MEDICAID: Adult Eligibility Would Reduce Uninsured
Extending Medicaid eligibility requirements to uninsured, low-income parents would reduce the uninsured population by 5.2 million, a June 2000 report from the Urban Institute finds. In 1997, 37% of low-income adults were uninsured, compared to 21% of low-income children. Parents represent more than one-third of the uninsured population and many could receive coverage under Medicaid if states broadened adult eligibility requirements, the report asserts. States now are required to allow children under age five in families with incomes up to 133% of the federal poverty level and children ages 6-15 in families with incomes below 100% into the Medicaid program. The 1996 welfare reform package, known as the Personal Responsibility and Work Opportunity Reconciliation Act, expanded Medicaid eligibility to include adults and children who previously would have been entitled to Aid to Families with Dependent Children. This new category of Medicaid eligibility gives states the ability to use "less restrictive income and resource standards" to determine an adult's eligibility for Medicaid. Of the 7.3 million low-income parents who were uninsured in 1997, 3.5 million would qualify for coverage under existing Medicaid law since their incomes fall below the federal poverty level if states expanded Medicaid eligibility using the authority given to them under welfare reform. Expanding Medicaid to include children and their parents with incomes up to 200% of poverty would make another 2.1 million uninsured parents eligible for Medicaid. At the same time, the report notes that President Clinton has proposed allowing states to cover parents of children in Medicaid or CHIP by providing federal matching funds currently available under CHIP. The report notes that under such an expansion, "more states might be inclined to expand coverage to parents" and possibly even include coverage to higher-income parents (Dubay et al., "Extending Medicaid to Parents: An Incremental Strategy for Reducing the Number of Uninsured," June 2000). The full report is available at http://newfederalism.urban.org/html/series_b/b20/b20.html.
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