New Medicaid Rules for Premiums and Co-payments

A new rule implementing the 2006 Deficit Reduction Act  allows states to impose premiums and higher co-payments for hospital care, prescriptions, and doctors’ services for those over the Federal Poverty Limit (those on TANF and SSI are exempt from the changes). The rule allows a sliding scale based on income requirements (up to a total of 5 percent of a family's income). It also allows for states to deny services to those who don’t pay the required premiums and co-payments. This may generate over a billion dollars in new revenue, though some worry that low-income individuals may forgo or delay services due to increased costs.

The rule is available at: http://edocket.access.gpo.gov/