AGP » Topics » Medicaid, CHIP and FamilyCare Eligibles

This excerpt taken from the AGP 10-K filed Feb 22, 2010.
Medicaid, CHIP and FamilyCare Eligibles
 
Medicaid makes Federal matching funds available to all states for the delivery of healthcare benefits to eligible individuals, principally those with incomes below specified levels who meet other state-specified requirements. Medicaid is structured to allow each state to establish its own eligibility standards, benefits package, payment rates and program administration under broad Federal guidelines.
 
Most states determine Medicaid eligibility thresholds by reference to other Federal financial assistance programs, including TANF and Supplementary Security Income (“SSI”).
 
TANF provides assistance to low-income families with children and was adopted to replace the Aid to Families with Dependent Children program, more commonly known as welfare. Under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Medicaid benefits were provided to recipients of TANF during the duration of their enrollment, with one additional year of coverage.
 
SSI is a Federal income supplement program that provides assistance to ABD individuals who have little or no income. However, states can broaden eligibility criteria. The ABD population is approximately 25% of the eligible Medicaid population. For ease of reference, throughout this Form 10-K, we refer to those members who are aged, blind or disabled as ABD, as a number of states use ABD or SSI interchangeably.
 
CHIP, created by Federal legislation in 1997 and previously referred to as SCHIP, is a state and Federally funded program that provides healthcare coverage to children not otherwise covered by Medicaid or other insurance programs. CHIP enables a segment of the large uninsured population in the U.S. to receive healthcare benefits. States have the option of administering CHIP as a Medicaid expansion program, or administratively through their Medicaid programs, or as a freestanding program. Current enrollment in this non-entitlement program is approximately seven million children nationwide. The President signed a bill on February 4, 2009 to reauthorize and expand the CHIP program. The expanded program is expected to cover up to an additional eleven million children by 2011 and provide an additional $32.8 billion in funding over a four and a half year period ending in 2013. The increase is paid for by a nearly 62 cent increase in the tax levied on cigarettes and allows states to expand coverage up to 300 percent of the Federal poverty level (“FPL”) and grandfathers those states that are currently above 300 percent of the FPL. For states that want to expand their CHIP programs above 300 percent of the FPL, those states will be reimbursed at the Medicaid rate for children for amounts exceeding 300 percent of the FPL. The bill also allows the states an option for legal immigrant children to be covered under CHIP. The prior law required legal immigrant children to be in the country for at least five years before becoming eligible for Federal programs. CHIP will continue to be funded at an enhanced match, with the minimum Federal amount being 65 percent.
 
FamilyCare is a Medicaid expansion program that has been developed in several states. For example, New Jersey’s FamilyCare program is a voluntary state and Federally funded Medicaid expansion health insurance program created to help low income uninsured families, single adults and couples without dependent children obtain affordable healthcare coverage.


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These excerpts taken from the AGP 10-K filed Feb 24, 2009.
Medicaid, CHIP and FamilyCare Eligibles
 
Medicaid makes Federal matching funds available to all states for the delivery of healthcare benefits to eligible individuals, principally those with incomes below specified levels who meet other state-specified requirements. Medicaid is structured to allow each state to establish its own eligibility standards, benefits package, payment rates and program administration under broad Federal guidelines.
 
Most states determine threshold Medicaid eligibility by reference to other Federal financial assistance programs, including Temporary Assistance to Needy Families (“TANF”) and Supplementary Security Income (“SSI”).
 
TANF provides assistance to low-income families with children and was adopted to replace the Aid to Families with Dependent Children program, more commonly known as welfare. Under the Personal Responsibility and Work


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Opportunity Reconciliation Act of 1996, Medicaid benefits were provided to recipients of TANF during the duration of their enrollment, with one additional year of coverage.
 
SSI is a Federal income supplement program that provides assistance to aged, blind and disabled (“ABD”) individuals who have little or no income. However, states can broaden eligibility criteria. The ABD population is approximately 24% of the eligible Medicaid population. For ease of reference, throughout this Form 10-K, we refer to those members who are aged, blind or disabled as ABD, as a number of states use ABD or SSI interchangeably.
 
CHIP (sometimes referred to as “SCHIP”), created by Federal legislation in 1997, is a Federal and state funded program that provides healthcare coverage to children not otherwise covered by Medicaid or other insurance programs. CHIP enables a segment of the large uninsured population in the U.S. to receive healthcare benefits. States have the option of administering CHIP as a Medicaid expansion program, or administratively through their Medicaid programs, or as a freestanding program. Current enrollment in this non-entitlement program is approximately seven million children nationwide.
 
FamilyCare is a Medicaid expansion program that has been developed in several states. For example, New Jersey’s FamilyCare program is a voluntary Federal and state funded Medicaid expansion health insurance program created to help low income uninsured families, single adults and couples without dependent children obtain affordable healthcare coverage.
 
Medicaid,
CHIP and FamilyCare Eligibles



 



Medicaid makes Federal matching funds available to all states
for the delivery of healthcare benefits to eligible individuals,
principally those with incomes below specified levels who meet
other state-specified requirements. Medicaid is structured to
allow each state to establish its own eligibility standards,
benefits package, payment rates and program administration under
broad Federal guidelines.


 



Most states determine threshold Medicaid eligibility by
reference to other Federal financial assistance programs,
including Temporary Assistance to Needy Families
(“TANF”) and Supplementary Security Income
(“SSI”).


 



TANF provides assistance to low-income families with children
and was adopted to replace the Aid to Families with Dependent
Children program, more commonly known as welfare. Under the
Personal Responsibility and Work





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Table of Contents






Opportunity Reconciliation Act of 1996, Medicaid benefits were
provided to recipients of TANF during the duration of their
enrollment, with one additional year of coverage.


 



SSI is a Federal income supplement program that provides
assistance to aged, blind and disabled (“ABD”)
individuals who have little or no income. However, states can
broaden eligibility criteria. The ABD population is
approximately 24% of the eligible Medicaid population. For ease
of reference, throughout this
Form 10-K,
we refer to those members who are aged, blind or disabled as
ABD, as a number of states use ABD or SSI interchangeably.


 



CHIP (sometimes referred to as “SCHIP”), created by
Federal legislation in 1997, is a Federal and state funded
program that provides healthcare coverage to children not
otherwise covered by Medicaid or other insurance programs. CHIP
enables a segment of the large uninsured population in the
U.S. to receive healthcare benefits. States have the option
of administering CHIP as a Medicaid expansion program, or
administratively through their Medicaid programs, or as a
freestanding program. Current enrollment in this non-entitlement
program is approximately seven million children nationwide.


 



FamilyCare is a Medicaid expansion program that has been
developed in several states. For example, New Jersey’s
FamilyCare program is a voluntary Federal and state funded
Medicaid expansion health insurance program created to help low
income uninsured families, single adults and couples without
dependent children obtain affordable healthcare coverage.


 




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