Baltimore Sun Examines Medicaid Coverage for Maryland’s ‘Medically Needy’

The Baltimore Sun on Sept. 1 examined the situation of Maryland residents whose incomes are too high to qualify for Medicaid coverage full-time but qualify for coverage on a temporary basis through "spend-down rules." Such residents can qualify for Medicaid coverage as "medically needy" if the difference between their incomes and medical bills meet the standard eligibility level. Eligibility is determined over a six-month period. John Folkemer, executive director of the state health department's office of planning, development and finance, said up to 4,000 people have Medicaid coverage off and on during the course of a year as they meet the spend-down qualifications. Yet this "revolving door" coverage leaves such beneficiaries with gaps in coverage, during in which time many go without necessary medical treatments because of cost, the Sun reports. Some residents who qualify as medically needy could receive permanent Medicaid benefits if the state's income eligibility limits were raised. However, while the state Legislature has boosted eligibility for the state's CHIP program, it has not adjusted the Medicaid eligibility limits "in at least a decade," the Sun reports. House Speaker Casper Taylor (D) said that while the state Legislature next session is likely to consider action on several different plans to expand health coverage, a "tight state budget" and a weak economy could prevent allocation of new funds for any approved plan and "hampe[r] further extensions" (Salganik, Baltimore Sun, 9/1).