State Approaches to Diversion Programs and Activities under Welfare Reform: Table V-1: State Options to Affect Medicaid Eligibility Post-PRWORA

State Approaches to Diversion Programs and Activities under Welfare Reform

**Table V-1: State Options to Affect Medicaid Eligibility Post-PRWORA**
OPTION	AUTHORIZING AUTHORITY	REQUIREMENTS	FLEXIBILITY	DURATION
1. Modify income and resource standards and methodologies.	Section 1931(b) of the PRWORA Nominal HCFA Approval of State Medicaid Plan Amendment	Must apply uniformly to all populations with type of income or resource	May target certain income/resources for disregards (e.g., lump sum diversion payment; first three months of earned income)	Indefinite
2. Continue Title IV-A waivers terms affecting Medicaid eligibility.	Section 1931(d) of the PRWORA Nominal HCFA Approval	Waiver submitted prior to 8/22/96 and approved on/before 7/1/97 Limited to waivers of: income and resource standards and methodologies; deprivation requirements; and caretaker relative requirements	Individuals subject to IV-A waivers in some states retain Medicaid eligibility if they would have been eligible in the absence of the demonstration - in this case state must continue welfare reform demonstration on exactly same terms	Indefinite - even though welfare reform demonstration may expire or be terminated by state, IV-A waiver terms affecting Medicaid eligibility can continue indefinitely
3. Continue Title XIX waivers. Seek new Title XIX waivers.	Section 1115 of the Social Security Act HCFA Approval for both continuation and new	Existing waiver is not required to meet budget neutrality test New waiver approved after 8/22/96 must comply with budget neutrality requirements		Expire at end of IV-A demonstration
4. Continue existing Section 1115 Medicaid waivers. Seek new Section 1115 Medicaid waivers.	Section 1115 of the Social Security Act HCFA approval	Waiver must comply with budget neutrality requirements	May expand eligibility to near poor	Waivers usually limited to 5 years
5. Expand eligibility for pregnant women and children	Section 1902r(2) of the Social Security Act		May apply more liberal income and resource methodologies for pregnant women and children	Indefinite

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