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F I S C A L I M P A C T R E P O R T

SPONSOR:	Aragon		DATE TYPED:	02/11/03		HB
SHORT TITLE:		Medicaid Waiver to Expand Eligibility				SB	SJM 0019
					ANALYST:		Weber

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY03	FY04	FY03	FY04
	$0.0		See narrative

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates SJM 19

SOURCES OF INFORMATION

Responses Received From

Human Services Department

SUMMARY

Synopsis of Bill

Senate Joint Memorial 19 requests that the Human Services Department (HSD) apply for a Medicaid Waiver from the federal Centers for Medicare and Medical Services (CMS) to enable New Mexico citizens meeting Medicaid eligibility who leave institutions and who were enrolled in Medicaid prior to institutionalization to enjoy presumptive eligibility and immediate access to Medicaid benefits upon completion of the enrollment process. Further, the Waiver would enable other New Mexico citizens leaving institutions to be eligible for Medicaid upon completion of the enrollment process. The Waiver would include all options that will maximize the potential Medicaid benefits to all New Mexicans.

Significant Issues

Medicaid eligibility is based upon one’s current circumstances. The receipt of Medicaid prior to institutionalization does not assure all eligibility factors will be met upon deinstitutionalization. If a woman were receiving Medicaid based upon the fact that she was living with her eligible children, she would again need to reside with the children upon deinstitutionalization. Current federal regulations allow only children and pregnant women to receive presumptive eligibility.

Any New Mexico citizen leaving an institution is potentially eligible for Medicaid upon the completion of the enrollment process if they otherwise meet all eligibility conditions.

Individuals receiving Supplemental Security Income (SSI) in New Mexico are eligible for Medicaid. If their Medicaid is dependent upon receipt of SSI, eligibility for this must be first established.

FISCAL IMPLICATIONS

Senate Joint Memorial 19 contains no appropriation. There would, however, be a cost, based upon the number of individuals enrolled in the program. A determination of the number of individuals deinstitutionalized each year who were on Medicaid immediately prior to their institutionalization would be necessary but is not now currently available.

OTHER SUBSTANTIVE ISSUES

It is unnecessary to have language that would enable citizens leaving institutions to be eligible for Medicaid upon completion of the enrollment process. Citizens are already eligible if they meet all conditions of eligibility.

MW/yr