Mitigating Medicaid Cliffs

PRS Briefs
Monday, September 12, 2022

A Medicaid coverage cliff is a situation in which beneficiaries have incomes that exceed the limit for Medicaid supplemental coverage but still do not earn enough to afford private insurance. This report identifies the scope of Medicaid cliffs in Vermont and gives the Vermont House Committee on Healthcare recommendations on its current policies, provides case studies that explore new policies Vermont may implement, and offers alternative policies that can be put in place. First, the report examines the current state of Medicaid and Medicaid benefit cliffs in Vermont. Next, the report assesses previous and existing programs in Vermont that alleviate the pressure of benefits cliffs including Reach Up, a cash assistance program that targets families. Then, it explores case studies from other states such as Mississippi, Maine, Massachusetts, and New York that may help inform the efforts of the Committee to mitigate cliffs. Lastly, the report presents two alternative solutions: Transitional Medicaid with Increasing Copays and the promotion of the No Wrong Door Policy.