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County LIHP Applications Now Available Online

One of the most significant parts of the new section 1115 waiver is the Low Income Health Program (LIHP). In essence, the LIHP is an opportunity for California counties to receive federal matching funds to provide coverage for their medically indigent adult (MIA) populations between June 1st of this year and January 1st, 2014, when they become eligible for either Medi-Cal or the Exchange.

Some Background on the LIHP

The LIHP actually consists of two separate programs: the Medicaid Coverage Expansion (MCE) and the Health Care Coverage Initiative (HCCI). The MCE will provide coverage for adults with incomes of less than 133% of poverty, and its federal matching money is unlimited. HCCI is coverage for adults with incomes between 133 and 200% of poverty, and its expenditures come from the waiver’s federal safety net care pool which is capped at $600 million. Counties have the option to chose in which programs they want to participate (based in large part by the amount of local resources available for this effort), but neither program is open to undocumented workers.

Under the LIHP, counties will be able to leverage this new 50/50 federal match (of monies that they’re already spending) in order to (1) cover more of the uninsured, (2) increase access to care, (3) pay for uncompensated services, (4) identify persons eligible for care under the ACA, and (5) develop the new delivery systems. The state projects that more than half a million adults will be eligible under the LIHP, with 385,000 eligible for MCE and 127,000 eligible for HCCI.

For more on the LIHP and the entire waiver, see ITUP’s recent waiver summary.

County Plans Now Available to Review

Counties that are interested in participating in the MCE and/or the HCCI were required to send an initial application to the state by February 14, 2011. Over the next three months, these counties will work with the state Department of Health Care Services (DHCS), the federal Center for Medicare and Medicaid Services (CMS), and other stakeholders to ensure their proposals are feasible.

DHCS has just posted these applications online. You’re welcome to review your county’s proposal, which includes expected coverage levels, benefit levels, costs, etc. Remember: these are just initial proposals, and the final plans might look considerably different after discussions with the state and federal government.

Stay tuned to the ITUP website and blog for a summary and analysis of these plans.

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