Access to Medicaid Coverage Under the Affordable Care Act: New and Existing Eligibility Groups

Regulation Authority:

Chapter 40-8 of the Rhode Island General Laws, as amended

Purpose and Reason:

EOHHS is informing Rhode Islanders of the scope and purpose of the new eligibility system, explaining its impact on new and existing coverage groups, and identifying the role and responsibilities of both the Medicaid agency and applicants are critical for ensuring that the rights of consumers are protected adequately during the period covered in this interim rule from October 1, 2013 to December 31, 2013. It is in this three month time span that the transition will begin to a new standard for determining income eligibility for Medicaid funded and other forms of affordable health coverage. It is crucial that consumers who are using the new on-line eligibility system during the interim rule period are informed fully that: (1) if deemed eligible, actual coverage will not begin until January 1, 2014; and (2) there may be options for obtaining coverage during the interim rule period by under already existing application rules and procedures. Additionally, the EOHHS is committed to making consumers who may benefit from the new on-line eligibility system aware of the advantages of applying during the interim rule period from October 1, 2013 through December 31, 2013. Therefore, the EOHHS is confident that emergency rule-making for the period of this interim rule is in the best interest of the health, safety and welfare of all Rhode Islanders. During the interim rule period, the EOHHS will file a notice of intended action to initiate the promulgation of a final rule that will describe the full scope of changes in the Medicaid program to take effect on January 1, 2014. The proposed rule will be subject the full requirements for public notice and comment specified in R.I.G.L. §42-35-3. The final rule will supersede the interim rule in scope and effect.

Brief statement of Reason for Finding Imminent Peril:

In accordance with Rhode Island General Laws §42-35-3(b), the Executive Office of Health and Human Services (EOHHS) is pursuing an emergency rule to ensure that Rhode Islanders are aware of the opportunities for affordable health coverage that will begin on October 1, 2013, when the on-line eligibility system Rhode Island developed in conjunction with federal health reform goes live. Due to delays in the promulgation of federal regulations governing the operations of the new systems, there was not sufficient time to pursue non-emergency rule-making.