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Since 2020, we’ve seen thousands of changes to Medicaid programs nationwide. With so many moving parts, it can be challenging to keep up with how access to Medicaid is evolving both nationally and within your state. To help you navigate this complexity, we’ve consolidated the most important updates you need to know to ensure your clinic and patients stay informed and prepared.
2024 Updates
In 2024, Medicaid has undergone significant updates to better address public health needs. These changes focus on reducing maternal mortality, advancing health equity, improving healthcare access for immigrants, and supporting underserved communities. State Medicaid budgets have also been adjusted, with increased fee-for-service rates for primary care physicians and behavioral health providers, as well as new strategies to control prescription drug costs.
As of this publication, we are a little over halfway through the year and PointCare has made over 1982 changes impacting over 1500 programs nationwide. Here are a few highlights:
- 269 Eligibility rule changes
- 904 Changes to program applications
- 15 New programs added
Below you’ll find an outline of the ongoing updates and changes to Medicaid programs across the United States. This section provides a comprehensive review of new programs, program updates, and discontinued initiatives to ensure you stay informed on the latest developments.
2024 Medicaid Plan Updates
New Programs
Connecticut - State HUSKY B (New Program)
July 1, 2024
This update significantly broadened access to health insurance for children in Connecticut, especially for those who may not qualify for Medicaid but whose families cannot afford private insurance. There is no requirement with regard to immigration status, both documented and undocumented children, who fall within the income group are eligible to access health coverage under the state's CHIP program.
Who’s Covered:
- Child 15-19 from familieswith incomes between 201% and 323% of the FPL
Michigan - Medicaid
August 1, 2024
Michigan’s Medicaid expansion now covers children under 19 and pregnant women who are lawfully residing in the U.S., broadening healthcare access for legal immigrants.
Who’s Covered:
- Children under the age of 19
- Pregnant women
- Lawful immigrants and those who are in the process of achieving full citizenship.
Washington Apple Health
July 1, 2024
Washington's Apple Health program expanded to provide Medicaid-like coverage for low-income undocumented immigrants and DACA recipients to address significant gaps in healthcare access for these populations.
Unlike traditional Medicaid, which is federally funded, this program relies on state-based funding, which is capped. This means that while the program is designed to mimic Medicaid, its resources may be limited.
Who’s Covered:
- Low-income undocumented immigrants and DACA (Deferred Action for Childhood Arrivals) recipients.
- Eligibility is capped at 138% of the Federal Poverty Level (FPL).
Name Changes
New Mexico Centennial Care (Name change to “Turquoise Care”)
July 1, 2024
New Mexico's rebranded 'Turquoise Care' remains committed to providing Medicaid services to young children with continuous enrollment.
Portal Updates
California Children's Presumptive Eligibility (CPE)
July 1, 2024
The state of California updated their Tenant Portal to integrate the Children's Presumptive Eligibility (CPE) program. This is aimed to simplify and improve access to coverage for children.
New Programs On the Horizon
Review new Medicaid coverage options set to launch in your state starting in 2025.
Colorado “Children’s Basic Health Plan” (New program)
January 1, 2025
Colorado's new "Children's Basic Health Plan" will offer presumptive Medicaid eligibility to low-income children, ensuring they receive timely healthcare without barriers related to immigration status.
Who’s Covered:
- Child under the age of 19 can receive temporary coverage while their full application is being processed
- Families with incomes at or below 147% of the Federal Poverty Level (FPL).
- No Immigration status requirements
Health First Colorado
January 1, 2025
Next year, Colorado will expand their Medicaid program to ensure pregnant women can receive immediate access to care via presumptive eligibility without immigration status verification.
Who’s Covered:
- Pregnant Women
- Those with incomes at or below 200% of the Federal Poverty Level (FPL).
- There are no immigration status requirements
KanCare Medicaid Expansion
January 1, 2025*
In 2025, Kansas will expand KanCare to extend Medicaid coverage to low-income adults in an effort to fill gaps in healthcare access.
Who’s Covered:
- Low-Include adults aged 19-64
- Individuals with incomes up to 138% of the Federal Poverty Level (FPL).
*Estimated launch date
MinnesotaCare
January 1, 2025
Minnesota will broaden coverage to include all ages to ensure more residents, regardless of their immigration status, can access healthcare.
Who’s Covered:
- Expanding to include all age demographics
- No changes are being made to the income requirements
- No restrictions based on immigration status
Previous Program Updates
Key changes and updates to Medicaid plans from 2023- Spring 2024 that might impact your patient population.
Name Changes
Virginia Medicaid (Name Change)
July 1, 2023 - “Cardinal Care” - (Transition started January 1, 2023)
Virginia rebranded its Medicaid program to create a more cohesive and recognizable healthcare program for state residents.
New Programs
California Medi-Cal
January 1, 2024
In January 2024, Medi-Cal was expanded to include adults ages 26-49 regardless of immigration status. This made healthcare more accessible to a larger percentage of the state population.
Who's Covered:
- Adults 26-49 whose income is up to 138% of the Federal Poverty Level (FPL).
- No Immigration Status
Colorado OmniSalud Program - Individual Plans (New program)
Open Enrollment (January 1, 2023)
Colorado’s OmniSalud program provides affordable health insurance options for low- to moderate-income individuals, with no immigration status requirements.
