Social Security Amendments (P.L. 89-97)
1. Created Medicaid as an optional program jointly funded by the federal government and states with certain mandatory populations and services to be covered.
Social Security Amendments (P.L. 90-248)
1. Mandated early and periodic screening, diagnostic, and treatment (EPSDT) services for Medicaid children younger than 21.
Social Security Amendments (P.L. 92-603)
1. Repealed the Medicaid “maintenance of effort” requirement for states.
2. Required states to either cover those receiving Supplemental Security Income (newly created in 1972) or maintain their 1972 eligibility levels for Medicaid coverage.
Omnibus Reconciliation Act (P.L. 97-35)
1. Repealed states’ obligation to pay Medicare hospital payment rates and allowed states to make additional payments to hospitals serving a disproportionate share of low-income people (usually called disproportionate share hospital, or DSH, payments).
2. Created freedom-of-choice (section 1915b) waivers, enabling states to enroll certain Medicaid populations into mandatory managed care; and HCBS (section 1915c) waivers, allowing states to cover home and community-based long-term care for the elderly and disabled at risk of needing institutional care.
Omnibus Reconciliation Act (P.L. 99-509)
1. Mandated coverage of emergency services for illegal immigrants who would otherwise be eligible for Medicaid.
2. Allowed states to cover children up to age 5 and pregnant women up to the federal poverty level (FPL), and allowed states to pay for Medicare cost-sharing and premiums for low-income qualified Medicare beneficiaries (QMBs) with income below the poverty level.
Medicare Catastrophic Coverage Act (P.L. 100-360)
1. Made coverage of poor infants, pregnant women, and QMBs mandatory (see P.L. 99-509, item 2).
Family Support Act (P.L. 100-485)
1. Required states to extend one year of transitional medical assistance to families that lose Aid to Families with Dependent Children (AFDC) cash assistance because of work earnings.
Omnibus Budget Reconciliation Act (P.L. 101-239)
1. Mandated coverage of children under 6 and pregnant women with incomes less than 133 percent of FPL.
2. Expanded the EPSDT benefit to include necessary diagnostic and treatment services for children, even if similar services were not covered for adults in a given state (see P.L. 90-248).
Omnibus Budget Reconciliation Act (P.L. 101-508)
1. Created the Medicaid prescription drug rebate program.
2. Required phased-in coverage of children age 6–18 in families with incomes up to the poverty level, to be completed by 2002.
3. Mandated coverage of Medicare premiums for beneficiaries with incomes between 100 and 120 percent of FPL (called special low-income Medicare beneficiaries, or SLMBs).
Personal Responsibility and Work Opportunity Reconciliation Act (P.L. 104-193)
1. Replaced AFDC with Temporary Assistance for Needy Families (TANF). Mandated coverage of families meeting AFDC eligibility standards as of July 16, 1996, while permitting coverage of higher-income families.
2. Prohibited Medicaid coverage for legal immigrants entering the United States after August 21, 1996, and allowed states to cover these immigrants after they are in the country for five years.
Balanced Budget Act (P.L. 105-33)
1. Created the State Children's Health Insurance Program (SCHIP), later referred to as CHIP.
2. Allowed states to implement mandatory managed care enrollment for most Medicaid beneficiaries without obtaining section 1915(b) waivers.
3. Required coverage of Medicare premiums for beneficiaries with incomes between 120 and 135 percent of FPL (referred to as QIs), subject to fully federal capped funding.
Breast and Cervical Cancer Prevention and Treatment Act (P.L. 106-354)
1. Allowed coverage of uninsured women with breast or cervical cancer regardless of their income and resources.
Medicare Prescription Drug, Improvement, and Modernization Act (P.L. 108-173)
1. Created the Medicare Part D prescription drug program with full premium subsidies for people whose incomes fall below 135 percent of FPL.
2. Transferred drug coverage of individuals dually eligible for Medicaid and Medicare to Medicare starting in 2006. Medicaid also still provides some prescription drug coverage for the dually eligible population for prescription drugs not covered under Medicare Part D.
Patient Protection and Affordable Care Act (P.L. 111-148)
1. Expanded Medicaid to almost all individuals with incomes up to 138 percent of FPL starting in 2014. The Supreme Court ruling in 2012 made the coverage expansion optional for states.