States Given Greater Flexibility to Provide Medicaid to Two-parent Families

H. C. Covington (ach1@sprynet.com)
Sun, 9 Aug 1998 19:48:45 -0500


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  Home | News | What's New | Analyses | Services | Publications | Links  =

    HCFA Final Rule with Comment Period =20
                        States Given Greater Flexibility to Provide =
Medicaid to Two-parent Families=20
                =20
    =20
   =20
     =20
August 7, 1998=20
The Clinton Administration has promulgated a Final Rule with Comment =
that revises the definition of an unemployed parent under the pre-PRWORA =
AFDC statute.  This change is intended to give states greater =
flexibility to provide Medicaid coverage to two-parent families.  =
Comments on the final rule are due by 5:00 p.m. on October 6, 1998.=20

Background=20

Under PRWORA , States must provide Medicaid to families who would have =
qualified for Medicaid under the old AFDC program.  Under the pre-PRWORA =
AFDC rules, however, in order for a family to qualify for assistance, =
its child had to be deprived of parental support or care due to the =
death, absence, incapacity, or unemployment of a parent.  As a general =
rule, two parent families could qualify for AFDC cash and Medicaid only =
if one parent, the principle wage earner, was unemployed.=20

Under regulations for the old AFDC program, as a general rule, a parent =
was considered to be unemployed if he or she was employed less than 100 =
hours a month.  45 C.F.R. Section 233.101(a)(1).   A parent could exceed =
the standard in one month and still be considered unemployed but only if =
the work is intermittent and the excess is of a temporary nature as =
evidenced by the fact that the parent was under the 100 hour standard =
for the prior 2 months and is expected to be under the standard during =
the next month.=20

Under the revised definition, states have the option to define =
"unemployed" as long as the standard is reasonable and, at a minimum, =
the definition include any parent who is employed less than 100 hours a =
month, or meets the exception for certain intermittent work specified in =
existing regulations.  In other words, states can now establish a =
reasonable standard for defining who is unemployed as long as it is no =
more restrictive than the existing standard.=20

IMPACT=20

The 100-rule has been a significant barrier to eligibility for =
low-income, two parent families.  Thirty-two states, however,  operate =
under statewide Title IV-A waivers that already allow them to disregard =
the 100 hour rule and to treat single-parent and two-parent families the =
same for purposes of determining eligibility for Title IV-A benefits.  =
According to the Urban Institute, if the100-rule were repealed, 546,000 =
people -- mostly adults -- would gain Medicaid eligibility specifically =
because of the change.=20

Although the Administration's proposal falls short of repealing AFDC =
deprivation rules that define unemployment as working less than 100 =
hours a month, states have wide latitude to set their own standard.  If =
states take advantage of this option and also exercise their option =
under Section 1931(b)(2) to use less restrictive income and resource =
methodologies to establish titleIV- A eligibility, the potential exists =
to significantly expand Medicaid coverage to low-income families.=20

-Claudia Schlosberg, NHeLP DC=20

Full Text of the Final Rule with Comment Period from the Federal =
Register=20
[Federal Register: August 7, 1998 (Volume 63, Number 152)]=20
[Rules and Regulations]=20
[Page 42270-42275]=20
 =20

Home | News | What's New | Analyses | Services | Publications | Links=20
   =20
     =20

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States Given Greater Flexibility to = Provide Medicaid to Two-parent Families
 
 =20
 Home | News | = What's = New | Analyses = | Services = | Publications |=20 Links = ;
HCFA Final Rule = with Comment=20 Period  =
States Given Greater Flexibility to = Provide=20 Medicaid to Two-parent=20 = Families
 
August 7, = 1998=20

The Clinton Administration has promulgated a Final Rule with Comment = that=20 revises the definition of an unemployed parent under the pre-PRWORA AFDC = statute.  This change is intended to give states greater = flexibility to=20 provide Medicaid coverage to two-parent families.  Comments on the = final=20 rule are due by 5:00 p.m. on October 6, 1998.=20

Background=20

Under PRWORA , States must provide Medicaid to families who would = have=20 qualified for Medicaid under the old AFDC program.  Under the = pre-PRWORA=20 AFDC rules, however, in order for a family to qualify for assistance, = its child=20 had to be deprived of parental support or care due to the death, = absence,=20 incapacity, or unemployment of a parent.  As a general rule, two = parent=20 families could qualify for AFDC cash and Medicaid only if one parent, = the=20 principle wage earner, was unemployed.=20

Under regulations for the old AFDC program, as a general rule, a = parent was=20 considered to be unemployed if he or she was employed less than 100 = hours a=20 month.  45 C.F.R. Section 233.101(a)(1).   A parent could = exceed=20 the standard in one month and still be considered unemployed but only if = the=20 work is intermittent and the excess is of a temporary nature as = evidenced by the=20 fact that the parent was under the 100 hour standard for the prior 2 = months and=20 is expected to be under the standard during the next month.=20

Under the revised definition, states have the option to define=20 "unemployed" as long as the standard is reasonable and, at a = minimum,=20 the definition include any parent who is employed less than 100 hours a = month,=20 or meets the exception for certain intermittent work specified in = existing=20 regulations.  In other words, states can now establish a reasonable = standard for defining who is unemployed as long as it is no more = restrictive=20 than the existing standard.=20

IMPACT=20

The 100-rule has been a significant barrier to eligibility for = low-income,=20 two parent families.  Thirty-two states, however,  operate = under=20 statewide Title IV-A waivers that already allow them to disregard the = 100 hour=20 rule and to treat single-parent and two-parent families the same for = purposes of=20 determining eligibility for Title IV-A benefits.  According to the = Urban=20 Institute, if the100-rule were repealed, 546,000 people -- mostly adults = --=20 would gain Medicaid eligibility specifically because of the change.=20

Although the Administration's proposal falls short of repealing AFDC=20 deprivation rules that define unemployment as working less than 100 = hours a=20 month, states have wide latitude to set their own standard.  If = states take=20 advantage of this option and also exercise their option under Section = 1931(b)(2)=20 to use less restrictive income and resource methodologies to establish = titleIV-=20 A eligibility, the potential exists to significantly expand Medicaid = coverage to=20 low-income families.=20

-Claudia Schlosberg, = NHeLP DC=20

Full=20 Text of the Final Rule with Comment Period from the Federal=20 Register
[Federal Register: August 7, 1998 (Volume = 63, Number=20 152)]
[Rules and Regulations]
[Page 42270-42275]
 =20

Home | News | = What's = New | Analyses = | Services = | Publications |=20 Links<= /TD>
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