Changes in the Eligibility for Medicaid May Be Underway

1. September 6, 2017 Changes in the Eligibility for Medicaid May Be Underway As more Americans are expressing a newfound public appreciation and public awareness for Medicaid, it seems like certain changes to the program, including eligibility for Medicaid are on the horizon. According to Medicaid's executive director of the National Association of Medicaid Directors Matt Salo, this is critical for the program's future. He also acknowledged that it’s now up to the states to bolster Medicaid in such a way that it becomes holistic, value-driven and most of all, better coordinated for the program's most needy beneficiaries. P a g e 1 | 3

2. Recent Attempt to Cut Medicaid Budget Failed Recently, GOP congressional proposals have been aimed at one thing: to place a ceiling on the federal spending for Medicaid. This is intended to be part of the group's effort to overthrow the Affordable Care Act, a goal they have failed to meet yet again just recently. If they had succeeded, Medicaid would have lost as much as $834 billion in funding. This amount is critical considering that Medicaid spends around 80 percent of its budget on long-term care, seniors, children, and disabled beneficiaries. Despite the recent victory, the Medicaid program still believes that changes are coming, especially when it comes to eligibility particularly with respect to the approval of the Section 1115 waiver demonstrations. Section 1115 demonstrations are intended to give the Secretary of Health and Human Services the authority to approve certain demonstration, pilot or experimental projects to help promote the objectives of both Medicaid and Children's Health Insurance Program (CHIP) programs. Such projects may include the imposition of more stringent eligibility rules. For instance, possible beneficiaries may be asked to meet a required minimum number of work hours as well as beneficiary premiums and copays. Moreover, there may also be a required number of drug screenings. Waivers May Become a Popular Choice in Determining Medicaid Eligibility According to Salo, these waivers are likely to be approved especially in states like Maine, Wisconsin, Indiana and Kentucky who have already requested for them. Meanwhile, he also said that states such as California and New York may actually decide to not follow these restrictions. This is despite a poll conducted by Kaiser Family Foundation in June saying that most Americans actually appreciate the addition of drug-testing and work hours as requirements to one's eligibility for Medicaid for those who are not disabled. P a g e 2 | 3

3. Medicaid Expansion Helped Reduced Federal Income Assistance Reliance On the other hand, one study conducted by the University of Wisconsin-Madison School of Medicine and Public Health found that expanding Medicaid can actually play a vital role in reducing people's reliance on federal income assistance. Based on their findings, the participation in Supplemental Security Income program decreased by around three percent following the implementation of the Affordable Care Act. Hence, Medicaid expansions have effectively reduced the trade-off that certain low income adults face when it comes to obtaining their health insurance and increasing both their savings and income. Today, much uncertainty still remains as far as Medicaid eligibility goes. This may make processing a patient at hospitals quite a challenge unless you decide to get professional assistance. Consider partnering up with a company that provides ACA enrollment and SSI/SSDI eligibility services. This way, your staff can be more focused on what they do best: giving patients the best standard of care possible. About DECO: At DECO, we can work with you and your staff in order to help determine a patient's eligibility for Medicaid more efficiently. Aside from eligibility management, we also specialize in revenue reimbursement and medical eligibility management services. We can make your administrative life easier so you can better focus on caring for your patients. Sources: Medicaid Directors See Boon in Newfound Public Awareness, bna.com Study: Medicaid Expansion Helped Reduce Reliance on Federal Income Assistance, med.wisc.edu P a g e 3 | 3