Category Archives: Medicaid Eligibility

Why are Medicaid and CHIP enrollment numbers declining?

For much of the past two years, enrollment in the Medicaid and CHIP programs has been declining.  In May, 2017, enrollment in both programs was 74.6 million people.  As of May of this year, enrollment had declined by 2.5%, to 72.8 million.  This decline has applied across the board, in almost every state, for adults and for children.

Superficially, this might make sense;… More

As a Public Charge Rule is Finalized by DHS, Concern Over Upcoming DOJ Rule Grows

Last Fall, we wrote about a proposed regulation issued by the Department of Homeland Security that involved one of our favorite topics:  the intersection of immigration and health care law.  My colleague Christian Springer and I have been following this proposed regulation very closely, and last week, it was issued in final form.  Because it has generated enormous press attention and because it has significant implications for the Medicaid program,… More

CMS Updates “Settings that Isolate” Guidance for HCBS Waivers, Providing Relief to Farmstead and Lifesharing Communities

On March 22, 2019, CMS published a long-awaited letter to State Medicaid Directors and a new guidance document regarding the Home and Community-Based Services (HCBS) waiver program.  The letter  revises previous guidance that CMS had provided to states on “Settings that have the effect of isolating individuals receiving HCBS from the broader community” for purposes of receiving Federal funding for services provided under a HCBS waiver. … More

Medicaid Long-Term Care: A Background and look at the Eligibility Rules

One of the most common misperceptions of the American health care system is that if an elderly individual – maybe a parent or a grandparent – has to enter a nursing home, their stay will be fully covered by the Medicare program.  But that is not accurate.  Medicare does not cover long-term care.  It will pay for up to 100 days in a skilled nursing facility per spell of illness,… More