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A trustee is named to manage the trust, giving that individual legal control of the trust funds. The Commonwealth Fund Biennial Health Insurance Survey has found that working-age adults who experience gaps in their health insurance during the year report problems getting heath care because of cost at nearly the same rate as people who are without coverage for the entire year (Exhibit 3). For more information see Medicaid Waiver Services. Sarah Huckabee Sanders has said her state will ask the federal government to allow it to require people on its expanded Medicaid program to work. When checking eligibility, please determine if the individual is enrolled in PACE. A federal judge ruled against Kentucky's proposal to impose work requirements to Medicaid recipients. Thus, we project that 108,000 adults either experience a permanent coverage loss (68,000 to 107,000) or a gap in coverage (600 to 40,000) over a two-year period directly as a result of work requirements (Appendix Exhibit 4). Eligibility for these groups is determined by a number of factors, including family size, income, and the Federal Poverty Level (FPL). However, Spousal Impoverishment Provisions permit the non-applicant spouse of a Medicaid nursing home or Waiver applicant a Community Spouse Resource Allowance (CSRA). With Kentucky being the first state to create a law like this, the judge's decision could . Healthcare Notice Summary: You Are Subject to the Work Requirement, accessed Mar. Based on the MEPS analysis, we assume that of the first group, 24.5 percent would likely churn off Medicaid because of the new administrative barriers. 4. The strategy has been submitted to the Centers for Medicare and Medicaid Services for review.Review 2023 Quality Strategy Draft, The Department for Medicaid Services has compiled a Based on Arkansass experience, MEPS data, and estimates from Randy Haught and colleagues at Dobson, DaVanzo and Associates, about 108,000 people would likely lose Medicaid coverage as result of the work requirements over a 24-month period. Updated March 12, 2021 UPDATE: After this Sidebar was published on March 4, 2021, the Supreme Court removed the Medicaid work requirement litigation from its oral argument calendar. (Appendix Exhibit 1). Republican lawmakers rushed a bill through the Kentucky House of Representatives Thursday adding work requirements for some Medicaid recipients and charging state officials with investigating food benefit use, among other proposed changes to public assistance. The Department for Public Health has published The income limit is $217 and resource limit is $2,000 for an individual. Note that there is no home equity limit for Regular Medicaid applicants. Take seasonal farmworkers. For more information see Nursing Facilities. Adding work requirements would thus increase the number of nondisabled adults churning off Medicaid in Kentucky over a two-year period from an estimated 108,000 adults to 216,000, an increase of 100 percent (Appendix Exhibit 3). In the meantime, the National Health Law Program, Legal Aid of Arkansas, and the Southern Poverty Law Center filed a new lawsuit challenging HHSs approval of Arkansass Medicaid work requirement that the state began introducing in June.4, Work requirements present a serious risk some Medicaid enrollees will not be able to meet the requirements and will lose their coverage. If you are elderly or disabled, Medicaid Waiver programs can provide Medicaid coverage for many different services that help you stay in your home. Who is included in the expanded population? In this issue brief, we report findings from a NovemberDecember 2018 survey of 500 low-income Kentuckians (including 297 who reported having Medicaid coverage) that asked about their understanding of and experiences with the states work requirements and their current work or other community engagement activities. For example, the estimates dont predict the likelihood that people who are disenrolled for failing to meet work requirements will gain other insurance coverage, regain Medicaid, or remain uninsured. Employment, job searching, volunteering, school, caretaking of family members, and participating in treatment for substance use disorder are all examples of community engagement activities. Your cheat sheets for understanding health care's legal landscape The Kentucky work requirement has been blocked by the courts, but the states leaders remain committed to the policy. 29, 2019 (no longer available online). Medicaid enrollees also face significant documentation requirements both at the time of enrollment and during reenrollment. The decision is under appeal and a ruling is possible later in the year.12 Despite this, many low-income adults in Kentucky are not aware of the requirements, and there is substantial confusion about whether the policy is currently in effect. 1. More on how this allowance is calculated. Twelve percent incorrectly thought they were in effect; only 8 percent knew the policy was not in effect (data not shown). By the end of the period more than one-third (36.9%) of adults who had churned off Medicaid were uninsured, 27.8 percent had regained Medicaid, 26.2 percent had coverage through an employer, 5.3 percent had individual market coverage, and 3.8 percent had enrolled in Medicare. This can be thought of as a deductible. Our Scorecard ranks every states health care system based on how well it provides high-quality, accessible, and equitable health care. House Bill 7 would also create work requirements for some Medicaid recipients, requiring at least 80 hours of "community engagement activities" a month to stay enrolled. MCI grant announcement for information on the grant and how to get involved.. Participants may have up to $773 in unearned income to qualify. 