ACA amendments to spousal impoverishment requirements are extended through December 31, 2019.
An informational bulletin from the Center for Medicaid and CHIP Services (CMCS) details an additional temporary extension of spousal impoverishment rules for married applicants and recipients of home- and community-based services. The recently enacted Sustaining Excellence in Medicaid Act of 2019 (P.L. 116-39) modifies section 2404 of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) to require the application of spousal impoverishment rules through December 31, 2019 (CMCS Informational Bulletin, September 4, 2019).
In determining the eligibility of married applicants for Medicaid coverage of care in a medical institution, nursing facility, or, in some circumstances, for home- and community-based services, states were required to exclude a certain amount of the couple’s income and resources. The ACA amended the requirements such that states were required to apply the spousal impoverishment rules to additional individuals receiving long-term services and supports.
In a previous informational bulletin, CMCS advised stakeholders that the expiration date of the spousal impoverishment-related provision was set to expire December 31, 2018, and provided instructions on how states should proceed once the provision expired. The Medicaid Extenders Act of 2019 (P.L. 116-3) extended the provision through March 31, 2019, and the Medicaid Services Investment and Accountability Act (P.L. 116-16) further extended the requirements through September 30, 2019. Until December 31, 2019, CMCS advised states to follow the guidance published in 2015 related to the application of the provision.
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