800        INTRODUCTION TO MEDICAID

Medicaid is intended to provide medical coverage for needy children and adults, pregnant women, and aged, blind and disabled persons. Medicaid is jointly financed by the federal and state governments. The federal government, under the Center for Medicare and Medicaid Services (CMS), establishes parameters for states to follow. Within the parameters, the states administer Medicaid, which results in states having different types of coverage.

The Alaska Department of Health (DOH) administers the Medicaid program in accordance with federal and state laws and regulations.

The Division of Public Assistance (DPA) processes Medicaid applications and determines eligibility.

The Division of Health Care Services (DHCS) oversees the processing of Medicaid claims, payment to health care providers, and overall fiscal responsibilities of the Medicaid program. DHCSDivision of Health Care Services contracts with Health Management Systems (HMS) to handle the day-to-day processing of medical claims and payments.

800 A.     HISTORY OF FAMILY MEDICAID, DENALI KIDCARE, AND MAGI MEDICAID

Medicaid was established by Title XIX of the Social Security Act in 1965. Alaska joined the Medicaid program in September 1972. The Medicaid program in Alaska is authorized under Alaska Statutes 47.07.010 - 47.07.900 and the Alaska Administrative Code, Title 7 Chapter 100 through Chapter 160.

Before July 1, 1997, individuals and families who were eligible for and/or received Aid to Families with Dependent Children (AFDC) were automatically eligible for Medicaid. This entitlement was removed by the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. This legislation eliminated the AFDC program but required that Medicaid continue to be available to those who would have qualified for AFDC. This category of Medicaid was called Family Medicaid.

The Balanced Budget Act of 1997 established the Child Health Insurance Program (CHIP) in Title 21 of the Social Security Act. This program provides Alaska with enhanced federal matching money to expand Medicaid eligibility to more children. At the same time, eligibility was also expanded for pregnant women.

Beginning March 1, 1999, income eligible children under age 19 and pregnant women qualified for Medicaid. This expanded coverage is collectively referred to as Denali KidCare.

In March 2010, the Affordable Care Act (ACA) was signed into law. The ACAAffordable Care Act is based on the Patient Protection and Affordable Care Act (Public Law 111-148) and the Health Care and Education Reconciliation Act (Public Law 111-152). The law expands Medicaid coverage to millions of low-income individuals and families, and makes many improvements to Medicaid.

The ACAAffordable Care Act allows coverage by either Medicaid or an affordable insurance exchange. Households may apply for coverage using a single application and have eligibility determined for all insurance affordability programs through one simple process. The ACAAffordable Care Act changes for Medicaid came into effect January 1, 2014, replacing Alaska's Family Medicaid with MAGI Medicaid.