Issuu on Google+

      The  Affordable  Care  Act  (ACA)  makes  improvements  to  both  Medicaid  and  the  State  Children’s  Health   Insurance  Program  (CHIP).    These  include  expanding  Medicaid  coverage,  controlling  costs  and  improving   Medicaid  service  delivery  for  beneficiaries,  including  patients  with  liver  disease.    These  changes  are  in   the  process  of  being  implemented  and  are  outlined  below:       Medicaid   • • • •   Eligibility  Expansion.    Eligibility  is  expanded  and  all  individuals  with  incomes  at  or  below  133   percent  of  the  federal  poverty  level  will  be  eligible  for  coverage  as  of  January  1,  2014.    The   mandatory  Medicaid-­‐eligibility  level  for  children  ages  6-­‐19  increases  from  100  to  133  percent  of   the  federal  poverty  level.    This  expansion  means  that  non-­‐elderly,  non-­‐pregnant  adults  without   children  will  be  eligible  for  Medicaid  based  on  their  incomes  for  the  first  time,  and  this  is  the   primary  mechanism  of  the  ACA  to  expand  access  to  insurance.     Medicaid  Benefits.    Those  newly  eligible  for  Medicaid  will  be  eligible  for  “benchmark”  or   “benchmark-­‐equivalent”  plans,  which  was  defined  by  the  Deficit  Reduction  Act  of  2005.     Benchmark  plans  can  either  be  full  Medicaid  benefits  or  a  more  limited  package  of  benefits.     However,  all  states  will  be  required  to  provide  at  least  the  same  essential  health  benefits   required  of  coverage  purchased  through  an  exchange.    A  complete  explanation  can  be  found   here.     Maintenance  of  Eligibility.    Prior  to  the  Medicaid  expansion  on  January  1,  2014,  states  are   required  to  maintain  the  eligibility  standards  in  effect  on  the  date  ACA  was  enacted  into  law.    All   individuals  who  met  the  state’s  eligibility  rules  as  of  that  date  will  remain  eligible  for  full   Medicaid  coverage,  not  a  benchmark  plan.    However,  states  providing  coverage  to  beyond  those   who  are  pregnant  or  disabled  with  incomes  above  133  percent  of  poverty  can  scale  back   eligibility  for  those  beneficiaries  during  that  time.     Medical  Homes.  As  of  January  1,  2011,  states  have  had  the  option  of  enrolling  Medicaid   beneficiaries  with  at  least  two  chronic  conditions,  like  liver  disease,  into  a  health  home   composed  of  a  team  of  health  providers  that  would  provide  comprehensive,  care  coordination   services.     American Liver Foundation Ÿ 39 Broadway, Suite 2700, New York, NY 10006-3003 Ÿ Tel: 212-668-1000 Ÿ Fax: 212-483-8179 HelpLine: 800-GO-LIVER (800-465-4837) Ÿ

Healthcare Reform Act Medicaid

Related publications