February 25, 2016

Medicaid Cost Sharing

OLR Report 2016-R-0007 describes the limits that federal law places on states from imposing cost sharing requirements on Medicaid recipients.

Federal Law (1) limits cost sharing to nominal amounts for recipients under 100% of the federal poverty level (FPL) and (2) allows for greater, though limited, cost sharing for individuals over 100% of the FPL.  States are prohibited by law from imposing cost sharing for (1) Medicaid emergency services or family planning services or supplies and (2) services for children under the age of 18 and pregnant women (42 USC § 1396o). 

Generally, most of Connecticut’s Medicaid recipients receive health care through one of the Department of Social Services’ HUSKY programs. (i.e., HUSKY A, C, and D), which do not require deductibles and copayments.

For more information, read the full report here.