SHADAC Article in Journal of Aging & Social Policy Urges States to Use COVID-19 Flexible Medicaid Authority for LTSS Eligibility

This journal article focuses on how state-level Medicaid program flexibility, along with recent emergency waivers, can expand Medicaid financial eligibility for long-term supports and services (LTSS) for these at-risk individuals.

Traditionally, Medicaid LTSS eligibility criteria for states (though federal standards are also a key component) have been based on financial rules and functional needs assessments. Due to complexities surrounding these eligibility requirements, many beneficiaries are at risk of losing coverage throughout the year. Under public health emergency authority granted to states during the COVID-19 pandemic, however, mechanisms such as state plan amendments, section 1115 and 1135 waivers, and 1915(c) Appendix K can be used by states to ease these difficulties and ensure that eligible individuals get coverage.