Simulation of Medicaid and SCHIP Eligibility: Implications of Findings From 10 States. Final Report.. Footnotes


1. The rules and policies discussed in this report are current as of January 1, 1999.

2. Within our sample of 10 samples, all but Arkansas, California, and New York automatically enroll TANF recipients into the Medicaid program.

3. The Community Tracking Survey was not included in our assessment of household surveys because the community focus of the sample does not make it an obvious choice for state-level simulation.

4. Applicants to AFDC first had to pass a gross income test which was set at 185 percent of the Federal poverty level. If gross income was below this threshold, then net income was determined and compared against the state's threshold for net income.

5. The Colorado Medicaid poverty expansion program and the S-SCHIP program do not use an earnings disregard. We classify these programs as using a net income test because they use child support and child care disregards, and the S-SCHIP program disregards all medical care bills due and payable within 12 months.

6. Data reported by the National Academy for State Health Policy show that, as of the summer of 1998, 13 M-SCHIP programs and 14 S-SCHIP programs used a gross income test (NASHP 1999).

7. In Florida, the Healthy Kids program for school-age children and their siblings uses a gross income test; the MediKids program, which is a Medicaid look-alike program for preschoolers, uses a net income test.

8. Need and payment standards are set by the states. The need standard reflects the dollar amount a "needy person" requires to obtain basic essentials such as housing and food. The payment standard is the maximum cash benefit paid by the AFDC program. The payment standard is frequently below the need standard. States use a variety of methods to calculate these standards, but all adjust them for family size.

9. The earnings disregard in the Massachusetts TANF program distinguishes between those who are or are not exempt from work requirements. People exempt from work requirements are subject to old AFDC standard earnings disregard policies, while nonexempt people have a more generous earnings disregard.

10. Under AFDC, applicants with earnings received a $90 disregard for work expenses. Recipients with earnings received the $90 disregard, plus an additional $30 disregard plus one-third of remaining earnings for the first four months of earnings. The disregard was then reduced to $90, plus $30 for months 5 through 12. After month 12, recipients with earnings received only a $90 earnings disregard.

11. The 1931 Medicaid program in California uses the $90 disregard for applicants, but has developed new earnings disregards for recipients, which differ from those used by the TANF program.

12. The old AFDC standard disregards the first $175 in child care expenses per month per child if the child is at least two years of age, and $200 per month per child if the child is less than two years old.

13. State Medicaid programs continue to use small disregards for gifts.

14. Connecticut's TANF program counts eight percent of the payment standard when the assistance unit is subject to the time limit, but eight percent of the need standard otherwise.

15. In this sample of 10 states, all continue to exclude the value of homes in assets tests.

16. The old AFDC asset test was to disregard the first $1,500 in equity value of one vehicle and to limit eligible families to no more than $1,000 in countable assets. Countable vehicle assets would include the difference between the equity value of the one vehicle and the $1,500 disregard plus the full equity value of any other vehicles. Vehicles used for commercial purposes were excluded.

17. The poverty expansion program in Colorado uses the asset test for children but not pregnant women.

18. The S-SCHIP programs in Colorado and New Jersey count the benefits received by adult SSI beneficiaries, but not those of child SSI beneficiaries.

19. To be eligible for the TANF program in Arkansas, net income must be less than $223 regardless of family size. Eligibility for the Medicaid 1931 program occurs when net income is less than the payment standard which is $204 for a family of three.

20. States are no longer mandated to provide Medicaid coverage to welfare recipients, although half of the states in our sample told us they automatically enroll TANF recipients into Medicaid. States must enroll all applicants who meet their 1931 eligibility requirements and the 1931 requirements must be as generous as those in place on July 16, 1996 for AFDC recipients.

21. We were restricted to considering three-person households because our data on the need and payment levels that are used to determine income threshold tests in some TANF and many Medicaid 1931 programs pertain only to three-person families.

22. We chose this type of age distribution because the Medicaid poverty expansion programs have mandated income thresholds that differ depending on whether the child is younger or older than six years of age.

23. In Arkansas it is ARKids first, a 1115 waiver program that the state intends to convert into a S-SCHIP program.