| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | AFFORDABLE INSURANCE STANDARDS CHANGE; MANUAL REVISION #28 SECTION 0920.020.10.05 |
DISCUSSION:
Effective August 28, 2007, Senate Bill 577 modifies the definition of affordable health insurance for families with income above 150% of the Federal Poverty Level (FPL). Families with income between 150% and 300% of the FPL with access to insurance must meet the following affordability guidelines:
-
151%-185% of the FPL = $64/month
-
186%-225% of the FPL = $106/month
- 226%-300% of the FPL = $161/month
If insurance is available for the children below these levels, the child is not eligible for the MC+ healthcare coverage due to access to affordable health insurance.
Applications and Interim Changes
For pending Legacy applications/case actions, utilize the new affordability standards to determine September 2007 eligibility. If a family is eligible based on the new guidelines, void any outstanding adverse actions and notify the family of continued eligibility.
For pending FAMIS applications/case actions, the new affordability standards to determine September 2007 and ongoing eligibility will be applied and the household notified systematically.
Legal Basis
Senate Bill 577 amends the affordability standard in Section 208.640 RSMo effective August 28, 2007. The new affordability standard is based upon a percentage of income for a family of three at 150%, 185%, or 225% of the FPL, depending upon the family's gross income.
For families with gross income above 150% up to and including 185% of FPL the affordability standard is based upon a monthly premium amount of 3% of 150% of the FPL for a family of three ($2147 x 3%=$64).
For families with gross income above 185% up to and including 225% of FPL the affordability standard is based upon a monthly premium amount of 4% of 185% of the FPL for a family of three ($2648 x 4%=$106).
For families with gross income above 225% up to and including 300% of FPL the affordability standard is based upon a monthly premium amount of 5% of 225% of FPL for a family of three ($3220 x 5%=$161).
Notification
A notice 
is being sent to applicants/recipients who were rejected or closed from July 1, 2006, through the present based on access to affordable insurance under the old affordability standards. The notice advises these families of the change in the affordability standards, provides an income and affordability standards chart, and instructs them to contact the local Family Support Division office if they would like to reapply for MC+ under the new affordability standards.
NECESSARY ACTION:
- Apply the new affordability standards for September 2007 and later.
- Review this memorandum with appropriate staff.