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 in section 25.5-1-104.
(4)Eligible person means:
(a)(I) A person who is less than nineteen years of age, who is a citizen or
meets the immigration status requirements set forth in section 25.5-8-109 (6) or
25.5-8-109 (7), whose family income does not exceed two hundred sixty percent of
the federal poverty line, adjusted for family size, and who is not eligible for med
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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 in section 25.5-1-104.
(4) Eligible person means:
(a) (I) A person who is less than nineteen years of age, who is a citizen or
meets the immigration status requirements set forth in section 25.5-8-109 (6) or
25.5-8-109 (7), whose family income does not exceed two hundred sixty percent of
the federal poverty line, adjusted for family size, and who is not eligible for medical
assistance pursuant to articles 4, 5, and 6 of this title 25.5.
(II) Notwithstanding the provisions of subsection (4)(a)(I) of this section, if the
money in the healthcare affordability and sustainability hospital provider 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 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 sixty percent, but the percentage shall not be reduced to below two
hundred thirteen percent.
(III) Repealed.
(b) (I) A pregnant person who is a citizen or meets the immigration status
requirements set forth in section 25.5-8-109 (6) or 25.5-8-109 (7), whose family
income does not exceed two hundred sixty percent of the federal poverty line,
adjusted for family size, and who is not eligible for medical assistance pursuant to
articles 4, 5, and 6 of this title 25.5.
(II) Notwithstanding the provisions of subsection (4)(b)(I) of this section, if
the money in the healthcare affordability and sustainability hospital provider 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 sixty percent, but
the percentage shall not be reduced to below two hundred thirteen percent.
(III) Repealed.
(5) Enrollee means any eligible person that has enrolled in the plan.
(6) Essential community provider means a health-care provider that:
(a) 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
(b) Waives charges or charges for services on a sliding scale based on
income and does not restrict access or services because of a member's financial
limitations.
(7) Health-care program means any health-care program in the state that
is supported with 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 25.5-1-301.
(10) Subsidized enrollee means an eligible person who receives a subsidy
from the department 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 in purchasing 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. L. 2022: (4)(a)(I), (4)(a)(II), (4)(b)(I), and (4)(b)(II) amended, (SB 22-052), ch. 43, p. 217, � 4, effective March 24; (4)(a)(I) and (4)(b)(I) amended, (HB 22-1289), ch. 399, p. 2844, � 20, effective June 7. L. 2024: (6)(b) amended, (SB 24-176),
ch. 152, p. 673, � 97, effective August 7. L. 2025: (4)(a)(II) and (4)(b)(II) amended,
(SB 25-270), ch. 151, p. 606, � 16, effective May 1.