December 22, 2003
States Are Cutting 1.2 to 1.6 Million Low-Income People from Medicaid,
SCHIP and Other State Health Insurance Programs
by Leighton Ku and Sashi Nimalendran
States That Cut Enrollment in Medicaid, SCHIP or Other State Health Insurance Programs:
Summary of State Policies and Impacts
Estimate of Number Affected
Brief Description of Cuts
1.2 million to 1.6 million (490,000 to 650,000 children)
Cuts adopted in 34 states in state fiscal years 2003 and 2004. Almost half of the cuts are for children, but there also are cuts for low-income parents, senior citizens, people with disabilities, childless adults, and immigrants.
3,000 to 4,000
Stopped admitting eligible low-income children in SCHIP
Reduced income limit for children in SCHIP from 200 percent of the poverty line ($38,000 for a family of three in Alaska) to 175 percent ($33,000). Eliminated inflation adjustments on income limits for children in SCHIP and for pregnant women and aged and disabled people in Medicaid, so that income limits effectively fall over time.
Created enrollment barriers by requiring children, adults and certain aged and disabled people to submit paperwork every 6 months, rather than permitting 12-month continuous eligibility.
Increased monthly premium for certain disabled children who need medical care at home.
250,000 to 500,000
Created barriers that make it harder for low-income parents to stay enrolled in Medicaid. (In addition, Gov. Schwarzenegger has just proposed to stop enrolling eligible low-income children in SCHIP and to stop admitting immigrants in other health coverage programs, affecting an additional 114,000 children and 78,000 immigrants. These proposals are not included in the estimates of cuts already enacted in California.)
Stopped admitting eligible low-income children and pregnant women in SCHIP. (Also passed legislation to end Medicaid coverage for 3,500 legal immigrants. This is currently subject to an injunction because of a legal challenge and is not counted in our estimate.)
Reduced Medicaid income eligibility limit for low-parents from 150 percent to 100 percent of the poverty line (from ($22,890 to $15,260 for a family of three). Because of an injunction, this is delayed since many of these parents will retain transitional Medicaid benefits, but they will lose coverage when their transitional benefits expire. Created enrollment barriers for children that make it harder to apply for Medicaid from clinics and that make it harder to remain enrolled. Stopped admitting recent legal immigrants to Medicaid.
Stopped admitting low-income eligible children in SCHIP and now place them on a waiting list. About 44,000 have been placed on this list since July 2003. This adds to a waiting list of about 27,000 that already existed for immigrant and other children. Cut income eligibility limits for seniors and people with disabilities from 90 percent of the poverty line to 88 percent (from $8,082 for a single senior to $7,902)
32,000 to 40,000
Created enrollment barriers by requiring Medicaid children to submit paperwork every 6 months, rather than permitting 12-months coverage. Reduced Medicaid income limits for seniors and people with disabilities by narrowing methods of computing disposable income (currently blocked by lawsuit, so this cut is not counted).
Increased premiums for working disabled people's Medicaid coverage.
Tightened requirements so that fewer people who have left welfare for work retain their Medicaid coverage.
Increased monthly premiums for children in SCHIP. Terminated Medicaid coverage of parents who do not meet work requirements in welfare program. Reduced amount that an institutionalized person's spouse can keep.
Reduced Medicaid income limit for seniors and people with disabilities by narrowing methods of counting disposable income.
Stopped admitting eligible children in SCHIP who have incomes between 200 percent and 300 percent of the poverty line (between $30,520 and $45,060 for a family of three). Imposed monthly premiums for children with incomes between 185 percent of the poverty line and 200 percent ($28,230 to $30,520 for a family of three) in SCHIP, reducing enrollment of children in that income range by about half.
Temporarily ended insurance coverage for certain long-term unemployed people. Eliminated health insurance eligibility for certain immigrants. Increased premiums for some low-income children in Medicaid. Reduced Medicaid eligibility for certain adults by adding an asset limit.