5. Further complicating eligibility is that the financial criteria changes annually, varies with marital status, and that Kentucky offers multiple pathways towards eligibility. kynectkynect benefitskynect resourcesContact your local 12. During the look back, Medicaid checks all asset transfers to ensure none were gifted or sold under fair market value. Kentucky HEALTH does not impact aged, blind, or disabled individuals receiving Non-MAGI Medicaid. Foster Care children 19to 26 who do not receive Medicaid in another category. 27, 2019. The Medical Expenditure Panel Survey (MEPS) Household Component began in 1996 and collects data from a sample of families and individuals in selected communities across the United States, drawn from a nationally representative subsample of households that participated in the prior years National Health Interview Survey (conducted by the National Center for Health Statistics). The table below provides a quick reference to allow seniors to determine if they might immediately meet all the criteria for long-term care from a Kentucky Medicaid program. Benjamin D. Sommers, Professor of Health Policy and Economics, Harvard T.H. 8. The budget plan proposes to cut total federal Medicaid, CHIP and Affordable Care Act marketplace subsidy spending by more than half over the next decade, relative to current law. The ACA attempted to reduce coverage gaps by making it easier for people to move between coverage options. Dylan Scott, The Legal Fight over the Trump Administrations Most Aggressive Play to Cut Medicaid, Explained, Vox, Mar. Furthermore, for some program benefits, additional eligibility criteria may be required. 2) Qualified Income Trusts (QITs) Also called Miller Trusts or Qualifying Income Trusts, these trusts offer a way for individuals over the Medicaid income limit to still become income-eligible for Nursing Home Medicaid or a Medicaid Waiver. 13. Health Insurance Coverage of Adults 1964 Living in Poverty (under 100% FPL), Henry J. Kaiser Family Foundation, 2013; and Benjamin D. Sommers et al., Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults, Health Affairs Web First, published online May 17, 2017. In July, a federal district court judge vacated HHS Secretary Alex Azars approval of Kentuckys waiver and sent the matter back to the secretary for further review.3 Azar responded by reposting Kentuckys original application for a 30-day public comment period, which closed on August 18. A multivariate regression model confirmed that minorities (p=0.04), people with lower levels of education (p=0.05), and younger adults (p=0.04) were significantly less likely to know about the policy. Stewart v. Azar and the Future of Medicaid Work Requirements: What Are the Takeaways, and What Happens Next? These results indicate there may be relatively few Medicaid beneficiaries who might be compelled to work by the new policy. For seniors who dont meet the requirements, or are unsure, it is recommended they participate in Medicaid planning. Prior research by Benjamin Sommers has suggested that administrative barriers, particularly renewal, are likely a key reason adults become disenrolled from Medicaid.6, While some Medicaid enrollees will leave the program for employer coverage or Medicare, research suggests that leaving Medicaid for reasons other than gaining another coverage source, such as termination of eligibility, leaves most enrollees without insurance options. To investigate the frequency with which people with Medicaid churn off insurance, we looked over a 24-month period at a cohort of nondisabled adults, ages 25 to 63, who were enrolled in Medicaid in January 2014. If the non-applicants portion of the assets is under $29,724, 100% of the assets, up to $29,724 can be retained by the non-applicant. Learn more here., Important Note for All Medicaid Providers about Programs for All-Inclusive Care for the Elderly (PACE). Countable assets include cash from family and friends, employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, stock dividends, and Veterans benefits with the exception of Aid & Attendance pension. If you have not returned to work within six months, you no longer will be in the program. In the Medicaid Works Program, the income of the working disabled individual is counted. For more information see Nursing Facilities, For more information see Medicaid Waiver Services. MedicaidPlanningAssistance.org is a free service provided by the American Council on Aging, *All of a beneficiarys monthly income, with the exception of a, What is the Medicaid Estate Recovery Program, Program of All-Inclusive Care for the Elderly, local Department for Community Based Services (DCBS) office, general information about the application process, 2023 Kentucky Medicaid Long-Term Care Eligibility for Seniors, $2,000 for applicant & $148,620 for non-applicant, Medicaid Waivers / Home and Community Based Services, Regular Medicaid / Aged Blind and Disabled.

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