2114, § 150, effective August 11. L. 2017: IP, (4)(a)(II), and (4)(b)(II) amended, (SB 17-267), ch. 267, p. 1466, § 22, effective July 1.

Editor's note: (1) This section is similar to former § 26-19-103 as it existed prior to 2006.

2. Subsection (4)(a)(III)(C) and (4)(b)(III)(C) provided for the repeal of subsection (4)(a)(III) and (4)(b)(III), respectively, effective the July 1 following the revisor of statutes' receipt of the notice required pursuant to subsection (4)(a)(III)(B) and (4)(b)(III)(B). (See L. 2010, p. 2114.) The revisor of statutes received said notice dated February 17, 2017.

3. Section 34 of chapter 267 (SB 17-267), Session Laws of Colorado 2017, providesthat the section of the act changing this section does not take effect if the centers for medicare and medicaid services determine that the amendments do not comply with federal law. For more information, see SB 17-267. (L. 2017, p. 1478.) The executive director of the department of health care policy and financing did not notify the revisor of statutes by June 1, 2017, of such determination; therefore, the amendments to this section took effect July 1, 2017.

Cross references: For the legislative declaration in SB 17-267, see section 1 of chapter 267, Session Laws of Colorado 2017.