Governor Chris Gregoire announced on January 4 that the State of Washington has won federal approval to implement an expansion of its state Medicaid program to cover Washington residents currently enrolled in three longstanding, state funded programs. These are low income legal residents not within traditional Medicaid categorical and financial eligibility rules (such as most childless adults not qualifying for SSI disability benefits). Washington’s voluntary Medicaid expansion, permitted under an option for states in the Affordable Care Act (ACA), will serve as a bridge to full implementation of health care reform in 2014, when the ACA will mandate Medicaid eligibility and enrollment changes for individuals and families with incomes up to 133 percent of the federal poverty level. Rather than waiting until 2014 for a sudden Medicaid enrollment increase of up to 470,000 persons, the State of Washington is moving ahead with an “early expansion” of Medicaid under which a portion of individuals already on state funded programs will qualify for Medicaid federal financial participation (FFP) at regular Medicaid matching rates immediately, without jeopardizing the enhanced Medicaid matching rates for them beginning in 2014 under the ACA. Federal approval of Washington’s request will generate approximately $92 million annually in new federal revenue to help support Washington State’s Basic Health Plan, Disability Lifeline, and Alcohol and Drug Addiction Treatment and Support Act (ADATSA) programs. The largest of these three programs, the Basic Health Plan, now capped at 56,000 enrollees with a waiting list of 136,500, provides medical benefits to working adults in families with incomes up to 200 percent of the federal poverty level. A portion of this adult population will now qualify for Medicaid, subject to Medicaid income limits. The State of Washington was also awarded a $17.6 million CHIPRA bonus payment on December 27 for its exemplary efforts to increase enrollment of children, one of 15 states to earn that distinction, achieving the third highest award among all states (see Sam Fish’s item on CHIPRA bonuses).
About Tom Entrikin
A former policy specialist with the U.S. Health Care Financing Administration (now Centers for Medicare & Medicaid Services (CMS)), Tom Entrikin has vast experience providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; and Medicaid waiver programs.
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