Who’s Covered:
- Individuals with incomes up to 150% FPL can receive free coverage.
- Those with incomes between 150%-300% FPL will pay the full cost of coverage.
- No immigration status required
Connecticut - State HUSKY A (New Program)
January 1, 2023
The program expanded in 2023 to include younger children and barriers related to immigration status.
Who’s Covered:
- Children 12 and under
- Families with incomes up to 201% of the FPL.
- Program open to all eligible children, regardless of immigration status
Connecticut - State HUSKY B (New Program)
January 1, 2023
Additional coverage for Connecticut children to include those in a higher income bracket.
Who’s Covered:
- Children ages 12 and under
- Families with incomes between 201% and 323% of the FPL.
- No Immigration Status
Connecticut Husky A
April 1, 2023
Provided extended prenatal and postpartum care to a larger number of pregnant women to ensure continuous health coverage.
Who’s Covered:
- Pregnant women and those 12 months postpartum
- Women whose income is up to 263% of the FPL.
- All pregnant women within the income limits can receive care, prenatal and postpartum, regardless of immigration status.
Cover All DC - Private Plan
April 2023
Cover All DC offers a private insurance option for residents who do not qualify for Medicaid but still need healthcare coverage, with no immigration restrictions.
Who’s Covered:
- All Ages and Incomes above Medicaid limits - private Healthcare program, non-subsidized
- No Immigration Status requirements
Georgia Pathways to Coverage
July 1, 2023
This Georgia program offers Medicaid coverage to low-income adults who meet specific work or volunteer criteria.
Who’s Covered:
- Adults aged 19-64 with incomes up to 100% of the FPL.
- Participants must work or volunteer at least 80 hours per month to maintain eligibility.
Maryland Children's Health Program (MCHP) [county-based]
Maryland’s MCHP expansion in Prince George’s County granted more children access to healthcare, regardless of their immigration status.
Who’s Covered:
- Prince George’s County residents
- Children aged 0-18 whose family income are up to 300% of the FPL.
- All eligible children, regardless of immigration status, can receive coverage.
Maryland Medicaid [county-based]
This county-based program focuses on providing healthcare access to Montgomery County residents.
Who’s Covered:
- Montgomery County residents
- Adults 19 and older with incomes up to 250% of the FPL.
- All eligible adults, regardless of immigration status, can receive coverage.
Massachusetts Health Standard
January 1, 2023
Massachusetts now provides extended prenatal and postpartum care to more pregnant women, ensuring continuous health coverage without immigration barriers.
Who’s Covered:
- Pregnant Women whose income is up to 205% of the FPL are eligible for prenatal care and 12 months of postpartum care.
- All eligible pregnant women, regardless of immigration status, can access this care.
New York Medicaid
January 1, 2023
New York expanded Medicaid coverage ages to include more seniors who have access to healthcare, regardless of immigration status. The program includes resources for elder care and long-term support.
Who’s Covered:
- Adults aged 65 and older whose income is up to 138% of the FPL
- All seniors regardless of immigration status
New York Medicaid
March 1, 2023
New York’s Medicaid expansion provides extended care for pregnant women, with a focus on continuous coverage postpartum. This provides prenatal care and 12 months of postpartum care.
Who’s Covered:
- Pregnant women whose income is up to 223% of the FPL.
- All eligible pregnant women, regardless of immigration status, can receive this care.
Oregon Health Plan
January 1, 2023
The Oregon Health Plan now offers continuous Medicaid coverage for children aged 0-6, and two years of continuous coverage for children aged 6-18, regardless of changes in eligibility status. These changes are designed to provide stability and ensure that children in Oregon have uninterrupted access to healthcare services, reducing the administrative burden of frequent re-enrollment.
Who’s Covered:
- Children age 0-6 now receive guaranteed continuous Medicaid coverage - regardless of any changes in their eligibility status
- Children aged 6-18 will be granted two-year continuous coverage regardless of eligibility status change
NC Health Works - Medicaid Expansion - NEW Program
December 1, 2023
North Carolina expanded coverage to low-income adults who previously may not have qualified for Medicaid. By expanding eligibility, the state aims to reduce the uninsured rate and improve health outcomes among its residents.
Who’s Covered:
- Adults aged 19-64 with incomes below 138% of the Federal Poverty Level
Resource
South Dakota Medicaid Expansion
July 1, 2023
South Dakota expanded the state's Medicaid eligibility criteria to provide more low-income adults access to healthcare. The goal of this expansion is to reduce the uninsured rate and improve health outcomes for residents.
Who’s Covered:
- Adults aged 19-64 with incomes up to 138% of the Federal Poverty Level (FPL)
Discontinued Programs
California COVID-19 Uninsured Group Program (UIG):
Ended May 31, 2023
Maine COVID-19 Testing Program
Ended May 11, 2023
New Hampshire - COVID-19 Testing Benefit Program
Ended May 11, 2023
New Mexico - Presumptive Eligibility (PE) COVID-19 Program
Ended May 11, 2023
North Carolina Health Choice
Closed April 1, 2023 (merged into Medicaid)
Oregon - Presumptive Eligibility (PE) COVID-19 Program
Ended May 11, 2023
Utah COVID-19 Uninsured Group Program
Ended May 11, 2023