With the implementation of the Affordable Care Act (ACA) in January 2014, County Medical Services Program (CMSP) enrollment and costs have sharply declined. In December 2013, enrollment was 83,500 and the average enrollment July through December 2014 was 440. Estimated FY 2015/16 revenues are $40.35M and with estimated costs at $7.9M.
On June 25, 2015 the CMSP Governing Board held a Strategic Planning meeting to consider several options related to expanding eligibility and benefits, grant making priorities and investments, and the need for County Participation Fees.
The Yolo County agreement with CMSP was recently been amended to reflect that Yolo is a fully participating member county.
Highlights of the actions approved by the CMSP governing board are listed here:
- Waive the asset test for applicants with income up to 138% Federal Poverty Level (FPL)
- Modify the asset test for applicants above 138% FPL with limits increased based on family size
- Waive share of cost (SOC) for applicants with income up to 138% FPL
- Modify SOC for applicants with income above 138% FPL to 300% FPL to align SOC to be comparable to premium costs under Covered California
- Increase eligibility to 300% FPL
- Reinstate retroactive eligibility process with up to 1 month retroactive coverage
- Revise terms of enrollment for undocumented applicants to be "up to 3 months"
- Establish a basic primary care benefit for share of cost and undocumented applicants, in addition to existing coverage and without regard to the SOC. Provides for up to 3 primary/specialty care visits, standard diagnostic tests, nutrition counseling, rehab services, and pharmacy services (up to dollar cap)
- Waive the county participation fee for FY15/16
- Waive the county participation fee for FY16/17 contingent upon excess revenue
|