The bill amends Section 3 of P.L.1968, c.413 (C.30:4D-3) to increase the income threshold limit for certain Medicaid eligibility groups in New Jersey, establishing that the income standard for determining medically needy eligibility shall be 138 percent of the poverty level. The previous income standards for one and two-person households, capped at 133 1/3% of the State's payment level under the aid to families with dependent children program, have been deleted. Additionally, the resource standards for determining medically needy eligibility have been updated to align with those for recipients of Supplemental Security Income. The bill also modifies various eligibility criteria for Medicaid applicants, including adjustments to income limits for children, pregnant women, and individuals aged 65 and older or those who are blind or disabled, all of which have been increased to 138 percent of the poverty level.

Moreover, the bill proposes significant changes to the income eligibility thresholds for the Aged, Blind, and Disabled (ABD) eligibility group and the Qualified Medicare Beneficiary (QMB) Program, raising the income limit for the ABD group from 100 percent to 138 percent of the federal poverty level. This translates to an increase from $15,650 to $21,597 per year for individuals by 2025. The medically needy income limit will also be adjusted to 138 percent of the federal poverty level, increasing from $367 to $1,800 per month for individuals. The bill consolidates support into the QMB program, which assists low-income individuals in covering their Medicare costs, while phasing out the less generous Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) Programs. The Commissioner of Human Services is tasked with applying for necessary state plan amendments or waivers to implement these changes and streamline the Medicaid eligibility redetermination process.

Statutes affected:
Introduced: 30:4D-3