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
For every step in the simulation process, our findings indicate that there is at least some variation across the states. Often, there is variation across programs within a state as well. Replicating this variation in simulation algorithms presents an enormous challenge to researchers and one that must invariably involve many simplifications. The d
Four of the federal government's national household surveys may appeal to users as potential data sources for estimates of the number of children who are eligible for Medicaid and SCHIP plans over the next several years:
While simulation models take different forms, a model that seeks to capture all aspects of the eligibility determination process must include each of the following steps, which are applied, in turn, to every household in the database:
Simulating eligibility for Medicaid and SCHIP involves applying state rules for determining program eligibility to the data collected in a household survey. The data would be sufficient for a step-by-step replication of the eligibility determination process, but this remains only an ideal. With data from SIPP, researchers have achieved a high leve
As we show in Chapter II, the variability of income eligibility rules for Medicaid and SCHIP programs is staggering. While we expected to find marked differences in rules across states, the degree of within-state differences was somewhat surprising. This level of variability has two important implications for efforts to simulate Medicaid and SCHIP
SCHIP programs are required to implement anti-crowd-out policies that prevent or discourage families and businesses from dropping a child's current coverage for coverage through the SCHIP program. Programs are implementing an array of policies, such as imposing waiting periods without health insurance--Alabama, California, Colorado, Connecticut, F
Presumptive eligibility rules in the Medicaid program allow certain, qualified health care providers to grant pregnant women immediate, typically 60 days, of Medicaid coverage at the provider site. Formal eligibility would be made during the presumptive period. SCHIP programs have the option of providing presumptive eligibility. In most states, th
The most challenging and complex rules are those pertaining to family composition. These rules are important because they affect whose income is counted in the unit and the poverty threshold against which family income is measured. Medicaid and SCHIP programs are allowed to establish their own rules for determining family size. Typically family si
TANF and 1931 Medicaid programs continue to use assets tests; frequently, these tests are the same for both programs. In our sample of 10 states, these tests have more generous limits for vehicles and other assets than was previously allowed under AFDC. 15, 16 While all states in our sample use an assets test for their TANF program, and nine use
States have some discretion over the types of income they may or may not count when determining eligibility for Medicaid and SCHIP. Earnings of persons included in the family unit are typically counted, but some states and programs do not count the earnings of children and students-- for example, Arkansas and Connecticut. Arkansas and California a
With some exceptions, few states had other significant disregards. 13 Connecticut's TANF program raised the irregular gift disregard to $200 per year, but the Medicaid programs use only a $30 yearly disregard for irregular gifts. The Medicaid program in New Jersey disregards all alimony payments. In California, the 1931 Medicaid program and the M
Medicaid and SCHIP programs are not required to provide a disregard for child support payments made or received. When a program uses this disregard, it typically uses the old AFDC standard of the first $50 received. California continues to use the old AFDC standard but also disregards all court-ordered child or spousal support payments made by the
Many programs continue to use the old AFDC standard disregard for child care expenses. 12 All the programs in Alabama, Florida, and New York that use a net income test employ this disregard. Some TANF programs, however, have dropped this disregard when the state implements other forms of child care support for TANF families--for example, programs