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210-RICR-30-00-1 TITLE 210 – EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES CHAPTER 30 – MEDICAID FOR CHILDREN, FAMILIES, AND AFFORDABLE CARE ACT (ACA) ADULTS SUBCHAPTER 00 – AFFORDABLE COVERAGE GROUPS PART 1 – Medicaid Affordable Care Coverage Groups Overview and Eligibility Pathways 1.1 Overview A. The principal purpose of the Federal Patient Protection and Affordable Care Act (ACA), Pub. Law No. 111-148, was to increase access to health care by leveraging resources, expanding choice, and removing the administrative, financial, and legal barriers that have prevented people from obtaining the coverage they need. Toward this end, the ACA: 1. Consolidated many of the existing Medicaid coverage groups associated with the now defunct Federal Aid to Families with Dependent Children Program (AFDC) into three (3) broad categories: children, pregnant people and newborns, and parents/caretaker relatives; 2. Created an optional Medicaid coverage group for adults between the ages of nineteen (19) and sixty-four (64) who otherwise do not qualify for Medicaid and are not eligible for or enrolled in Medicare; 3. Established a new income counting methodology – Modified Adjusted Gross Income (MAGI) - for evaluating income eligibility for Medicaid and other publicly supported forms of affordable commercial coverage across these populations; 4. Eliminated distinctions in the financial criteria and standardized the income eligibility requirements for the Medicaid populations subject to the MAGI. This, in turn, made it possible for the States to reorganize the MAGI-eligible populations with similar characteristics into distinct, easily identifiable, Medicaid affordable care coverage (MACC) groups; 5. Mandated that the States automate the application and renewal process for populations subject to the MAGI methodology by building the capacity to determine eligibility on-line and conduct electronic verifications through a variety of government approved data sources; and 6. Applied these changes not only to Medicaid, but also to the Children’s Health Insurance Program (CHIP), which is administered through the Medicaid program in Rhode Island, and HealthSource RI (HSRI), the State’s health insurance marketplace.