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Medicaid/TANF
Over the past few years, States have made enormous progress increasing access to health care
coverage for low-income families and children through Medicaid and the State Children's
Health Insurance Program (SCHIP). At the same time, however, instances in which eligible
children and parents have lost out on coverage have come to light.
Since Medicaid eligibility was delinked from cash assistance by the Personal Responsibility
and Work Opportunity Reconciliation Act (PRWORA) in 1996, States have been able to
offer low-income families health care coverage regardless of whether the family is receiving,
or is eligible for, welfare. However, delinkage has created challenges as well as opportunities
for States.
We are concerned that some families who left the Temporary Assistance for Needy Families
(TANF) program and who remain eligible for Medicaid or Transitional Medical Assistance
(TMA) benefits may have lost coverage. In addition, it appears that some children
(commonly referred to as "Section 4913 children") who became ineligible for Supplemental
Security Income (SSI) benefits due to a change in the SSI disability rules may not have been
continued on Medicaid despite Congressionally-mandated requirements.
An April 2000 study by the Kaiser Commission on Medicaid and the Uninsured reported that
Medicaid enrollment in 21 States representing 73% of total Medicaid enrollment during 1997
(the twelve with the largest Medicaid enrollments in 1997, plus nine others selected to
include States with smaller enrollments to provide broader geographic representation) fell by
1.3% (300,000) from June 1997 to June 1999.
From June 1997 to June 1998, enrollment declined by roughly 2.7%, or nearly
620,000 individuals.
From June 1998 to June 1999, aggregate enrollment actually increased by 1.4%, or
nearly 320,000 people, but not enough to offset the earlier decline.
A June 2000 Families USA report, "Go Directly to Work, Do Not Collect Health Insurance:
Low-Income Parents Lose Medicaid," found that in the 15 States with the most uninsured
low-income adults, low-income parents' enrollment in Medicaid declined by roughly 27%, or
945,880 parents, from January 1996 to December 1999.
At the President's direction, HHS is working with States to make sure that Medicaid
application, enrollment and eligibility procedures function in the best possible way. As part
of this effort, HHS has conducted site visits in all 50 states, plus the District of Columbia and
Puerto Rico. At this writing, the Regional Offices have submitted initial reports for most
States. These reports are undergoing an extensive review by a team of HCFA and
Department staff to ensure that they are as complete, accurate, and consistent as possible.
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"ocrText": "Medicaid/TANF\nOver the past few years, States have made enormous progress increasing access to health care\ncoverage for low-income families and children through Medicaid and the State Children's\nHealth Insurance Program (SCHIP). At the same time, however, instances in which eligible\nchildren and parents have lost out on coverage have come to light.\nSince Medicaid eligibility was delinked from cash assistance by the Personal Responsibility\nand Work Opportunity Reconciliation Act (PRWORA) in 1996, States have been able to\noffer low-income families health care coverage regardless of whether the family is receiving,\nor is eligible for, welfare. However, delinkage has created challenges as well as opportunities\nfor States.\nWe are concerned that some families who left the Temporary Assistance for Needy Families\n(TANF) program and who remain eligible for Medicaid or Transitional Medical Assistance\n(TMA) benefits may have lost coverage. In addition, it appears that some children\n(commonly referred to as \"Section 4913 children\") who became ineligible for Supplemental\nSecurity Income (SSI) benefits due to a change in the SSI disability rules may not have been\ncontinued on Medicaid despite Congressionally-mandated requirements.\nAn April 2000 study by the Kaiser Commission on Medicaid and the Uninsured reported that\nMedicaid enrollment in 21 States representing 73% of total Medicaid enrollment during 1997\n(the twelve with the largest Medicaid enrollments in 1997, plus nine others selected to\ninclude States with smaller enrollments to provide broader geographic representation) fell by\n1.3% (300,000) from June 1997 to June 1999.\nFrom June 1997 to June 1998, enrollment declined by roughly 2.7%, or nearly\n620,000 individuals.\nFrom June 1998 to June 1999, aggregate enrollment actually increased by 1.4%, or\nnearly 320,000 people, but not enough to offset the earlier decline.\nA June 2000 Families USA report, \"Go Directly to Work, Do Not Collect Health Insurance:\nLow-Income Parents Lose Medicaid,\" found that in the 15 States with the most uninsured\nlow-income adults, low-income parents' enrollment in Medicaid declined by roughly 27%, or\n945,880 parents, from January 1996 to December 1999.\nAt the President's direction, HHS is working with States to make sure that Medicaid\napplication, enrollment and eligibility procedures function in the best possible way. As part\nof this effort, HHS has conducted site visits in all 50 states, plus the District of Columbia and\nPuerto Rico. At this writing, the Regional Offices have submitted initial reports for most\nStates. These reports are undergoing an extensive review by a team of HCFA and\nDepartment staff to ensure that they are as complete, accurate, and consistent as possible."
}