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Medicaid

Medicaid, an entitlement program created by the federal government, is the primary public program for financing basic health and long-term care services for low-income Alaskans. It is funded fifty percent by federal funds and fifty percent by State general funds. The program focuses on coverage for low-income children, pregnant women, families, the elderly, blind and the permanently disabled. The federal government establishes guidelines that requires the state to cover specific categories of people and types of benefits. It is, however, the legislature's responsibility to determine which services are to be covered, the qualifying standards and the categories of people who will be eligible for benefits under the Medicaid program. Within these guidelines and constraints, the Department of Health Services has considerable flexibility in establishing financial eligibility criteria, benefit packages and payment policies.

 

See if you're eligible: Medicaid Income and Eligibility standards

DPA Service Delivery

The Medicaid program is administered by the Division of Health Care Services (DHCS). While DHCS is responsible for program and policy development, the Division of Public Assistance (DPA) is responsible for determining the eligibility of individuals and families in need of Medicaid benefits.

Medical benefits are a crucial component of the safety-net services delivered through DPA. Careful assessment by DPA staff identifies Medicaid program best suited to meet the needs of applicant families and individuals. Division staff determine eligibility and authorize benefits for Family Medicaid, a program intended to meet the medical needs of low-income families. As families transition from welfare to work, DPA staff insure that eligible family members continue to receive Transitional Medicaid benefits. Staff also are responsible for determining eligibility and issuing benefits for infants, children, pregnant women, elderly, and disabled individuals who qualify for one of the other categorical Medicaid programs.

The majority of Medicaid recipients are beneficiaries of other programs and services administered and delivered by DPA. Most recipients of Alaska temporary assistance benefits receive Family Medicaid benefits. Many children, young adults, and elderly or disabled persons receiving Medicaid also receive food stamps or Adult Public Assistance benefits.

Almost 70,000 Alaskans receive medical benefits through the Medicaid Program.

Program Policy - Changes and Issues

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 repealed the Aid to Families with Dependent Children program and required the separation of Medicaid and the Alaska Temporary Assistance Program, the state's TANF-funded assistance program. Today, eligibility for Family Medicaid is based on the essentially the same financial and non-financial criteria that governed the AFDC program, many of which are not used to determine eligibility for ATAP. While, there has been a concerted effort to limit the divergence of Medicaid and ATAP policy, additional staff time is now needed to verify the Medicaid eligibility of families receiving ATAP. As more families move from welfare to work, there will be an increased level of effort to monitor eligibility and authorize Transitional Medicaid benefits.

There is great interest in exploring the possibilities for increasing the categories of people who may be eligible for Medicaid. Changes in federal Medicaid laws may allow states to more easily expand the number of low-income children eligible for Medicaid, provide coverage for people with specific contagious diseases, or provide continuing Medicaid for the working disabled. Any changes which expand access to Medicaid will increase the work load of DPA staff responsible for determining eligibility and authorizing benefits.

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