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New Brief Reviews Expanded Presumptive Eligibility Policy under ACA

Health Affairs and the Robert Wood Johnson Foundation (RWJF) released a brief Jan. 9 that reviews how the Affordable Care Act (ACA) expands the presumptive eligibility policy. The presumptive eligibility policy allows hospitals and other entities to temporarily enroll eligible children and pregnant women in Medicaid or the Children’s Health Insurance Program (CHIP). The ACA expanded the role of hospitals in making presumptive eligibility determinations and expanded presumptive eligibility to parents and adults.

The brief reviews the regulations that update current presumptive eligibility rules to allow hospitals that are Medicaid providers to make presumptive eligibility determinations regardless of whether the state has adopted the policy. The brief also answers common questions about the expanded presumptive eligibility policy.


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