As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
Analysis of Eligibility Changes and Implications for Selected Medicaid and CHIP Eligibility Groups
National Academy for State Health Policy – Mary Henderson, Abigail Arons, and Alice Weiss
The Patient Protection and Affordable Care Act (ACA) has prompted the Centers for Medicare and Medicaid Services (CMS) to promulgate Medicaid and CHIP eligibility rules designed to simplify and collapse Medicaid eligibility categories in preparation for the changes in Medicaid that will become effective under the ACA in 2014. The changes in eligibility categories apply primarily to low-income children and adults whose eligibility is not tied to being elderly, disabled, or needing long term services and supports. This issue brief provides a detailed overview of the final federal Medicaid eligibility rules, transition issues and decision points that states will need to consider as they prepare to convert to the collapsed eligiblity categories in 2014.