Analysis of Eligibility Changes and Implications for Selected Medicaid and CHIP Eligibility Groups

The Patient Protection and Affordable Care Act (ACA) has prompted the Centers for Medicare and Medicaid Services (CMS) to promulgate Medicaid and CHIP eligibility rules designed to simplify and collapse Medicaid eligibility categories in preparation for the changes in Medicaid that will become effective under the ACA in 2014. The changes in eligibility categories apply primarily to low-income children and adults whose eligibility is not tied to being elderly, disabled, or needing long term services and supports. This issue brief provides a detailed overview of the final federal Medicaid eligibility rules, transition issues and decision points that states will need to consider as they prepare to convert to the collapsed eligiblity categories in 2014.