Simulation of Medicaid and SCHIP Eligibility: Implications of Findings From 10 States

Final Report

By:
Carol Irvin
John Czajka

August 16, 2000

Table of Contents

1. INTRODUCTION AND SUMMARY OF FINDINGS

2. SUMMARY OF ELIGIBILITY RULES
   1. INCOME TESTS
      1. Gross and Net Income Tests
      2. Income Thresholds

   2. DEFINING INCOME
      1. Earnings Disregards
      2. Disregards for Child Care
      3. Disregards for Child Support Payments
      4. Other Disregards
      5. Definition of Countable Income

   3. ASSETS TESTS

   4. FAMILY COMPOSITION RULES

   5. OTHER RULES
      1. Presumptive Eligibility
      2. Private Health Insurance

3. IMPLICATIONS FOR COMPARING ELIGIBILITY AMONG STATES AND PROGRAMS

4. IMPLICATIONS FOR SIMULATIONS BASED ON HOUSEHOLD SURVEY DATA
   1. DATA REQUIREMENTS FOR ELIGIBILITY SIMULATIONS

   2. COMPARISON OF FIVE NATIONAL SURVEYS

5. DISCUSSION

   APPENDIX TABLES

   REFERENCES

TABLES

II.1 STATE USE OF NET OR GROSS INCOME TESTS

II.2 DESCRIPTION OF EARNINGS DISREGARDS FOR APPLICANTS

II.3 DESCRIPTION OF EARNINGS DISREGARDS FOR RECIPIENTS

III.1 INCOME THRESHOLDS AND MAXIMUM ALLOWABLE EARNINGS AS OF JANUARY 1, 1999 FOR A FAMILY OF THREE

III.2 INCOME THRESHOLDS AND MAXIMUM ALLOWABLE EARNINGS LEVELS AS OF JANUARY 1, 1999 FOR A FAMILY OF THREE AS A PERCENT OF THE 1999 FEDERAL POVERTY LEVEL (FPL)

III.3 MEDICAID AND SCHIP ELIGIBILITY AS OF JANUARY 1, 1999 OF TWO CHILDREN AGES THREE AND NINE IN A THREE-PERSON FAMILY BY STATE, BY INCOME, AND BY DISREGARDS

III.4 MEDICAID AND SCHIP ELIGIBILITY AS OF JANUARY 1, 1999 OF A CHILD IN A THREE-PERSON FAMILY WITH TWO EARNERS BY STATE AND BY INCOME)

IV.1 DATA AVAILABILITY RELATIVE TO REQUIREMENTS FOR SIMULATION OF MEDICAID AND SCHIP ELIGIBILITY

A.1. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR TWO CHILDREN IN A THREE PERSON FAMILY MOTHER WORKS FULLTIME AT THE MINIMUM WAGE ($993 IN MONTHLY EARNINGS) AND HAS AVERAGE MONTHLY CHILD CARE EXPENSES^b

A.2. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR TWO CHILDREN IN A THREE PERSON FAMILY MOTHER WORKS FULLTIME AT THE MINIMUM WAGE ($993 IN MONTHLY EARNINGS) AND HAS NO CHILD CARE EXPENSES^b

A.3. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR TWO CHILDREN IN A THREE PERSON FAMILY MOTHER WORKS FULLTIME AT $7.00 PER HOUR ($1,313 IN MONTHLY EARNINGS) AND HAS AVERAGE MONTHLY CHILD CARE EXPENSES^b

A.4. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR TWO CHILDREN IN A THREE PERSON FAMILY MOTHER WORKS FULLTIME AT $7.00 PER HOUR ($1,313 IN MONTHLY EARNINGS) AND HAS NO CHILD CARE EXPENSES^b

A.5. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A FIVE YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $1,157 (100 percent of 1999 FPL) AND AVERAGE MONTHLY CHILD CARE EXPENSES^b

A.6. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A FIVE YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $1,735 (150 percent of 1999 FPL) AND AVERAGE MONTHLY CHILD CARE EXPENSES^b

A.7. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A FIVE YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $2,313 (200 percent of 1999 FPL) AND AVERAGE MONTHLY CHILD CARE EXPENSES^b

A.8. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A FIVE YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $2,892 (250 percent of 1999 FPL) AND AVERAGE MONTHLY CHILD CARE EXPENSES^b

A.9. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A 17 YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $1,157 (100 percent of 1999 FPL)^b

A.10. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A 17 YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $1,735 (150 percent of 1999 FPL)^b

A.11. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A 17 YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $2,313 (200 percent of 1999 FPL)^b

A.12. COUNTABLE INCOME^a AND ELIGIBILITY AS OF JANUARY 1, 1999 FOR A 17 YEAR OLD CHILD IN A THREE PERSON FAMILY WITH TWO EARNERS AND MONTHLY GROSS INCOME OF $2,892 (250 percent of 1999 FPL)^b

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