State waivers for Nevada and Utah receive CMS approval

Waivers providing for extension of health care coverage in Nevada and Utah have been approved by the Centers for Medicare & Medicaid Services.

The Nevada waiver expands health care coverage to an estimated 1,700 children whose parents have lost their jobs. Under the plan, the state will no longer count a parent’s unemployment compensation when determining a child’s eligibility for the Children’s Health Insurance Program (CHIP). Nevada’s program now provides coverage to some 28,000 children from families with annual incomes up to 200% of the federal poverty level.

The Utah Medicaid demonstration waiver will expand benefits for primary care and preventive services to some 25,000 residents who otherwise would not have access to health care coverage. Those coming into coverage will be adults age 19 and older with annual incomes under 150% of the federal poverty level.

Officials said Utah was able to expand its Medicaid population by adjusting benefits to some individuals already in the program and by instituting an annual $50 enrollment fee for the newly eligible enrollees and others who are eligible for Medicaid at the state’s option. Mandatory-eligible beneficiaries will not have to pay an enrollment fee.

New enrollees will receive primary and preventive care benefits. Some of the state’s currently enrolled Medicaid recipients will receive a benefit package that resembles the state’s CHIP plans. The state also will simplify its enrollment process and screen applicants for enrollment in the expansion group to ensure they are not already eligible for Medicaid.

In addition to the adults over age 19 with incomes at 150% of the poverty level, Utah proposes to provide full Medicaid coverage to 150 high-risk pregnant women each year whose assets are in excess of that currently permitted by the state. The women will be exempt from the enrollment fee and any increased cost sharing. The state also has exempted children, the elderly, blind, disabled, and pregnant women from the changes in the benefit package.

In both cases, HHS secretary Tommy Thompson said the agency’s goal was to give states the flexibility they need to strengthen their Medicaid programs and provide health care coverage to additional citizens through innovative efforts.