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Table 1: States' Implementation of the Requirement to Replace
the Automatic Eligibility Link between Medicaid and Welfare
with a Family Coverage Category
This table is designed to provide basic information on
whether states have established a family coverage category (as required under federal
law), as well as whether families with children have access to Medicaid through
alternative routes. Note that most children are eligible for Medicaid at
significantly higher income and asset levels under categories other than the family
coverage category (e.g., the poverty level eligibility groups for children). Thus, the
family coverage category rules described in this table primarily determine the extent to
which parents are eligible for Medicaid coverage. In states without a family
coverage category, this table provides information on the alternative circumstances under
which parents can gain access to Medicaid. (For state-specific information on the
income level at which children are eligible for Medicaid, see the table prepared by the
Center on Budget and Policy Priorities at http://www.cbpp.org/shsh/elig.htm.)
Column 1 answers the basic question of whether a state has
established a family coverage category.
Column 2 identifies whether those states that have not yet
implemented the federal requirement to create a family coverage category nevertheless
provide coverage to some parents who are not on welfare. The states without family
coverage categories may have extended Medicaid to parents in one of two ways:
- Medically needy category — Some states without a family
coverage category do have a "medically needy" eligibility category for families
with children that can be used to cover parents who are ineligible for or who elect not to
be on TANF. (These states also generally provide Medicaid to all families on TANF.) The
medically needy eligibility category for families with children is an optional Medicaid
eligibility category that covers families who have income and assets below
state-established medically needy standards or who fall below these standards after they
"spend down" their "excess" income and assets on medical bills.
Traditionally, the medically needy eligibility category has been used by states primarily
for people with high medical bills, but, in some states, it also can serve as a source of
coverage for other parents if their income and assets are below medically needy standards
even when medical bills are not taken into account.
- 1115 waiver — Some states without a family coverage
category have expanded Medicaid to parents under a section 1115 Medicaid waiver. Note that
the terms of the Medicaid coverage available to parents under a waiver may vary from what
is available to them under a state’s regular Medicaid program.
Column 3 indicates whether a state covers parents via a
Medicaid expansion enacted under an 1115 waiver and, if so, describes the extent of the
expansion. Note that some states with 1115 waiver expansions also have established a
family coverage category, while others have not. The column describes the coverage of
"parents" because children are eligible for Medicaid in almost every state at
significantly higher income levels under alternative Medicaid eligibility categories.
| State |
Family coverage category established |
If no, is there a route to coverage for
families with children who are not on welfare? |
Has the state enacted a Medicaid expansion
under an 1115 waiver that covers parents regardless of their welfare status? |
| Totals |
46 Yes
5 No |
|
9
Yes
42 No |
| Alabama |
Yes |
n/a |
No |
| Alaska |
Yes |
n/a |
No |
| Arizona |
Yes |
n/a |
No |
| Arkansas |
Yes |
n/a |
No |
| California |
Yes |
n/a |
No |
| Colorado |
Yes |
n/a |
No |
| Connecticut |
Yes |
n/a |
No |
| Delaware |
Yes |
n/a |
Yes,
covers all uninsured adults with countable income up to 100% of FPL |
| District of Columbia |
Yes |
n/a |
No |
| Florida |
Yes |
n/a |
No |
| Georgia |
Yes |
n/a |
No |
| Hawaii |
No |
Yes, via
Medicaid expansion enacted under an 1115 waiver; HI also provides Medicaid to all TANF
recipients |
Yes,
covers parents with gross income up to 100% of FPL |
| Idaho |
Yes |
n/a |
No |
| Illinois |
Yes |
n /a |
No |
| Indiana |
Yes |
n/a |
No |
| Iowa |
Yes |
n/a |
No |
| Kansas |
Yes |
n/a |
No |
| Kentucky |
Yes |
n/a |
No |
| Louisiana |
Yes |
n/a |
No |
| Maine |
Yes |
n/a |
No |
| Maryland |
Yes |
n/a |
No |
| Massachusetts |
No |
Yes, via
Medicaid expansion enacted under an 1115 waiver; MA also provides Medicaid to all TANF
recipients |
Yes,
covers all parents with gross income up to 133% of FPL |
| Michigan |
Yes |
n/a |
No |
| Minnesota |
Yes |
n/a |
Yes,
covers parents with gross income up to 275% of FPL |
| Mississippi |
Yes |
n/a |
No |
| Missouri |
Yes |
n/a |
Yes,
covers uninsured working parents with countable income up to 100% of FPL |
| Montana |
Yes |
n/a |
No |
| Nebraska |
No |
Yes, via
medically needy category; NE also provides Medicaid to all TANF recipients |
No |
| Nevada |
Yes |
n/a |
No |
| New Hampshire |
Yes |
n/a |
No |
| New Jersey |
Yes |
n/a |
No |
| New Mexico |
Yes |
n/a |
No |
| New York |
Yes |
n/a |
No |
| North Carolina |
Yes |
n/a |
No |
| North Dakota |
Yes |
n/a |
No |
| Ohio |
Yes |
n/a |
No |
| Oklahoma |
Yes |
n/a |
No |
| Oregon |
Yes |
n/a |
Yes,
covers parents with gross income up to 100% of FPL |
| Pennsylvania |
Yes |
n/a |
No |
| Rhode Island |
Yes |
n/a |
No |
| South Carolina |
Yes |
n/a |
No |
| South Dakota |
Yes |
n/a |
No |
| Tennessee |
Yes |
n/a |
Yes,
covers parents who have lost eligibility for regular Medicaid under the "family
coverage" category up to 400% of FPL |
| Texas* |
No |
Yes, via
medically needy category; TX also provides Medicaid to all TANF recipients |
No |
| Utah |
No |
Yes, via
medically needy category; UT also provides Medicaid to all TANF recipients |
No |
| Vermont |
Yes |
n/a |
Yes,
covers parents with countable income up to 150% of FPL |
| Virginia |
Yes |
n/a |
No |
| Washington |
Yes |
n/a |
No |
| West Virginia |
Yes |
n/a |
No |
| Wisconsin |
Yes |
n/a |
Yes,
covers parents up to 185% of FPL and allows them to remain enrolled until their income
reaches 200% of FPL |
| Wyoming |
Yes |
n/a |
No |
* Texas plans to provide Transitional Medicaid
Assistance to families with income below TANF limits in the state’s medically needy
eligibility category whose new or increased earnings or child support causes the
family’s income to exceed the TANF limits. When it does so, the state’s
medically needy eligibility category will serve a function identical to the family
coverage category the state is required to create by federal law.
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