Eligibility & Enrollment
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Getting MAGI Right: Changes to Income Counting Rules in Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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How Do Updated 2015 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?
Over the weekend, Healthcare.gov uploaded the new 2015 federal poverty levels (FPL) to use in assessing eligibility for Medicaid and CHIP. What does this mean to consumers applying for coverage? Let’s start with eligibility for Marketplace subsidies. For 2015 calendar year coverage, regardless of when someone applies or enrolls, eligibility is based on the 2014…
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Getting MAGI Right: When Does Social Security Income Count?
UPDATED VERSION HERE Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate…
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Millions Gain Coverage Through Affordable Care Act – What’s Medicaid Got to Do With It?
Last week, the Centers for Medicare and Medicaid Services (CMS) released Medicaid enrollment data that sheds light into how many people have gained Medicaid coverage though the Affordable Care Act. According to CMS, more than 3.2 million Medicaid beneficiaries were able to sign up for Medicaid in 22 expansion states because they fell into the…
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Need Help Learning Eligibility Rules and Application Process for Families with Immigrants?
With less than two weeks left until the end of Open Enrollment two, assisters are racing to get everyone covered, including families with immigrants, often among the most difficult cases. I recently had a chance to help train more than 800 consumer assisters about how to overcome barriers to eligibility and enrollment for health coverage programs…
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Getting MAGI Right: An Assisters Worksheet for Determining Household Size in Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes, but to further complicate things, there are some differences that apply…
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Getting MAGI Right: Exceptions for Who Counts in the Household for Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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Getting MAGI Right: Differences in Medicaid and CHIP Add Complexity
Next to the fact that millions of people are gaining health insurance, one of my favorite aspects of the ACA is its transformation of Medicaid – moving Medicaid into a modern era by harnessing technology and tapping trusted sources of electronic data to determine eligibility in real time. Launching a new high-performing eligibility system is…
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Getting MAGI Right: A Primer on Differences that Apply to Medicaid and CHIP
Although Medicaid, CHIP, and tax subsidies in the marketplaces share a common method for determining eligibility – known as MAGI – there are several exceptions that apply only to specific circumstances in Medicaid and CHIP. These exceptions, along with significant changes in Medicaid/CHIP eligibility, pre- and post-ACA, add complexity to the implementation of MAGI, both…
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CMS Clarifies Health Coverage Options for Low-Income Pregnant Women
It’s critical that expectant mothers have access to comprehensive, affordable coverage and continuity of care during this critical time of life. The Affordable Care Act expanded coverage options for pregnant women but the intersection of these changes to the law with other state and federal policies is a bit confusing to untangle. Recent federal guidance…
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Modern Era Medicaid: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP as of January 2015
One year into implementation, the Affordable Care Act (ACA) has broadened Medicaid’s base of coverage for the low-income population and accelerated state efforts to move from outdated, paper-driven enrollment processes to a new modernized enrollment experience. Given the fast-paced policy environment leading up to when the ACA’s key coverage provisions went into effect on January 1, 2014, an abbreviated report based…
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Kaiser Family Foundation & CCF Release 50-State Survey on Medicaid and CHIP
It’s that time again – the release of the annual 50-state survey on Medicaid and CHIP eligibility, enrollment, renewal and cost-sharing policies conducted by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families. Today, my co-authors from Kaiser – Samantha Artiga, Jessica Stephens, and Alexandra…
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Two New Reports Focus on Arizona Children Who Lost CHIP Coverage and Lessons Learned for Future
Fourteen thousand children in Arizona lost their health insurance at the end of January 2014 when the state ended its KidsCare program for low-income children, becoming the only state in the country without an active Children’s Health Insurance Program (CHIP). Two new reports released by the Georgetown University Center for Children and Families today focus…
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Medicaid to 26: Reaching out to Former Foster Youth
By Kari Siddiqui, Schuyler Center for Analysis and Advocacy One of the most popular provisions of the Affordable Care Act (ACA) allowed young adults to stay on their parents’ health insurance until they turned 26. However, less talked about are the strides the ACA made for youth who were in foster care. Recognizing that young…
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Tennessee Proposal Highlights Importance of Medicaid Expansion for Residents and Providers
By Sean Miskell This week, Governor Haslam announced his plan to expand Medicaid via a two-year pilot program called Insure Tennessee. Like other formerly recalcitrant states that are now embracing expansion, Tennessee is pursuing a state-specific approach that differs from ‘traditional’ Medicaid expansion. One element of this plan – in which the Tennessee Hospital Association…
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A Step Forward For Lawfully Present Immigrants Living in Poverty
It’s no secret that during last year’s open enrollment many applicants for health coverage in immigrant families faced major barriers to enrolling in marketplace coverage. One big problem was that lawfully present immigrants with income under 100 percent FPL—who are ineligible for Medicaid based on their immigration status but are eligible for premium tax credits…
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Policy Brief: Resolving Enrollment Conflicts as States Expand Medicaid
I wrote about this issue a couple months ago here on the blog and there was enough interest we’ve turned that piece into a policy brief. Basically, states moving towards expanding Medicaid have to deal with the fact that significant numbers of people who will now be eligible for Medicaid are already enrolled in health plans…
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The President’s Immigration Announcement: What Do Health Policy Wonks Need to Know?
Last Thursday, President Obama announced immigration reforms that will provide up to five million people with relief from deportation and work authorization. While the reforms will do much to alleviate the constant fear of separation that many immigrant families face, most people included in the reforms will not be eligible for federal health coverage affordability…
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Consumers Should Resist the Urge to Do Nothing and Renew Coverage through the Federal Marketplace
When enrollment reopens in the health insurance marketplaces in just a few days, the 7-8 million current enrollees will have an opportunity to make sure they get the right amount of financial assistance and are enrolled in a plan that best fits their needs for 2015. This new brief outlines the process for consumers in…
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We Can Reach the Finish Line on Health Coverage for Hispanic Kids
Ensuring that every child in America has the protection of health care coverage is an attainable goal. Today, in partnership with National Council of La Raza, we released a 50-state analysis of health coverage for Hispanic children. Our analysis found that Washington, DC is just a step away from the finish line already with 99…