HHS Issues Final Rule on Federal Reform Law’s Medicaid Expansion
On Friday, HHS released the final rule governing the Medicaid expansion under the federal health reform law, Modern Healthcare reports.
Background
Beginning in 2014, the health reform law extends Medicaid coverage to individuals between ages 19 and 64 with incomes up to 133% of the federal poverty level -- $14,856 for an individual and $30,656 for a family of four (Daly, Modern Healthcare, 3/16).
The law states that the federal government will pay 100% of the cost of covering all newly eligible people through 2016 and pay at least 90% through 2020 (Dick Tocknell, HealthLeaders Media, 3/16).
Final Rule
The new guidelines are based on policies that HHS first proposed in August 2011. Responding to feedback from states and various stakeholders, the final rule includes additional protections for consumers and additional options and flexibility for states, according to a CMS release.
The final rule also makes it easier for eligible residents to enroll in Medicaid and the Children's Health Insurance Program by reducing paperwork and coordinating enrollment within the state-based health insurance exchanges, which are scheduled to begin operating in January 2014 (Modern Healthcare, 3/16).
According to Medicaid Director Cindy Mann, applicants will be notified almost instantly if they qualify for Medicaid or premium subsidies provided under the overhaul (Galewitz, Kaiser Health News/National Journal, 3/16). "Medicaid will look and feel like a very different program by 2015," Mann said (Radnofsky, Wall Street Journal, 3/16).
In the CMS release, CMS Acting Administrator Marilyn Tavenner said, "Today, too many uninsured Americans turn to the emergency room for care and can't pay their bills," adding, "Insuring more Americans will decrease the hidden tax states and consumers with insurance pay to cover the cost of caring for the uninsured" (CMS release, 3/16).
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