In a message dated 10/28/2011 2:26:37 P.M. Central Daylight Time,
[email protected] writes:
URGENT TIME SENSITIVE ACTION ALERT: LAST DAY TO RESPOND IS MONDAY, October
31st
CMS has recently issued a Notice of Proposed Rulemaking (NPRM) regarding
the upcoming eligibility changes to Medicaid as result of the Affordable
Care Act (ACA), but the proposed regulations will have significant NEGATIVE
impact on some individuals with disabilities if implemented as proposed.
CMS will only change the proposed rules if they receive a significant amount
of feedback addressing the issue.
PLEASE RESPOND ASAP!
It takes less than five minutes!
BACKGROUND:
In the proposed regulations, people who apply to Medicaid for health care
coverage will see a significant change in the eligibility process. Unless
we take action, states will be required to assess eligibility based on a
measure of income called Modified Adjusted Gross Income or MAGI. The proposed
regulations state that some--but not all--people with disabilities will be
exempt from this new financial eligibility. People with disabilities who
will be exempt include those who:
· receive SSI,
· are pregnant,
· are over the age of 65,
· receive Medicare (Part A or Part B).
Everyone outside of these groups of individuals will be assessed for
eligibility using the MAGI methodology. Anyone with modified adjusted gross
income less than 133% of the federal poverty level for their family size
(approximately $14,600 annually for an individual) will be enrolled in a
LIMITED
package of healthcare eligibility called a "benchmark" plan. The benchmark
plan will not contain access to many of the long-term services and supports
often needed by individuals with disabilities to live and work in the
community. Individuals who are eligible for the benchmark plan will not be
eligible for additional services traditionally offered through waiver programs
(such as respite care, expanded personal attendant services and supported
employment). Further, any individuals who are enrolled in the benchmark plan
will no longer have the choice to enroll in other optional Medicaid
programs – such as a Medicaid Buy In program (healthcare coverage for workers
with disabilities).
The main concerns with the proposed regulations are that:
1) Some people with disabilities will be worse off following ACA
implementation because they will no longer be able to access long-term care
services needed to live and work in the community;
2) Once someone is placed in a benchmark plan, there is not a process
in place to ensure that if needs are not met due to disability or new
onset of disability, that the individual will be able to access long-term care
services needed to live and work in the community; and
3) Some people with disabilities will be under-insured in 2014
because they will not have access to long-term services and supports needed to
live and work in the community.
TAKE ACTION
Go to: _http://ly.adapt.org/J_ (http://ly.adapt.org/J)
Comment: You can develop your own comments or copy and paste the text
below into the “Type Comment” box and (if you choose) personalize your
comments. Even if you don't have time to personalize your comments, PLEASE
SUBMIT
THE TEXT BELOW!
Individuals with disabilities who are currently receiving services to live
independently in the community and who need access to long-term care
should not be adversely impacted by ACA implementation. People with
disabilities should be exempt from the Modified Adjusted Gross Income
methodology and
be able to make an INFORMED CHOICE about enrolling in the healthcare
package that best meets their needs – whether that is the benchmark plan or a
traditional Medicaid program.
Individuals with disabilities should be eligible for long-term care
services based on need and should be eligible to receive the services in the
most
integrated setting. Individuals with disabilities who are found eligible
for Medicaid should not be placed in the benchmark plan if their functional
level of need makes them eligible for services that are not available
through that plan. Individuals incorrectly placed in a benchmark plan – or
those who experience the onset of disability following an initial
determination – with a need for long-term services and supports should be able
to move
to a different category of eligibility so that they can access those
additional services.
CMS needs to allow individuals with disabilities to work with community
organizations to expedite eligibility for individuals who require a higher
level of care than provided by benchmark plans.
Please modify the rules to assure that people with disabilities will not
be worse off following ACA implementation because they will no longer be
able to access long-term care services needed to live and work in the
community.
THANK YOU FOR TAKING ACTION!!!
