By Deborah Hammonds, J.D.
CMS provided information on the extension of the ACA’s spousal impoverishment provision through March 31, 2019.
The spousal impoverishment provision of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) has been temporarily extended until March 31, 2019. The provision was supposed to expire on December 31, 2018, but it was extended by the recently enacted Medicaid Extenders Act of 2019 (P.L. 116-3), which modified section 2404 of the ACA to require that state Medicaid agencies apply the spousal impoverishment rules to married applicants and beneficiaries eligible for home and community-based services (HCBS). The terms of the spousal impoverishment-related provision were not modified beyond the extension of its sunset date (CMCS Informational Bulletin, February 8, 2019).
CMS published an information bulletin in November advising stakeholders of the ACA’s spousal impoverishment-related provision’s December expiration. The bulletin instructed states that, if the provision were to expire, eligibility redeterminations and post-eligibility treatment-of-income (PETI) recalculations would be necessary for many married individuals receiving HCBS.
States that have completed redeterminations for married HCBS recipients and informed any such beneficiaries that (due to the expiration of the ACA provision) they are no longer eligible for Medicaid or will have their PETI calculation modified should revise their decisions and immediately inform these individuals that they remain eligible for Medicaid or that their PETI calculation will not change. However, if the ACA provision is not extended beyond the new March 31 expiration date, states will need to conduct redeterminations and recalculations in accordance with the instructions in the November bulletin.
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