Medicaid.Gov Posts State Profiles, Verification Plans and MAGI Eligibility Levels

Happy open enrollment day! If you are looking for detailed information on your state’s plans for implementing the new streamlined application and ACA eligibility requirements, check out this link, then click on your state. Although some of the information is in progress for some states, it’s great to have a wealth of information in one place. Thanks to the hardworking public servants at CMS for making it a priority to share this information. Here’s what you’ll find for each state:

  • Medicaid and CHIP Eligibility Levels – CMS has worked with states to “convert” their Medicaid and CHIP eligibility levels based on new modified adjusted gross income (MAGI) rules as required by the Affordable Care Act. To understand what this means for kids coverage, check out this blog.
  • Application and Enrollment in 2014 – The section provides links to the marketplace (either the federal or state-based marketplace), as well as the state’s Medicaid and CHIP applications.

  • Consumer Experience Profiles – This one pager describes the application process in each state, including what applications are available, the different ways people can apply (i.e. online, over the phone), how the online application will work and details on coordinating coverage between the marketplace and Medicaid/CHIP.

  • Medicaid/CHIP Eligibility Verification Plans – These plans describe how the state plans to verify eligibility electronically, including what data sources the state will use and how they will determine if information reported by the individual is reasonably compatible with data from electronic sources. For more information on the verification plans, check out this blog.

  • MAGI Conversion Plans – The two documents in the section respectively indicate whether the state is using the standardized conversion methodology calculated by HHS or the state’s own methodology (approved by HHS) and list the state’s converted levels. The new eligibility levels basically take into account income disregards and deductions that are in place today but are no longer allowed under the ACA. Keep in mind that the new MAGI levels are effective January 1, 2014, however, the new levels are effective today in 12 states that elected an early adoption of MAGI, including CO, DC, HI, IL, KS, LA, MO, NV, NJ, OK, OR and WA.

  • Medicaid/CHIP State Plan Amendments – States are expected to submit a number of state plan amendments (SPA) to be in compliance with new ACA requirements. You can find the SPA templates and instructions here. It doesn’t appear that many of the new SPAs have yet to be posted for the individual states but check back frequently to see if your state’s SPAs are posted.

In addition to the state specific information, you’ll find tables summarizing some of the data on a new “Medicaid Moving Forward 2014” landing page. If you need help deciphering any of the plans, please let us know and we’ll do our best to help you figure it out.

Tricia Brooks is a Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.