Medicaid
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“Stairstep” Children Moved from CHIP to Medicaid Receive Better, More Affordable Coverage
The Affordable Care Act (ACA) aligned coverage for more than half a million low-income, school-aged children in 22 states that were previously covered under different programs. Prior to 2014, state Medicaid programs were required to cover children of different age groups at different minimum income eligibility thresholds. Young children under age six with family incomes up…
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Employed and Uninsured: Many Uninsured Working Adults Would Benefit from Medicaid Expansion
As states considering Medicaid expansion explore their options in program design, work requirements have surfaced as part of the debate. While work requirements perhaps serve as a strong talking point in reluctant states, a recent report from the Kaiser Commission on Medicaid and the Uninsured finds that the majority of those who stand to benefit…
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Early Returns From Iowa’s Health and Wellness Plan: Are Healthy Behavior Programs Working?
Being healthier is a good thing, so it’s appealing for policymakers to insert the issue into their Medicaid expansion debates but so far healthy behavior programs set up by states for their Medicaid beneficiaries are producing more talking points and red-tape than results. It’s still early though, so we will keep watching, but count me…
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Medicaid Expansion in Utah: Good for Working Parents & Kids
In Utah, where one in ten children lack health insurance coverage, extending Medicaid coverage for parents is an effective strategy to boost children’s enrollment rates. Governor Gary Herbert’s proposed Healthy Utah Plan would expand Medicaid eligibility and insure tens of thousands of low-income adults. Uninsured parents account for over one-third of the population potentially eligible…
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Utah Parents and Families Would Benefit from Medicaid Expansion
Working parents would receive significant help with health insurance costs if Utah moves forward with Governor Gary Herbert’s Healthy Utah plan, according to new research by Utah Voices for Children and Georgetown University’s Center for Children and Families. More than two-thirds (68%) of the low-income uninsured parents that could benefit from the Healthy Utah plan…
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Cuts to Medicaid Pregnancy Coverage: Penny Wise and Pound Foolish
By Tricia Brooks and Sophia Duong, Maryland and Ohio are considering rolling back Medicaid coverage for pregnant women. Currently, Maryland’s eligibility level is at 259% FPL, and Ohio’s eligibility threshold rests at 200% FPL (not including the standard 5 percentage point disregard). Governors Hogan and Kasich’s proposed budgets cut these eligible income levels, but how…
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Arkansas Approves Private Option Improving Security for Families, Hospitals & State Budget
By Marquita Little, Arkansas Advocates for Children and Families Arkansas’s unique approach to Medicaid expansion, known as the Private Option, has been a success during its short lifespan. However, some state policy makers want to see the program end. Within just a couple weeks of being sworn in as the new Governor, Asa Hutchinson spoke…
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Getting MAGI Right: Current Monthly Income vs. Projected Annual Income
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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Lessons in the Defeat of Tennessee Governor Haslam’s Medicaid Expansion Plan
In a disappointing committee vote yesterday Tennessee Governor Bill Haslam’s carefully crafted state-specific plan for using federal Medicaid expansion dollars was rejected. A state budget cost-neutral financing mechanism through hospital fees and multiple other provisions that would have made the plan a significant showcase of conservative health policy ideas were not enough to obtain legislative…
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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?
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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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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Anticipated Cuts to Uncompensated Care Funds Increase Pressure on Florida to Expand Medicaid
Today I had the pleasure of joining the League of Women Voters of Florida and Florida Legal Services on a conference call to discuss a topic of utmost importance – the decision facing Florida’s policy makers as to whether or not to expand Medicaid – especially in light of the scheduled expiration of Florida’s Low…
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Indiana Becomes the 29th State (Including DC) to Expand Medicaid
[Editor’s Note: The terms and conditions and letter issued by federal CMS are available through these links: agreement, special terms and conditions and letter.] Today Governor Mike Pence received approval from federal CMS for a Section 1115 waiver to implement his Healthy Indiana Plan (HIP2.0) and extend coverage to as many as 350,000 Hoosiers –…
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Indiana Agreement Wins the Award for Bureaucratic Complexity and Red Tape
I am still waiting for paper but here is what I know about Indiana so far. The good news is that Indiana becomes the 29th state (including D.C.) to extend Medicaid coverage. The less than good news is that this is an enormously complicated program which will likely prevent some low-income adults from getting the…
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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…