By Sheryl Allenson, J.D.
The 2018 federal poverty level (FPL) guidelines reflect a 2.1 percent increase between calendar years 2016 and 2017, according to a CMS information bulletin released March 6, 2018. The guidelines are applied to eligibility criteria for programs such as Medicaid and the Children’s Health Insurance Program (CHIP). FPLs are also used to determine eligibility for tax credits under the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) (CMCS Informational Bulletin, March 24, 2017).
After an inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family and household sizes. For a family or household of four people living in one of the 48 contiguous states or the District of Columbia, the FPL is $25,100. There are separate FPLs for Alaska, Hawaii, and the territories.
The information bulletin also includes the 2018 Duel Eligible Standards chart which sets out new standards for the Medicare Savings Programs. Low income seniors and disabled individuals may be eligible for coverage under both Medicare and Medicaid, FPLs provide the basis for such eligibility. Several categories exist, as identified on the chart attached to the informational bulletin. These categories include Qualified Medicare Beneficiary (QMB); Specified Low-Income Medicare Beneficiary (SLMB); Qualifying Individual (QL); and Qualified Disabled Working Individual (QDWI). Each of these categories reflect a different percentage of the FPL.
These annual updates increase the Census Bureau’s current official poverty level thresholds by the relevant percentage change in the Consumer Price Index for All Urban Consumers.
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