Medicaid and Managed Care Plans
Using Federal Matching Funds to Ease Budgetary Pressures in Recessionary Periods
Unlike private insurance, Medicaid is a government-funded health insurance program that covers millions of Americans. This program is funded by the federal government through matching funds that ease budgetary pressures on states during recessionary periods. It is also administered by managed care plans, which provide health care services to Medicaid recipients.
Federal matching funds ease budgetary pressures on states during recessionary periods
Using federal matching funds to ease budgetary pressures on states during recessionary periods is not as simple as it sounds. For starters, state lawmakers must first identify the state’s most vulnerable departments and agencies, then decide which programs deserve the most funding. Then, they must consider the impact of inflation on major spending programs. A well-designed and executed program can ensure state taxpayers’ wallets are not left empty at the end of the month. In a time of austerity, federal matching funds can be a lifesaver.
The best way to go about it is to consider the state’s budget as a whole, not just the departments and agencies that comprise it. Getting the state’s budget in order can take years, if not decades, but with the federal government’s assistance, the state of Connecticut can reclaim its rightful place as a premier destination in the world of business.
Getting a state budget in order is a top priority for state lawmakers and their staff. The state is projected to face an operating deficit of $8 billion in 2026-27, but a slew of tax and fee changes, along with a growing state population, can keep the state’s budget in check for years to come. The state’s budget is accompanied by a host of other challenges, but state lawmakers will need to consider the big picture before committing to the proverbial punch bowl.
The state’s biggest challenges include funding higher education and ensuring access to quality healthcare for all. Despite these challenges, Connecticut has some bright spots, including the new state capital, a major university campus, and a state-of-the-art hospital. Fortunately, a healthy state budget is an opportunity for lawmakers to demonstrate fiscal restraint, which can only be good for Connecticut’s business climate and its citizens.
Coverage available to 12 million people
Counting a single person in the home care department, the healthcare juggernaut has a few stipulations and a few caveats. The sex and age restrictions may be a deal breaker, as may the etiquette that is akin to a dog on a leash. Those who want to be in the game must be rewarded with a healthy diet, plenty of exercises,s and a semblance of privacy to do so.
Of course, they must also be able to keep the kids out of the house. If the aforementioned conditions are met, they can enjoy a nirvana of health and quality of life. One could argue that the aforementioned is a worthwhile endeavor. Nevertheless, it would have been fun to have a family to hang out with. Fortunately, we are lucky enough to have some very close friends. Moreover, we have been fortunate enough to be surrounded by some of the best people in the business, most of whom are afflicted with good genes.
Income and asset limits
Whether you’re applying for Medicaid or simply need help understanding your options, it’s important to understand the asset and income limits for Medicaid. These limits will affect your eligibility, but there are many planning strategies to help you get past them.
First, it’s important to understand that there are two kinds of Medicaid: “Non-MAGI” and “Magic.” Non-MAGI Medicaid covers individuals who are disabled or receive SS Disability benefits. These individuals have an income limit below 250% of the federal poverty line.
“Magic” Medicaid covers individuals who are not eligible for SS Disability benefits. These individuals have a MAGI income limit of 138% of the Federal Poverty Line. This is equal to $1,563 per month for an individual in 2022.
The MAGI-based methodology uses the taxable income and tax filing relationships of an individual to calculate income. The state does not take into consideration any income disregards.
In addition to the MAGI methodology, some states have asset and income limits. While the federal minimum of $27,480 applies in most states, some states have higher limits.
In California, the asset limit will increase to $130,000 for an individual on July 1, 2022. This increase is the first of its kind in the state. The income limit for individuals with disabilities will also rise to 138% FPL in January 2023.
In New York, the asset limit will increase from $24,600 to $37,908 for an individual and a couple. This is an increase of 50 percent.
New York’s asset rules currently exclude cash assets, retirement funds, and homes. These rules are biased against people of color.
If you’re looking for assistance navigating Medicaid, it’s important to work with a professional. Using a Medicaid planner can help you and your family avoid asset transfers and become eligible for Medicaid.
Managed care plans provide Medicaid services
Almost 90 percent of Medicaid beneficiaries in the United States are enrolled in Medicaid managed care plans, a federally-mandated health care program. These plans provide access to a contracted network of providers. They also provide support services such as health education programs and care coordination. They are designed to improve access to the services Medicaid beneficiaries need.
In addition to the federal government’s oversight role, states have the flexibility to develop their own program requirements, including actuarially sound payments for Medicaid MCOs. They can also develop mandatory programs for certain geographic areas or populations. State policymakers are interested in ensuring that their Medicaid beneficiaries have access to the services they need.
The 2020 CMS Medicaid managed care final rule gives states flexibility in defining the scope of their managed care programs. It allows states to use any quantitative standard, including time and distance standards. It also removes the requirement for states to monitor distance and time standards. It also allows states to adopt a pass-through payment requirement.
Many states also require minimum provider rates in contracts with MCOs. These rates are typically tied to fee-for-service rates. Using this approach, states can maintain access to providers without increasing administrative costs. However, there are some challenges related to recruiting primary care providers and specialty providers.
State policymakers may lack data to monitor the quality of care offered by Medicaid-managed care plans. Monitoring access to care can help identify problems and guide program improvement. It can also serve as accountability.
In 2022, CMS plans to release technical assistance toolkits to address issues related to provider network adequacy and behavioral health access. It will also publish reporting templates for required managed care reports.
Federal law dictates that states may not reduce other welfare benefits
Providing federal welfare benefits to deserving families has been an ongoing debate for decades. The best practices for administering these programs have been honed over time. In fact, the average entitlement benefit was about $12,000 per year in 1995.
The best practices include the following: a) assigning support rights to eligible adults, b) providing child care assistance for children in need, c) monitoring and reporting fugitive felons, and d) promoting employment among the lucky few. As mentioned above, some states are using the block grant to provide adult-supervised living arrangements. The best practices associated with these programs have a high degree of success. In fact, there are currently eighteen states using the block grant to augment welfare programs.
In fact, the federal government is proposing to expand the block grant to include a new TANF program. Unlike the old-fashioned AFDC program, the new program is designed to stimulate the formation of two-parent households by enhancing the tenancy of eligible adults. The new program will also allow states to flex their fiscal muscles by increasing benefits through a consumer price index.
The new program also entitles states to reduce the maximum benefits level for families with a lower income. The new program can be considered a good first step in the direction of a more prosperous future. The program will also be required to share information about fugitive felons with law enforcement. The aforementioned measures will be rolled out in phases, with the most promising states starting in late 2016. Considering the new program’s modest budget, we can expect that it will have a big impact on welfare costs in the long term.
Health Sources:
Health A to Z. (n.d.). HSE.ie. https://www2.hse.ie/az/
U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
Directory Health Topics. (n.d.). https://www.healthline.com/directory/topics
Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
