Families USA, PhRMA Propose National Income Eligibility Floor For Medicaid

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pharma Industry / Biotech Industry;  Health Insurance / Medical Insurance
Article Date: 23 Apr 2009 - 2:00 PDT

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Families USA, a national consumer health organization, and the Pharmaceutical Research and Manufacturers of America, which represents the drug industry, on Tuesday unveiled a campaign to encourage Medicaid policies aimed at improving access to affordable health coverage, BNA reports. The two groups said they support the establishment of nationwide Medicaid eligibility floor at 133% of the federal poverty level, or about $24,400 in annual income for a family of three. According to the groups, only 16 states provide eligibility up to 100% of the federal poverty level, and Medicaid income eligibility criteria in 43 states currently does not cover childless adults at all, even if they have no income. The groups also proposed offering sliding-scale subsidies to moderate-income individuals who surpass Medicaid income limits but cannot afford private insurance. In addition, they are seeking a cap on out-of-pocket health expenses, which they said would help families afford essential care and avoid bankruptcy from major health care bills. Families USA Executive Director Ron Pollack said the proposed policies "are not novel, but they are essential building blocks for making health coverage affordable" (BNA, 4/22).

According to CQ Today, the groups will launch a multimillion dollar campaign -- including lobbying efforts, advertising and grassroots mobilization -- to encourage lawmakers to include their policy suggestions in the expected health care reform efforts this year. Sen. Max Baucus (D-Mont.), chair of the Senate Finance Committee, said increasing access to Medicaid is "a critical part of health care reform" and a "quick and efficient way to cover all low-income Americans, bringing us closer to the ultimate goal of coverage for all" (Attias, CQ Today, 4/21).

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