LEGISLATIVE FISCAL ESTIMATE

[First Reprint]

ASSEMBLY, No. 4612

STATE OF NEW JERSEY

221st LEGISLATURE

 

DATED: MAY 1, 2025

 

 

SUMMARY

 

Synopsis:

Increases resource threshold limit for certain Medicaid eligibility groups.

Type of Impact:

Annual State expenditure and revenue increases.

Agencies Affected:

Department of Human Services.

 

 

Office of Legislative Services Estimate

Fiscal Impact

Year 1 

Year 2 and Beyond

 

State Expenditure Increase – Service Related

$22.6 million to

$30.5 million

$315,000

 

State Revenue Increase – Service Related

$11.3 million to

$15.2 million

$157,500

 

State Expenditure Increase – Administrative Related

Indeterminate

N/A

 

State Revenue Increase – Administrative Related

Indeterminate

N/A

 

 

 

 

 

·         The Office of Legislative Services (OLS) concludes that this bill will increase State Medicaid service expenditures in the first year of implementation between approximately $22.6 million and $30.5 million due to enrollment growth in certain Medicaid eligibility groups, resulting from the increased resource limits established in the bill.  These increased costs concomitantly will grow State revenue in the form of federal cost reimbursements for Medicaid service expenditures between $11.3 million and $15.2 million, for a net State cost of $11.3 million and $15.2 million in the first year of implementation. 

·         In the out years, enrollment growth will drop as this estimate assumes the bulk of the newly eligible enrollees will be captured in the initial roll out.  The OLS predicts in the second year and beyond that annual State service expenditures will increase by approximately $315,000 and annual State revenue will increase by $157,500, for an annual net State cost of $157,500. 

·         Additional to service costs, the OLS estimates that the Department of Human Services will experience a one-time indeterminate administrative cost increase to update the State’s eligibility systems to comply with this bill.  As with service expenditures, these administrative expenses will qualify for federal reimbursements.

 

BILL DESCRIPTION

 

      This bill increases the resource eligibility limit for the Aged, Blind, and Disabled eligibility group, the Medically Needy eligibility group, the Managed Long-Term Services and Supports Program, and the Medicare Savings Programs, to $40,000 for an individual and $60,000 for a couple. 

      The current resource thresholds for an individual under these eligibility pathways are as follows: $4,000 for the Aged, Blind, and Disabled and Medically Needy eligibility groups; $2,000 for the Managed Long-Term Services and Supports Program; and $9,660 for the Medicare Savings Programs.    

 

 

FISCAL ANALYSIS

 

EXECUTIVE BRANCH

 

      None received.

 

OFFICE OF LEGISLATIVE SERVICES

 

      The OLS concludes that this bill will increase State Medicaid service expenditures in the first year of implementation between approximately $22.6 million and $30.5 million due to enrollment growth in certain Medicaid eligibility groups, resulting from the increased resource limits established in the bill.  These increased costs concomitantly will grow State revenue in the form of federal cost reimbursements for Medicaid service expenditures between $11.3 million and $15.2 million, for a net State cost of $11.3 million and $15.2 million in the first year of implementation.  In the out years, enrollment growth will drop as this estimate assumes the bulk of the newly eligible enrollees will be captured in the initial roll out.  The OLS predicts in the second year and beyond that annual State service expenditures will increase by $315,000 and annual State revenue will increase by $157,500, for an annual net State cost of $157,500.  Additional to service costs, the OLS estimates that the Department of Human Services will experience a one-time indeterminate administrative cost increase to update the State’s eligibility systems to comply with this bill.  As with services expenditures, these administrative expenses will qualify for federal reimbursements.

      The eligibility groups affected under this bill are referred to as the Non-Modified Adjusted Gross Income (Non-MAGI) eligibility groups.  Non-MAGI eligibility groups refer to individuals who qualify for Medicaid benefits based on factors other than their Modified Adjusted Gross Income, meaning their eligibility is determined using criteria like age, disability status, or blindness, rather than just their income level.  The chart below provides information about the State’s non-MAGI eligibility groups, and the impacts of the bill on these populations. 

 

*Includes Medically Needy within the Aged, Blind, and Disabled eligibility group.   Does not include other subcategories, such as pregnant individuals, of Medically Needy Program. 

      This estimate assumes the current cost per enrollee in each of the affected eligibility groups and that enrollment for each group will grow by between 0.26 percent and 0.35 percent in the first year of implementation.  This translates to between 1,398 and 1,882 newly eligible enrollees, across all eligibility groups, in the first year of implementation.  In the out years, enrollment growth will drop to approximately 19 newly eligible enrollees per year.  The growth rates used to provide this fiscal estimate are based upon an analysis of enrollment data for non-MAGI eligibly groups in California, after the state increased the resource limits for these groups.  

 

 

Section:

Human Services

Analyst:

Sarah Schmidt

Principal Research Analyst

Approved:

Thomas Koenig

Legislative Budget and Finance Officer

 

 

This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.

 

This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).