Re­form’s regs to call for Med­i­caid in­come stan­dard

Modern Healthcare - - LATE NEWS -

HHS will cre­ate a min­i­mum in­come-based el­i­gi­bil­ity stan­dard for ev­ery state’s Med­i­caid pro­gram, ef­fec­tive in 2014, un­der final reg­u­la­tions car­ry­ing out the health­care re­form law’s Med­i­caid ex­pan­sion. The rule im­ple­ments pro­vi­sions of the Pa­tient Pro­tec­tion and Af­ford­able Care Act that elim­i­nated a va­ri­ety of el­i­gi­bil­ity cat­e­gories in fa­vor of an in­come-based stan­dard of 133% of the fed­eral poverty level. That rate is cur­rently $14,856 for an in­di­vid­ual and $30,656 for a fam­ily of four. The law al­lows states ef­fec­tively to raise the thresh­old to 138% of the fed­eral poverty level, Cindy Mann, deputy ad­min­is­tra­tor of the CMS, said dur­ing a call with re­porters. “In­sur­ing more Amer­i­cans will de­crease the hid­den tax states and con­sumers with in­sur­ance pay to cover the cost of caring for the unin­sured,” Marilyn Taven­ner, act­ing ad­min­is­tra­tor of the CMS, said in a news re­lease. Other pro­vi­sions aim to ease the ap­pli­ca­tion and el­i­gi­bil­ity re­newal process for the pro­gram, in­clud­ing a mod­ern­iza­tion of el­i­gi­bil­ity ver­i­fi­ca­tion rules to rely pri­mar­ily on elec­tronic data sources. The Med­i­caid ex­pan­sion is ex­pected to add up to 17 mil­lion ben­e­fi­cia­ries by 2016, ac­cord­ing to re­cent Con­gres­sional Bud­get Of­fice es­ti­mates. The ex­pan­sion has drawn a con­sti­tu­tional chal­lenge from of­fi­cials rep­re­sent­ing 26 states who say they can­not af­ford it, although the fed­eral gov­ern­ment will pay 100% of ex­pan­sion costs for the first three years and 90% there­after. The Supreme Court is sched­uled to hear that ar­gu­ment March 28

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