MaineCare Rule #303A - Household Income Standard for Children and CHIP Changes

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The adopted rule increased the Federal Poverty Level (FPL) to 300% from 208% of the FPL for all children. The adopted rule aligns the MaineCare Eligibility Manual with a legislative change to 22 M.R.S. § 3174-G(B) made by P.L. 2024 ch. 597, §5. The adopted rule is anticipated to increase access to health insurance coverage.

Part 4, Section 4(B, D and E) updates the Federal Poverty Level (FPL) for children under age 21 to 300% of the FPL from 208% of the FPL effective retroactive to October 1, 2023 and consistent with Maine’s State Plan Amendment approved by the Center for Medicaid & CHIP Services. In addition, the adopted rule removes language from D and E that indicates uninsured children, with income between a certain FPL, may be covered under CHIP.

The adopted rule updates Part 4, Section 1, Family Definition as follows:

  1. “individual” would replace “woman”
  2. “one individual” would replace “herself” and “1 person”
  3. “they are” would replace “she is”

CHIP replaces Cub Care throughout the open parts of this rule consistent with legislative changes to 22 M.R.S. §§ 3174-G, 3174-NNN and 3174-T made by P.L. 2024, Ch. 597, An Act to Correct Language Related to Medicaid Coverage for Children.

In order to comply with Medicaid rules at 42 C.F.R. § 433.147, Part 5, Section 3 removes “There is no requirement to refer the non-custodial parent without health insurance to the Division of Support Enforcement and Recovery (DSER).”

Part 5, Section 6, Income Standard increases the household income for all children from 208% of the Federal Poverty Level (FPL) to 300% of the FPL effective retroactive to October 1, 2023.

Retroactive rulemaking is permissible under 22 M.R.S. § 42(8) as these updates provide a benefit to recipients and applicants.

This rule will not have an adverse impact on municipalities or small businesses.

Statutory Authority: 22 M.R.S. §§ 42(1) and (8); 3174-G; 3174-NNN; and 3174-T

Effective Date: August 18, 2024

Office: Office for Family Independence

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