Medicare benefits in Flint

On March 3, 2016, the U.S. Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services (CMS) has approved the State of Michigan’s 1115 demonstration to extend Medicaid coverage and services to Flint residents impacted by the lead exposure. In recognition of the public health crisis in Flint, it is a top priority for the Administration and for the Department to ensure that all children and pregnant women exposed to lead in their water in Flint have access to the services they need. Learn More >>

HHS Approves Major Medicaid Expansion for Flint

FLINT, Mich. – Today, the U.S. Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services (CMS) has approved the State of Michigan’s 1115 demonstration to extend Medicaid coverage and services to Flint residents impacted by the lead exposure. In recognition of the public health crisis in Flint, it is a top priority for the Administration and for the Department to ensure that all children and pregnant women exposed to lead in their water in Flint have access to the services they need. Approximately 15,000 additional children and pregnant women will be eligible for Medicaid coverage and 30,000 current Medicaid beneficiaries in the area will be eligible for expanded services under this new waiver agreement.

“Expanding Medicaid coverage to tens of thousands of expectant mothers and youth means the most vulnerable citizens served by the Flint water supply can now be connected to a wide range of needed health and developmental services, including lead-blood level monitoring and behavioral health services,” said HHS Secretary Sylvia M. Burwell.

Michigan will expand Medicaid coverage to children up to age 21 and pregnant women who were served by the Flint water system from April 2014 up to a date specified by the Governor, and who have incomes up to 400 percent of the federal poverty level (FPL). Michigan will also set up a state program allowing pregnant women and children up to age 21 who were served by the Flint water system and individuals with incomes above 400 percent of FPL to purchase unsubsidized coverage. This comprehensive health and developmental coverage includes lead-blood level monitoring and behavioral health services, among other services.

“Connecting children to primary care providers who can follow their health as they grow and develop is a critical component of this response and recovery effort,” said Dr. Nicole Lurie, HHS Assistant Secretary for Preparedness and Response, who is leading the federal response and recovery effort in Flint. "The expanded benefits available through this Medicaid waiver give parents in Flint access to this type of care and support that may be needed to help their children overcome possible effects of high lead exposure. The ultimate goal is for children to thrive.”

Individuals receiving Medicaid coverage will receive full state plan benefits, primarily delivered using the state’s existing managed care system and will not be subject to cost sharing or premiums. The agreement will also enable the state to provide targeted case management services designed to support those exposed to lead through the water system. Targeted case management services will include assistance to help impacted residents gain access to needed medical, social, educational and other services. Eligibility for this coverage starts today and services will be implemented in the coming weeks.

The demonstration will last for five years. HHS is continuing to work with the state on other initiatives to remove lead hazards in homes that are outside the scope of this 1115 demonstration.

Further, the Administration is working across government to support state and local efforts to ensure that families in Flint have access to safe drinking water and the assistance they need to mitigate any harmful impacts of lead contamination in the water supply. Additional federal support underway in Flint includes efforts to analyze the water supply and control the corrosion of pipes (EPA); distribute bottled water, filters and replacement cartridges (FEMA); connect residents with blood-lead level screenings and follow-up care (HHS); help families on food stamps purchase infant formula that doesn’t need to be mixed with water (USDA); inspect and abate lead in homes (HUD); and provide impacted small business owners with low-interest economic injury disaster loans (SBA). Approximately 100 experts and incident management staff from federal agencies, including members of the U.S. Public Health Service Commissioned Corps, and the CDC, have been deployed to Flint to assist with the response and recovery effort.

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To learn more about the Department’s response to the Flint crisis visit:http://www.hhs.gov/blog/2016/02/22/ground-flint.html

For a copy of the full waiver approval, visit: https://www.medicaid.gov/medicaid-chip-program-information/by-topics/waivers/waivers_faceted.html