230 GRANITE ADVANTAGE (MAM)

_____________________________________________________________

The Affordable Care Act (ACA) and implementing regulations at 42 CFR 435.119, mandated Medicaid-funded health coverage for an adult group of non-disabled, non-pregnant individuals who were between the ages of 19-64, and who were not entitled to or enrolled in Medicaid or Medicare Part A or B, with income less than or equal to 133% of the FPL. However, due to a US Supreme Court decision that removed the authority to mandate coverage of this group, states were allowed to voluntarily elect to cover this group.  NH has opted to cover this group.

The Granite Advantage Health Care Program (Granite Advantage) uses modified adjusted gross income (MAGI) in the eligibility determination process. The purpose of Granite Advantage is to:

• provide health insurance coverage to more of NH’s low-income citizens;

• improve population health;

• increase provider reimbursement; and

• reduce uncompensated care costs.

All general, categorical, technical, and financial factors related to the MAGI categories of medical assistance apply to Granite Advantage.

References: He-W 511-512, He-W 641.01, He-W 837, RSA 126-A:5-b, RSA 126-A:67, 42 CFR 435.119, Section 1902(a)(10)(A)(i)(VIII) of the Social Security Act (SSA) [42 USC 1396a(a)(10)(A)(i)(VIII)], Section 1906 of the SSA [42 USC 1396e], Section 1937 of the SSA [42 USC 1396u-7]