Medicare Compliance & Reimbursement

Change would end income loophole for many families.

States could allow middle-income families with disabled children to buy into Medicaid under legislation approved by the Senate in a May 6 voice vote.
 
"Many parents of disabled children have to drop out of the workforce or keep themselves in a low-paying job just to remain eligible for Medicaid," said Sen. Chuck Grassley (R-IA), who teamed with Sen. Edward Kennedy (D-MA) to introduce the Family Opportunity Act, S 622.

Often private insurance does not cover the broad array of benefits, such as physical therapy and medical equipment, that disabled children need, Grassley
said in a statement. Even when these benefits are offered, they often come with unaffordable copayments, added the Finance Committee chair.

To address this, S 622 would give state Medicaid programs the right to cover families with children who would be eligible for Supplemental Security Income disability payments but for family income or resources.  In states that exercised this option, families with incomes up to 250 percent of the federal poverty level could purchase Medicaid coverage on an income-based sliding premium scale.

The Grassley-Kennedy legislation is scored at $7 billion over 10 years. Rep. Pete Sessions (R-TX) has introduced companion House legislation (HR 1811), but the Energy and Commerce Committee has yet to consider the bill. A Senate Democratic aide said May 6 that Sessions was encountering substantial resistance in the lower chamber.