Arizona Moving To Add AHCCCS Five-Year Limits

18September
2017

Arizona is moving to tighten requirements for Medicaid eligibility. It could become one of the first states to impose work requirements and five-year lifetime limits on “able-bodied” adult enrollees. While this plan has been delayed for over 5  months, the Trump administration appears to be favorable to the plan and the state hopes to get their answer in 2018.

What Does “Able-Bodied” Mean?

Abled-bodied is defined by the law as anyone over the age of 19 who is mentally and physically capable of having a job. Under this new requirement, anyone who is judged to be mentally healthy enough to work a job can only be covered by Medicaid for 5 years in their entire life.

There are exceptions to the able-bodied requirement for people in certain circumstances. These exceptions apply to anyone who is still in high school at or after age 19, sole caregivers of children under age 6, anyone who qualifies for the Arizona Long Term Care System (ALTCS) and anyone already receiving long-term disability. For people with the above circumstances that may be able to be insured by Medicaid for longer than 5 years.

What Does This Mean For Mental Health?

If you are determined by a medical health care professional to be mentally unfit for employment, you can still apply for Medicaid and may be eligible for longer than five years. The draft of the new law is not specific enough yet to list what determines a person’s mental health status. It does not exempt people with disabilities and mental-health issues.

Other Provisions To The Law

The draft of the new law contains other provisions for people who are eligible to receive Medicaid. They include:

  • Enrollees would be required to verify that they are meeting the work requirement and any changes in family income on a monthly basis.
  • The ability to ban enrollees for a year if they knowingly fail to report a change in family income or make false statements about their compliance with work requirements.

Photo by Paul Fearn

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