In 2014, nearly all Americans with incomes below 133 percent of the Federal Poverty Level (FPL) will become eligible for Medicaid, without the requirement that they meet additional categorical eligibility criteria. Some people will be ineligible because of immigration status.
Newly eligible people who did not previously qualify for Medicaid on the basis of age, disability, or other categorical criteria are likely to get coverage for a benchmark benefit package that may not include some of the services covered under full scope Medicaid.10 According to the ACA, the minimum essential benefits offered by the benchmark benefit plans must include treatment services for mental health and substance use disorders as well as rehabilitation and habilitative services.11 Behavioral health treatment cannot be more limited than treatment for physical conditions.
HHS will provide additional guidance and rules for benchmark services, which may have a significant impact on the scope of services that will be available to newly eligible Medicaid beneficiaries, including chronically homeless people and formerly homeless people who are residents of PSH. However, state policy decisions will determine whether Medicaid will cover many of the services that are most often delivered in PSH, since many of these services will still be considered optional benefits. States will continue to decide whether to provide these services as covered benefits, as well as the qualifications that providers must meet before they can be certified to receive Medicaid reimbursement for the services they deliver.