400.16 MAGI FEDERAL POVERTY LEVEL PROGRAMS OVERVIEW

Prior to implementation of federal poverty level programs, children and pregnant women were covered under the AFDC program, using cash assistance policy and need standards based on cash assistance. Below is a brief history of the implementation of programs based on using federal poverty levels as the need standard: Legislation Children Pregnant Women Omnibus Reconciliation Act of 1986 (P.L. 99-509) allowed states the option of providing Medicaid to pregnant women & infants using 100% FPL MS legislature implemented optional Medicaid coverage for this group effective October 1, 1987 Infants to age 1 at/below 100% FPL Children born on or after October 1, 1986, up to age 5. Program for children & pregnant women called “Expanded Medicaid” with a program code of “87,” referring to the year legislation authorized implementation. Pregnant women at/below 100% FPL • Allows for needs of unborn • Allows for 12 months post-partum eligibility after delivery • Allows point in time eligibility, i.e., once determined eligible, eligibility continues without regard to any increase(s) in income • Resource test applied. Legislation Children Pregnant Women Omnibus Reconciliation Act of 1987 (P.L. 100-203) allowed states the option of providing Medicaid to pregnant women & infants using 185% FPL MS legislature implemented optional Medicaid coverage for this group effective October 1, 1988. Infants to age 1 at/below 185% FPL Program for children & pregnant women called “Infant Survival” with a program code of “88,” referring to the year legislation authorized implementation. Infants to age 1 transitioned to COE-071 effective 01/01/2014. Pregnant women at/below 185% FPL • Resource test eliminated COE-O88 continues for coverage of pregnant women & minors. Omnibus Reconciliation Act of 1989 (P.L. 101-239) mandated expansion of coverage of pregnant women and children to age 6 using 133% FPL This was a mandated expansion of the “87” group, effective July 1, 1990. COE-087 ended with the implementation of the ACA. Children age 1 to age 6 transitioned to COE-072 effective 01/01/2014. No change needed for pregnant women; MS already covered pregnant women to 185% FPL. Omnibus Reconciliation Act of 1990 (P.L. 101-508) mandated phased in coverage of children born after 09/30/1983 who have not yet attained age 19 using 100% FPL Effective July 1, 1991, this law phases in coverage of children to age 19 at/below 100% FPL. The “Poverty Level” program with a program code of “91,” was implemented. No change needed for pregnant women; MS already covered pregnant women to 185% FPL. Legislation Children Pregnant Women COE-091 ended with the implementation of the ACA. Children age 6 to age 19 transitioned to new COE’s as follows effective 01/01/2014: COE-073 for children in families with income at/below 100% FPL, COE-074 for children in families with income above 100% FPL but at/below 133% FPL. The Balanced Budget Act of 1997 (P.L. 105-33) established the Children’s Health Insurance Program (CHIP), allowing states to cover uninsured children in families with income at/below 200% FPL. The MS legislature implemented CHIP Phase I on July 1, 1998, as a Medicaid expansion program for children up to age 19 at/below 100% FPL. Effective January 1, 2000, Phase II of CHIP provided coverage for children up to Uninsured children to age 19 at/below 200% FPL. Child cannot be eligible for Medicaid. COE-099 continues to cover CHIP children – Effective 01/01/2014, CHIP coverage is for children in families with income greater than 133% FPL but at/below 200% FPL Pregnant minors eligible in CHIP are transitioned to COE- 088 for coverage during pregnancy and for the 12 month postpartum period, provided the pregnancy is discovered or reported prior to delivery of the child. A pregnant minor can be covered under CHIP with the following limitations: • The needs of the unborn child are not considered under CHIP, • A child born to a CHIP mother is not considered a deemed newborn, the mother must apply separately Legislation Children Pregnant Women age 19 at/below 200% FPL under a separate health plan. for coverage of the infant.