The Medicaid Extenders Act of 2019 was signed into law on January 24th, 2019. This bill alters several Medicaid programs and funding mechanisms. First and foremost it  revises the Money Follows the Person Re-balancing Demonstration Program. (Under this program, the Centers for Medicare & Medicaid Services must award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.) Before this bill the spouse of the applicant for home and community-based services would have to include their income on the application even though they were not the recipient of the services.  This bill protects the spouse’s income and assets, at least temporarily.

Home and community-based services are usually done by a family member.  Even though most caregivers take care of family members without pay, there is a growing number that are becoming paid caregivers.  If caregivers live in the same home with the family member they are taking care of 12 months of the year their income is not taxable income.  If they get a W-2 you will usually see a 0 in the federal and state taxable income box and tax taken, but sometimes their W-2 doesn’t reflect this.  If that is the case they can either request a new W-2 from the agency they work under or under deductions there is a line for income received from taking care of a family member that is in the home 12 months of the year.  This will subtract the income from taxable income on the family member’s total income.

States that have yet to implement an asset-verification program for determining Medicaid eligibility will have their federal matching rates reduced during the 2019 fiscal year.  The decision to add this provision to the Medicaid Extenders Act of 2019 came from the overwhelming hospital bills that some states are seeing from the uninsured that have an income that is too low to qualify for the tax credit issued through healthcare.gov.  Some states do not have a Medicaid program in place for the low income uninsured.

This Act will reduce funding available to the Medicaid Improvement Fund beginning in FY2021.   The Medicaid Improvement Fund will be available to the Secretary to improve the management of the Medicaid program by the Centers for Medicare & Medicaid Services, including oversight of contracts and contractors and evaluation of demonstration projects.