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Proposed changes to Medicaid URGENT ACTION NEEDED

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  • Proposed changes to Medicaid URGENT ACTION NEEDED

    Please read and respond. Will only take 5 minutes. Thanks.


    CMS has recently issued a Notice of Proposed Rulemaking (NPRM) regarding the upcoming eligibility changes to Medicaid as result of the Affordable Care Act (ACA), but the proposed regulations will have significant NEGATIVE impact on some individuals with disabilities if implemented as proposed. CMS will only change the proposed rules if they receive a significant amount of feedback addressing the issue.

    It takes less than five minutes!

    In the proposed regulations, people who apply to Medicaid for health care coverage will see a significant change in the eligibility process. Unless we take action, states will be required to assess eligibility based on a measure of income called Modified Adjusted Gross Income or MAGI. The proposed regulations state that some--but not all--people with disabilities will be exempt from this new financial eligibility. People with disabilities who will be exempt include those who:
    · receive SSI,
    · are pregnant,
    · are over the age of 65,
    · receive Medicare (Part A or Part B).

    Everyone outside of these groups of individuals will be assessed for eligibility using the MAGI methodology. Anyone with modified adjusted gross income less than 133% of the federal poverty level for their family size (approximately $14,600 annually for an individual) will be enrolled in a LIMITED package of healthcare eligibility called a "benchmark" plan. The benchmark plan will not contain access to many of the long-term services and supports often needed by individuals with disabilities to live and work in the community. Individuals who are eligible for the benchmark plan will not be eligible for additional services traditionally offered through waiver programs (such as respite care, expanded personal attendant services and supported employment). Further, any individuals who are enrolled in the benchmark plan will no longer have the choice to enroll in other optional Medicaid programs – such as a Medicaid Buy In program (healthcare coverage for workers with disabilities).

    The main concerns with the proposed regulations are that:
    1) Some people with disabilities will be worse off following ACA implementation because they will no longer be able to access long-term care services needed to live and work in the community;
    2) Once someone is placed in a benchmark plan, there is not a process in place to ensure that if needs are not met due to disability or new onset of disability, that the individual will be able to access long-term care services needed to live and work in the community; and
    3) Some people with disabilities will be under-insured in 2014 because they will not have access to long-term services and supports needed to live and work in the community.

    Go to:

    Comment: You can develop your own comments or copy and paste the text below into the “Type Comment” box and (if you choose) personalize your comments. Even if you don't have time to personalize your comments, PLEASE SUBMIT THE TEXT BELOW!

    Individuals with disabilities, which incudes me who are currently receiving services to live independently in the community and who need access to long-term care should not be adversely impacted by ACA implementation. People with disabilities should be exempt from the Modified Adjusted Gross Income methodology and be able to make an INFORMED CHOICE about enrolling in the healthcare package that best meets their needs – whether that is the benchmark plan or a traditional Medicaid program.

    Individuals with disabilities should be eligible for long-term care services based on need and should be eligible to receive the services in the most integrated setting. Individuals with disabilities who are found eligible for Medicaid should not be placed in the benchmark plan if their functional level of need makes them eligible for services that are not available through that plan. Individuals incorrectly placed in a benchmark plan – or those who experience the onset of disability following an initial determination – with a need for long-term services and supports should be able to move to a different category of eligibility so that they can access those additional services.

    CMS needs to allow individuals with disabilities to work with community organizations to expedite eligibility for individuals who require a higher level of care than provided by benchmark plans.

    Please modify the rules to assure that people with disabilities will not be worse off following ACA implementation because they will no longer be able to access long-term care services needed to live and work in the community.

    My blog: Living Life at Butt Level

    Ignite Phoenix #9 - Wheelchairs and Wisdom: Living Life at Butt Level

    "I will not die an unlived life. I will not live in fear of falling or catching fire. I choose to inhabit my days, to allow my living to open me, to make me less afraid, more accessible, to loosen my heart until it becomes a wing, a torch, a promise. I choose to risk my significance; to live so that which comes to me as seed goes to the next as blossom and that which comes to me as blossom, goes on as fruit."

    Dawna Markova Author of Open Mind.

  • #2
    It does not take much time at all to fill in your name, address etc. and then room for your personal comments. Thanks Jen for the info, I know I do not need my medicaid changed.
    JeAnNE L1Burst Fracture inc. 11/5/10

    Live Well--Laugh often


    • #3
      I filled out the form it is good to be heard
      Thank you Jen Jen


      • #4
        Thanks for the link and info.