Senate Bill 1092 was passed in 2015 requiring AHCCCS to apply the Centers for Medicare and Medicaid Services (CMS) for a waiver or amendments to the current Section 1115 Waiver to allow the State to implement new eligibility requirements for “able-bodied adults”.

AHCCCS initially proposed implementing the following requirements for “able-bodied adults” receiving Medicaid services:

  • The requirement for all able-bodied adults to become employed or actively seeking employment or attend school or a job training program.
  • The requirement for able-bodied adults to verify on a monthly basis compliance with the work requirements and any changes in family income.
  • The authority for AHCCCS to ban an eligible person from enrollment for one year if the eligible person knowingly failed to report a change in family income or made a false statement regarding compliance with the work requirements.
  • The authority for AHCCCS to limit lifetime coverage for all able-bodied adults to five years except for certain circumstances.

Hundreds of comments were submitted urging the agency to consider modifications to the initial waiver request.  While AHCCCS hasn't released the content of their final waiver request, they did issue a letter last week (link below) outlining what they intend to include in the Waiver.

It's a lengthy letter and I can't summarize it all here- but interestingly- it includes a wider list of persons that would be exempt from the initial eligibility restrictions (which already included persons with disabilities) including:

  • Persons over 55 years old;
  • Foster persons up to 26 years old;
  • Full time college and graduate students;
  • Victims of domestic violence;
  • Homeless persons; and
  • Parents of kids less than 13 years old.

We'll continue to track this when the final waiver request is released.