There is no income test for eligibility under this new mandatory group for former foster care children. Therefore, MAGI-based methodologies are not relevant and states do not need to consider the parents' (or even the individual's own) income for purposes of Medicaid eligibility.
No. States may not impose an asset test for eligibility under the former foster care group.
While there is significant overlap in eligibility under the two groups, the mandatory group for former foster care children does not completely subsume or replace coverage under the optional group, and states that currently cover the optional group for independent foster care adolescents must continue to do so until the maintenance of effort for individuals under age 21 has expired in accordance with section 1902(gg) of the Act.
Individuals under age 21 who are eligible under the group for former foster care children are covered for EPSDT services. Individuals ages 21 - 25 who are eligible under this group are not covered for EPSDT services.
States have broad flexibility under the final regulations at section 435.956 regarding verification of non-financial eligibility requirements, other than citizenship and immigration status. States may, for example, accept self-attestation of the former foster care status and enrollment in Medicaid required for eligibility under this group.
No. In accordance with section 1902(a)(10)(G) of the Social Security Act, eligibility under the group for former foster care children takes precedence over eligibility under the new adult group. Thus, individuals who meet the requirements for both of these groups must be enrolled under the group for former foster care children.
No. Under the law, the state's regular federal matching rate applies for individuals eligible under the former foster care group.
Section 2101(a) of the Affordable Care Act amended section 2104(a) of the Social Security Act to extend title XXI funding for states' CHIP fiscal year allotments through September 30, 2015, the end of federal fiscal year (FY) 2015. The new law also amended section 2105(b) of the Social Security Act to increase the enhanced Federal Medical Assistance Percentage (Enhanced FMAP) rate by 23 percent applicable for certain expenditures for the period FY 2016 through FY 2019, but in no case will the enhanced FMAP exceed 100 percent.
Yes. States have a limited opportunity to expand CHIP eligibility without a section 1115 demonstration (through the use of a block of income disregard) that will then get incorporated into a MAGI converted eligibility level. Any state interested in expanding CHIP eligibility above 200 percent of the FPL must submit a state plan amendment (SPA) before Dec. 31, 2013. After such time, states could expand eligibility through a demonstration.
Yes. The CHIP enhanced FMAP will continue to be available for the expenditures for children shifted from CHIP to Medicaid, as long as their income is greater than the state's March 31, 1997 Medicaid income standard for children. In other words, if CHIP funding was available for this group of children when they were covered in a separate CHIP, it will continue to be available when the children are covered under Medicaid.
