2023 Updated Increases Announced for Medicaid and Medicare Savings Program for Disabled/Age 65+/ Blind - View Webinar recording from Jan. 18, 2023
28 Feb, 2023
2/10/23 UPDATE - NYS Dept. of Health updated the income and resource limits based on the 2023 Federal Poverty Levels. See NYS DOH GIS 23 MA/02 - 2023 Federal Poverty Levels and ATTACHMENT New York State Income and Resource Standards for Non-MAGI Population. These update the levels previously announced by NYS in December 2022 for 2023. See tables below. GIS 23 MA/02 specifies that the updated figures are to be used for all new and pending applications and for any redeterminations made since Jan. 1, 2023.
WHAT IS CHANGING -- Starting in 2023, financial eligibility has expanded for MEDICAID and the Medicare Savings Program for New Yorkers age 65+ and those who have disabilities. These changes were enacted in the NYS Budget for 2022-23. While advocates did not get everything, NYLAG thanks the Governor and Legislature for following California's lead in taking important steps to make health care more affordable for all and address racial disparities in health care. Unfortunately, undocumented immigrants age 65+ were scheduled to qualify for Medicaid starting Jan. 2023, but the Governor has proposed to delay this and the expansion of the Essential Plan for a year until 2024.
View recording of NYLAG's Jan. 18, 2023 webinar on these changes and how to help clients benefit from them - and download the materials --
The campaign ito expand Medicaid access and reduce racial disparities in health care sn't over - in Nov. 2022, advocates renewed their request to Gov. Hochul to repeal, or at least expand the asset limit in the SFY 2023-24 Budget.
IN THIS ARTICLE:
I. Five Key Changes Coming in 2023
II. Timing - When Will This Happen in 2023 - and What Can You Do To Help Consumers?
III. Background on Campaign to Expand Medicaid & MSP for Older New York & Those with Disabilities - and What's Next
I. FIVE Key Changes Coming in 2023
A. Increased Medicaid Income Limit for 65+, Blind, or Disabled INCOME LIMIT will increase to the same limit used for MAGI for people under 65 who do not have Medicare -- 138% of the Federal Poverty Line (FPL).
Feb. 10, 2023 - DOH updated the new 2023 income and resource limits in NYS DOH GIS 23 MA/02 - 2023 Federal Poverty Levels and ATTACHMENT - New York State Income and Resource Standards for Non-magi Population. These update the earlier GIS 22 MA/11 also GIS 22 MA/14 - 2023 Medicaid Levels and Other Updates and Attachment 1 (Chart of Eligibility Levels)
B. INCREASED MEDICAID ASSET LIMIT
* Initially, in Dec. 2022, DOH announced lower limits than the ones above, based on 2022 Federal Poverty Levels - in GIS 22 MA/14. They were increased to the amounts above with NYS DOH GIS 23 MA/02 - 2023 Federal Poverty Levels and ATTACHMENT, based on the 2023 FPL's that were announced on 1/12/23. Under NY Law, the asset limit equals 1.5 times the annual income limit.
Medicaid Buy-In for Working People with Disabilities - Asset limits will increase to the same limits from current $20,000 single and $30,000 couple. GIS 22 MA/11.
NYLAG and other consumer advocates had urged total repeal of the asset limits, which are biased against people of color, who are statistically less likely than white people to own a home or have retirement funds. Yet homes and retirement funds are largely exempt, while cash assets count dollar for dollar. (See more below). For the next NYS budget in 2023, NYLAG and other advocates have already asked the Governor to repeal or at least increase the asset limit further. See Nov. 2022 letter to Gov. Hochul.
C. Medicare Savings Program - Increased Income Limits (see more here)
The two Medicare Savings Programs (MSP) are a crucial subsidy for Medicare beneficiaries. A third MSP program (SLIMB) is eliminated in 2023. Both MSP programs - QMB and QI-1:
QMB has the added benefit of paying for the Medicare coinsurance under Part A and Part B, and protecting the beneficiary from balance billing for these charges. See more here.
Here are the 2023 Changes in MSP - see GIS 22 MA/10 --
*Initially, in Dec. 2022, DOH announced the 2023 limits that were lower than the ones in the above table, based on 2022 Federal Poverty Levels. On Feb. 10, 2023, they were increased to the amounts above - see NYS DOH GIS 23 MA/02 - 2023 Federal Poverty Levels and ATTACHMENT, based on the 2023 FPL's that were announced on 1/12/23.
DOWNLOAD this Fact Sheet on the Changes from Medicare Rights Center here.
