TMA VICTORY and MassHealth for Non-Parent Relatives

Subject: VICTORY!! Transitional Medical Assistance FIX and MassHealth for Non-Parent RelativesDMA AGREES TO FIX TMA AND PROVIDE MASSHEALTH TO SOME NON-PARENT CARETAKERSMarch 28, 2000A group of advocates from GBLS, MLRI, and Health Care for All met with the Division of Medical Assistance on March 27, 2000 to follow up on a letter we had sent pointing out that DMA is in violation of federal law with respect to Transitional Medical Assistance (TMA) and MassHealth for non-parent caretakers. The state currently provides TMA for 12 months only to families whose TAFDC cases close due to earnings and has no MassHealth category for non-parent caretakers. DMA agreed that its current rules and procedures violate federal law. Specifically, DMA agreed that the state is not currently complying with § 1931 of the Medicaid statute, which was added by the federal welfare law. Under § 1931, any family that would be eligible for TAFDC under the July 1996 income and asset rules is eligible for § 1931 Medicaid. TMA should now be triggered by loss of § 1931 Medicaid and not by loss of TAFDC. In addition, non-parent caretakers with income and assets below July 1996 TAFDC levels should be eligible for MassHealth. DMA is in the process of figuring out how it wants to fix the illegality and will give us a timetable by April 10, 2000 (the Commissioner is on vacation this week). In the meantime, you should be able to fix individual cases by calling Sarah Anderson at GBLS (617/603-1581) who will pass them on to Jean Sullivan, DMA General Counsel. Cases that should be fixed include the following:(1) Families with earnings that would have made them ineligible for TAFDC but whose cases close (or are coded as closing) for a reason other than earnings. These families should be eligible for TMA, so the parents should be eligible for Mass Health for a year after they became ineligible for § 1931 Medicaid (i.e., the point they became ineligible for TAFDC) even if their income is over 133% of poverty.(2) Families with income below § 1931 eligibility limits (i.e., TAFDC limits) and who subsequently have earnings that would make them ineligible for § 1931 Medicaid (i.e., above the TAFDC income and asset limits). These families should be eligible for TMA for a year after their income goes over § 1931 limits. For example, parents who are losing MassHealth because their incomes exceed 133% of poverty, should retain MassHealth if at some point during the previous 12 months they had income and assets below TAFDC levels (because they are eligible for a year of TMA from the point their income went over § 1931 levels). This includes families who used to be on TAFDC and whose cases closed for reasons other than income and families who were never on TAFDC. (3) Non-parent caretaker relatives with incomes below § 1931 eligibility limits (i.e., TAFDC limits). These relatives are eligible for Mass Health although the state*s waiver category for families below 133% of poverty only provides for MassHealth eligibility for parents.For more information, contact Sarah Anderson at GBLS,617/603-1581.