Cut eligibility and benefits for certain low-income adults who do not have children. Reduced Medicaid eligibility for newborn babies whose mothers were on Medicaid from 24 months to 12 months. Other miscellaneous cuts.
Lowered Medicaid income eligibility limit for parents from 100 percent of the poverty line to 77 percent (from $15,260 for a family of three to $11,750). This is somewhat delayed because of a court injunction, but the parents will lose Medicaid coverage when their transitional Medicaid benefits expire.
Stopped admitting eligible low-income children in SCHIP and place them on a waiting list.
Cut income eligibility limits for children and parents by changing methods of counting income and household composition. This is delayed by a court injunction, but the people will lose coverage when their transitional Medicaid benefits expire. Created enrollment barriers by making it more difficult for children to apply for Medicaid from health clinics. Ended Medicaid coverage for poor 19 and 20 year olds.
Cut Medicaid income limits for unemployed workers by changing methods of accounting for unemployment benefits.
Stopped admitting new low-income parents applying for NJ Family Care. Terminated coverage for certain immigrants and adults.
Reduced Medicaid eligibility limits for certain seniors and people with disabilities by changing methods computing assets in determining eligibility. Reduced Medicaid coverage for low-income parents who left welfare for work from two years to one.
Reduced Medicaid eligibility for two-parent families with a parent who works more than 100 hours per month . Narrowed eligibility for certain seniors.
Ended Medicaid coverage for low-income parents, children and seniors whose disposable incomes are reduced because of higher medical expenses.
Increased monthly premiums for low-income people in the Oregon Health Plan (standard). Also restricted other eligibility criteria. Ended Medicaid coverage for those whose disposable incomes are reduced because of high medical expenses. Cancelled earlier plans to expand coverage for adults with incomes over the poverty line.
Increased monthly premiums for families (including children) in Rite Care.
Reduced Medicaid income limit for parents by adding a limit on gross income. Created enrollment barrier by increasing paperwork requirements to renew children's Medicaid coverage.
Broad reductions in eligibility for TennCare. About 200,000 lost coverage in mid-2003 when the state required that large numbers of beneficiaries reapply. While the state has permitted a grace period for those who lost coverage to reapply, only a limited number are expected to successfully re-enroll. Reduced eligibility for "uninsurable" people with chronic health problems who cannot get private health insurance. Stopped admitting a large number of eligible of low-income children into TennCare.
345,000 to 495,000
Imposed an asset test for children in SCHIP, added monthly premiums and made it harder for children to stay enrolled in SCHIP. This will reduce enrollment in SCHIP by about one-third. Those who gain SCHIP coverage will not be able to use medical care in the first three months. Created enrollment barriers for children in Medicaid by rescinding a plan to streamline eligibility by letting the children stay enrolled for 12 months. Cut Medicaid income eligibility limit for pregnant women from 175 percent of the poverty line to 158 percent (from $21,210 for family of two to $19,150). Eliminated Medicaid eligibility of low-income adults whose disposable income is reduced because they have high medical expenses. Terminated Medicaid coverage for parents who are unable to meet work requirements for welfare.
Stopped admitting eligible, low-income children in SCHIP.
Increased monthly premiums for certain low-income adults, children and seniors in health coverage programs.
Reduced eligibility that lets low-income adults retain Medicaid when they leave welfare for work. Eliminated inflation adjustments in Medicaid income limits for certain seniors and people with disabilities.
Ended Medicaid eligibility for recent legal immigrants. Increased enrollment barriers for children and parents that make it more difficult for them to stay enrolled in Medicaid. Plan to increase premiums for low-income children in Medicaid. Reduced enrollment cap for Basic Health program by 36,000.
Created enrollment barriers for working families applying for BadgerCare by requiring further paperwork to verify income. Increased premiums for families with incomes greater than 150 percent of the poverty line. Reduced eligibility for seniors by modifying methods of counting assets and changing rules related to amounts that spouses may retain.
Full Report: PDF, HTML | Press Release: PDF, HTML
State by State Data: Map of States, PDF, HTML