D. UNDOCUMENTED OLDER IMMIGRANTS –POSTPONED UNTIL 2024
While Coverage4All did not pass, the 2022-23 NYS Budget said undocumented immigrants age 65+ woild be eligible for Medicaid Jan. 1, 2023. However, the Governor's NYS Budget proposal for 2023-24 says this will be postponed for a year until Jan. 1, 2024. When implemented, they will be required to join a “mainstream” Medicaid managed care health plan. NY SSL Sec. 366, subd. 1(g)(4)(a).
E. ESSENTIAL PLAN (People under age 65) --The income limit for the Essential Plan will increase from 200% to 250% FPL. This Insurance is for those under age 65 with income above the MAGI level. Also, the benefit package will expand to include long term care services not previously covered. These are defined as "certain services and supports" for those "who have functional limitations and/or chronic illnesses that have the primary purpose of supporting the ability of the enrollee to live or work in the setting of their choice, which may include the individual's home, a worksite, or a provider-owned or controlled residential setting." It is unclear whether these long term care services are the same as those covered by Medicaid.
Unfortunately, this expansion will not include undocumented immigrants.
II. Timing - When Will This Happen in 2023 - and What Can You Do?
New applications for Medicaid or MSP filed after Jan. 1, 2023 should be assessed under the new limits. We do not yet know about applications filed in 2022 but approved in 2023, but we believe they should also be assessed under the 2023 limits.
What about the hundreds of thousands of Medicaid recipients who:
This is not so simple. See materials from NYLAG 1/18/23 webinar, including sample forms, link to view recording, and other resources - links at the top of this article.
Unfortunately, the NYS Dept. of Health told advocates that because of the antiquated computer sytem, they cannot automatically recalculate the spend-down for everyone in January 2023 under the new limits. Consumers will have two choices:
However, once the PHE is declared over, which might be in April 2023, renewals will be sent to all Medicaid recipients over the course of a full year, going into 2024. When processing these renewals, the Medicaid offices will recalculate eligibility under the new income limits. Most people should see their spend-down go down – or be eliminated altogether. Many people will newly qualify for a Medicare Savings Program (MSP).
Until the renewal is processed based on actual current income, the spend-down, if any, will remain the same. It cannot be increased by the Medicaid office.
Beginning December 10, 2022, over 2 weeks, the NYS Dept. of Health will send out 2 notices to 2 groups of consumers.
HIGH PRIORITY --
LOW PRIORITY --
See links at top of this article for materials from NYLAG webinar on the strategies outlined below and how to help clients benefit from the new eligibility limits, held January 18, 2023
III. Background on Campaign to Expand Medicaid & MSP for Older New Yorkers and People with Disabilities
Background: In August 2021, over 50 organizations sent a letter to Governor Hochul asking her to expand Medicaid eligibility for older adults and people with disabilities in the 2022-23 Executive Budget. These groups were left out of Medicaid expansion under the Affordable Care Act (ACA). Lead organizations on the letter included New York Legal Assistance Group, along with Medicaid Matters New York, and other organizations. The letter to Gov. Hochul urged her to expand the income limits for the Medicare Savings Program or "MSP."
The Governor heard our message and in her State of the State message and then her proposed Budget proposed o align rules for INCOME and ASSETS for Medicaid for people age 65 and disabilities with Medicaid for younger people under the Affordable Care Act "so that low-income New Yorkers age 65 and up, as well as those with disabilities, are able to maintain Medicaid eligibility after they become eligible for Medicare. These changes would be effective January 1, 2023. See more here. Her State of the State message stated, "This coverage expansion will eliminate the resource eligibility test and raise the income level to 138 percent of the federal poverty level for these populations for these populations. These changes will enable extremely low-income seniors and individuals with disabilities to easily maintain secondary Medicaid coverage when their Medicare eligibility begins — significantly reducing health disparities across the State, reducing unnecessary eligibility redeterminations, and increase administrative efficiencies." Plan at page 35.
Though the Governor's proposed budget and both one-house bills of the NYS Senate and Assembly all proposed to repeal the asset test. The final NYS SFY 2022-23 budget increased but did not repeal the asset limit. Final enacted bill at A9006-C - See Part AAA Sections 2-4, p. 259 et seq.
See Justice in Aging's issue brief on the national movement to expand eligibilty for Medicaid and reduce racial disparities in health care access.
View this webinar held May 11, 2022, discussing this national trend sponsored by Justice in Aging, with participation by Valerie Bogart, NYLAG.
WHAT'S NEXT: In Nov. 2022, advocates renewed their request to Gov. Hochul to repeal, or at least expand the asset limit in the SFY 2023-24 Budget.
THANK YOU GOVERNOR HOCHUL and STATE LEGISLATURE FOR RECOGNIZING THAT NOW MORE THAN EVER ACCESS TO HEALTH CARE IS CRITICAL!!!