ASSEMBLY AGING AND HUMAN SERVICES COMMITTEE
STATEMENT TO
ASSEMBLY, No. 4612
with committee amendments
STATE OF NEW JERSEY
DATED: FEBRUARY 13, 2025
The Assembly Aging and Human Services Committee reports favorably and with committee amendments Assembly Bill No. 4612.
This bill, as amended, increases the resource threshold for certain Medicaid eligibility groups. Specifically, the bill increases the resource eligibility limit for the Aged, Blind, and Disabled (ABD) eligibility group and the Medically Needy eligibility group, as well as for qualified applicants to the State’s Managed Long-Term Services and Supports (MLTSS) Program and 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 ABD and Medically Needy; $2,000 for the MLTSS; and $9,090 for the Medicare Savings Programs.
The bill, as amended, stipulates that a qualified applicant or beneficiary for the Medicaid Managed Long-Term Services and Supports Program is eligible for the program if the applicant’s resources do not exceed 100 percent of the resource standard used to determine medically needy eligibility pursuant to section 3 of P.L.1968, c.413 (C.30:4D-3) after any allocation of resources to a community spouse has been made as otherwise required
The Medicaid ABD pathway provides medical coverage to individuals who are age 65 years or older as well as individuals determined blind or disabled by the federal Social Security Administration or by the State. The Medically Needy program allows an income ineligible applicant for ABD benefits to deduct certain medical expenses from the applicant’s income in order to become eligible for Medicaid. The MLTSS program provides access to Medicaid long-term care benefits, in addition to all other covered services, for older adults and people with disabilities who require a skilled nursing facility level of care. And finally, Medicare Savings Programs - such as the Qualified Medicare Beneficiary Program, the Specified Low-Income Medicare Beneficiary Program, and the Qualifying Individual Program - assist low-income individuals with Medicare costs via the Medicaid program. The bill aligns these programs’ resource standards with the State’s current resource threshold under the Jersey Assistance for Community Caregiver, or JACC, program. JACC provides non-Medicaid recipients access to a range of home and community-based services.
Under the bill, as amended, the Commissioner of Human Services is to apply for such State plan amendments or waivers as may be necessary: to implement the provisions of this act; to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program; and to reduce the administrative burden on, and simplify the redetermination process implemented by, the department regarding the Medicaid eligibility groups affected by the bill.
COMMITTEE AMENDMENTS
The committee amendments remove all provisions of the bill that would increase the income threshold of the applicable Medicaid eligibility populations. The committee amendments update the bill’s title and synopsis to reflect this change.
The committee amendments stipulate that a qualified applicant or beneficiary for the Medicaid Managed Long-Term Services and Supports Program is eligible for the program if the applicant’s resources do not exceed 100 percent of the resource standard used to determine medically needy eligibility pursuant to section 3 of P.L.1968, c.413 (C.30:4D-3), after any allocation of resources to the community spouse has been made as otherwise required by law.
The committee amendments require the Commissioner of Human Services to apply for such State plan amendments or waivers as may be necessary to reduce the administrative burden on, and simplify the redetermination process implemented by, the department regarding the Medicaid eligibility groups affected by the bill.