Skip to content
Blog Head Images - July 2024 Format (4)
PointCare MarketingAug 27, 2024 10:30:00 AM9 min read

Keeping Up With Medicaid Eligibility in 2024

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

Resource

 

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. 

Resource

 

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).

Resource



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. 

Resource | Resource



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.  

Resource 



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 

Page 11: Resource | Resource

 

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

Page 15: Resource | Resource

 

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).

Resource | Resource

*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 

Resource

 

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.  

Resource

 

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

Resource | Resource

 

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 

Resource

 

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 

Resource | Resource

 

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

Resource | Resource

 

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. 

Resource

 

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 

Resource

 

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.

Resource

 

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.

Resource | Resource

 

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.

Resource | Resource

 

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.

Resource

 

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 

Resource

 

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.

Resource

 

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

Resource

 

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)

Resource | Resource

 

Discontinued Programs

 

California COVID-19 Uninsured Group Program (UIG):

Ended May 31, 2023

Resource

 

Maine COVID-19 Testing Program

Ended May 11, 2023

Resource | Resource

 

New Hampshire - COVID-19 Testing Benefit Program

Ended May 11, 2023

Resource

 

New Mexico - Presumptive Eligibility (PE) COVID-19 Program

Ended May 11, 2023

Resource

 

North Carolina Health Choice

Closed April 1, 2023 (merged into Medicaid)

Resource

 

Oregon - Presumptive Eligibility (PE) COVID-19 Program

Ended May 11, 2023

 

Utah COVID-19 Uninsured Group Program

Ended May 11, 2023

https://medicaid.utah.gov/covid-19-uninsured-coverage/

RELATED ARTICLES