400.15 PARENT(S) AND OTHER CARETAKER RELATIVE(S) – (COE-075)

Coverage of parents and caretaker relatives has its roots in the Aid for Dependent Children (ADC) program that was in place when Mississippi implemented the Medicaid Program in 1969. Over the years, ADC became AFDC (Aid to Families with Dependent Children) as a succession of federal laws gradually added low-income pregnant women and single parents to the cash assistance program. With the passage of the Deficit Reduction Act of 1984, coverage of 2-parent families was implemented, creating the Medical Assistance Program (COE-085 – now obsolete) for low-income families with dependent children, which was still tied to AFDC cash assistance. The Personal Responsibility and Work Opportunity Act of 1996 (P.L. 104-193), commonly referred to as welfare reform, created the TANF block grant cash assistance program and de- linked Medicaid from cash assistance, establishing a new mandatory Medicaid eligibility group of low-income families with children under section 1931 of the Social Security Act. With the implementation of the ACA effective 01/01/2014, coverage of low-income families was split into Medicaid coverage for adults (parents and caretaker relatives), which is now separate from Medicaid coverage of children. Under the ACA, the Division of Medicaid must provide Medicaid to parent(s) and other caretaker relatives who have a dependent child or children under the age of 18 living in the home. Household income must be at/below the state set limit for the household size for COE-075. Factors of eligibility include the following: • The degree of relationship required for a caretaker relative is defined in Chapter 102, Non-financial Requirements, in section 102.11.03 that defines relationships. • Medicaid eligibility is also extended to the spouse of the parent or caretaker relative if the spouses live together and both apply. • The parent or caretaker relative must have primary responsibility for the dependent child under the age of 18 living in the home with them. Legal custody is not required to make a determination a parent or caretaker relative has primary responsibility for a child or children. • There is no requirement that the child or children also be an applicant in order for the adult (parents or caretakers) to be eligible. For example, a child may already have health insurance coverage through an absent parent and the applying parent may choose not to apply for the child. A parent or caretaker may apply on his/her own and qualify on the basis of a low-income parent or caretaker. • It is possible for one parent who is a member of an unmarried tax filer or non-filer couple to qualify as a low-income parent while the other parent cannot qualify due to excess income. For example, an unmarried couple lives together with their children. One parent works while the other parent either has no income or has income that does not count. The parent with no countable income can qualify as a low-income parent. • There is no requirement for a tax filer parent or caretaker relative in COE-075 to claim a child for tax purposes in order to qualify as that child’s primary caregiver. Tax filing status and dependent claiming determine household composition; it is not used to determine primary caretaker status. • A non-custodial parent, claiming a child not living with him/her as a tax dependent, cannot be eligible as a parent in COE-075 based on being the main caretaker for that child because the child does not live in the home. To qualify in COE-075, the non-custodial parent must have another child under age 18 who does live in the home. • In instances where a child or siblings live with a parent, grandparent or with other combinations of relatives, only one adult relative can be designated as the primary caregiver to the children to qualify in COE-075. Coverage of the adult parent or caretaker also brings into coverage the spouse of the parent or caretaker, provided the spouses live together. • The child support cooperation requirement for a parent or caretaker in COE- 075, as outlined in 102.08.06B, is a post-eligibility requirement under the ACA. If the applying adult indicates on the MAGI application that a parent of any of the children in the home lives outside the home and the applicant agrees to cooperate with child support services to collect medical support from the absent parent, then cooperation is established, and child support enforcement is handled as a post-eligibility function for the eligible adult.