A new survey from the Kaiser Family Foundation compares states' Medicaid and Children's Health Insurance Program (CHIP) eligibility levels and enrollment, renewal, and cost-sharing policies.
The information is current to January 2015, one year into implementation of the Patient Protection and Affordable Care Act's (ACA) major coverage provisions, according to the foundation.
States have made it easier to apply for and enroll in the Medicaid program, updating their processes to reflect ACA requirements for a more automated, data-driven, and seamless experience for individuals according to the survey.
Key findings include the following:
In all states but Tennessee, online Medicaid applications are available. The majority of states accept Medicaid applications by phone. States also have established policies that rely on electronic data sources and minimize paperwork to verify applicants' information.
There is still much transition work to be done under the ACA, including enhancing information technology systems, implementing automated renewal processes, and improving coordination between Medicaid and the insurance marketplaces.
As of January 1, 30 states charge premiums or enrollment fees and 27 states charge cost sharing for children. These charges are primarily in CHIP, reflecting the relatively higher family incomes of children covered by the program compared to Medicaid. No states charge premiums for parents or adults newly eligible under the ACA in traditional Medicaid, but most charge nominal cost sharing for both adult groups.
Eligibility levels for 2015 in all 50 states and the District of Columbia for children, pregnant women, and nondisabled adults in Medicaid and CHIP also are provided. The document for the 28 states that adopted ACA Medicaid expansion extends eligibility to parents and other adults up to 138% of the federal poverty level ($27,310 for a family of three or $16,105 for an individual), with two of these states extending eligibility for adults to higher levels. Among the 23 states not adopting the expansion, 19 states have eligibility levels for parents that are below poverty, and only one state provides Medicaid coverage to childless adults.
Eligibility for children is at or above 200% of the federal poverty level through Medicaid and CHIP in all but two states, and 33 states cover pregnant women at those income levels or higher.
The report, "Modern Era Medicaid: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP as of January 2015," is available at Kaiser Family Foundation's website.