Today the U.S. Department of Health and Human Services released
the final rule for Medicaid program eligibility changes under the Affordable Care Act (ACA). Similar to the exchange final rule
, certain provisions of the Medicaid final rule were issued as interim final, with a 45 day comment period. Under the ACA, individuals between ages 19 and 64 with incomes up to 133 percent of the federal poverty level (currently $14,856 for an individual and $30,656 for a family of four) are eligible for Medicaid coverage. Medicaid expansion will become effective in 2014 when the Exchanges begin operation. The federal government will pay 100 percent of the association expansion cost for the first three years and at least 90 percent after that.
The final rule announced today deviates from the August 2011 proposed rule enrollment rules. The proposed rule would have given the Exchanges the responsibility of determining who is eligible for Medicaid in order to facilitate "one-stop shopping" for coverage options. Under the final rule, however, states will now be able to choose whether the Exchange will enroll people in Medicaid or whether the state Medicaid agency alone will have that power.