Table A. MassHealth Demonstration Expansion Populations * Funding Stream Comments Groups with a Federal Poverty Expenditure and MassHealth Categorical Link Level (FPL) and/or Eligibility Group Made Eligible Other Qualifying (EG) Reporting Program through the Criteria Demonstration (“Hypotheticals”) The CommonHealth · < Age 1: 200.1 program existed to Higher income Title XIX if CommonHealth CommonHealth through 300% the separate XXI children with insured at the time Children’s Health disabilities of application CommonHealth Insurance Program and · Ages 1 - 18: 150.1 was not affected by the Title XXI via the XXI maintenance of effort through 300% separate XXI date. The program if CommonHealth program uninsured at the is contained in the time of separate XXI state plan application and as authorized under (Funded through this 1115 demonstration. title XIX if title Certain children derive XXI is exhausted) eligibility from both the authority granted under this demonstration and the separate XXI program. Sliding scale premium Higher income responsibilities for those 300% Title XIX CommonHealth CommonHealth children with individuals above 150 disabilities ages 0 percent of the FPL through 18
Table A. MassHealth Demonstration Expansion Populations * Groups with a Categorical Link Made Eligible through the Demonstration (“Hypotheticals”) Federal Poverty Level (FPL) and/or Other Qualifying Criteria Funding Stream Expenditure and Eligibility Group (EG) Reporting MassHealth Program Comments Higher income children with disabilities · < Age 1: 200.1 through 300% · Ages 1 - 18: 150.1 through 300% Title XIX if insured at the time of application Title XXI via the separate XXI program if uninsured at the time of application (Funded through title XIX if title XXI is exhausted) CommonHealth CommonHealth XXI CommonHealth The CommonHealth program existed to the separate XXI Children’s Health Insurance Program and was not affected by the maintenance of effort date. The CommonHealth program is contained in the separate XXI state plan and as authorized under this 1115 demonstration. Certain children derive eligibility from both the authority granted under this demonstration and the separate XXI program. Higher income children with disabilities ages 0 through 18 300% Title XIX CommonHealth CommonHealth Sliding scale premium responsibilities for those individuals above 150 percent of the FPL
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