The Health Care Reform Bill’s Affect on Medicaid

Health Care Reform has affected a number of government programs, including Medicaid. For example, States will have to include Spousal Impoverishment Protection in their waiver programs, and offer this protection to spouses of HCBS waiver participants, including those who are medically needy. This protection will continue for 5 years.

The law also establishes a Community First Choice Option to provide community-based support and services to those with disabilities who are Medicaid eligible and require institutional level care. States that sign up for this program will be eligible for a Federal matching rate fully six percentage points above the norm. This provision takes effect October 1, 2011 and remains in force for a period of 5 years.

Next, the law establishes a State Balancing Incentive Program effective from October 1, 2011 to September 30, 2015 to provide a higher level of Federal Medicaid Matching Funds to States that currently spend less than 50% of their long-term care funds for home or community-based programs. The intent is to increase the number of Medicaid recipients able to receive these non-institutional long-term care services.

Finally, the law allows Medicaid to cover individuals who are 64 and under whose income does not exceed 133% of the Federal poverty line.

In an upcoming blog, I will talk about the law’s effect on long-term care, nursing homes, and related issues.

Jerry Shiles
Attorney at Law