Skip to content Skip to navigation

Medicaid Headed for Expansion in 2014

January 14, 2013
by Rajiv Leventhal
| Reprints

Under the Affordable Care Act, millions of Americans will gain access to affordable health coverage through Affordable Insurance Exchanges (also known as health insurance marketplaces) and improvements in Medicaid and the Children’s Health Insurance Program (CHIP) in 2014. Health and Human Services (HHS) Secretary Kathleen Sebelius has announced a proposed rule that promotes consistent policies and processes for eligibility notices and appeals in Medicaid, the Children's Health Insurance Program (CHIP) and Exchanges, and give states more flexibility when operating their Medicaid programs.

“Before the health care law was passed, millions of Americans were unable to obtain or afford quality health coverage,” Sebelius said in a statement. “Today, we are proposing a rule to provide Americans with access to affordable, high quality health coverage and give states more flexibility to implement the law in a way that works for them.”

Beginning in 2014, the health care law provides new opportunities for Medicaid coverage for adults who earn up to 133 percent of poverty—$14,865 for an individual or $30,656 for a family of four.  Other Americans looking for coverage will be eligible to buy it through a health insurance marketplace, where many will be eligible for tax credits to make coverage more affordable.  The proposed rules will help develop systems that will make it easy for consumers to determine if they are eligible for Medicaid or tax credits that make insurance more affordable. 

The proposed rule includes information on how consumers will receive coordinated communications on eligibility determinations and can appeal eligibility determinations.  It gives states flexibility in designing benefits and determining cost sharing in the Medicaid program.  The proposed rule also provides flexibility to state-based Exchanges by allowing them to choose to rely on HHS for verifying whether an individual has employer-sponsored coverage and conducting some types of appeals.



EHNAC and HITRUST Combine HIPAA Security Criteria, CSF Framework

The Electronic Healthcare Network Accreditation Commission (EHNAC) and the Health Information Trust Alliance (HITRUST) announced plans to streamline their accreditation and certification programs.

Halamka on MACRA Final Rule: “CMS is Listening and I Thank Them”

Health IT notable expert John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center in Boston, recently weighed in on the Medicare Access and CHIP Reauthorization Act (MACRA) final rule.

Texas Patient Care Clinic Hit with Ransomware Attack

Grand Prairie, Texas-based Rainbow Children's Clinic was the victim of a ransomware attack on its IT systems in August, affecting more than 33,000 patients, according to multiple news media reports this week.

Healthcare Organizations Again Go to Bat for AHRQ

Healthcare organizations are once again urging U.S. Senate and House leaders to protect the Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) from more budget cuts for 2017.

ONC Pilot Projects Focus on Using, Sharing Patient-Generated Health Data

Accenture Federal Services (AFS) has announced two pilot demonstrations with the Office of the National Coordinator for Health Information Technology (ONC) to determine how patient-generated health data can be used by care teams and researchers.

Is it Unethical to Identify Patients as “Frequent Flyers” in Health IT Systems?

Several researchers from the University of Pennsylvania addressed the ethics of behavioral health IT as it relates to “frequent flyer” icons and the potential for implicit bias in an article published in JAMA.