Dropping asset test should speed up Medicaid

Molly Ball

Wednesday, June 30, 2004 | 9:05 a.m.

About 1,200 needy children and pregnant women in Clark County are expected to benefit in the next year from a policy change that will make it easier for them to get state assistance.

On Thursday, Nevada will remove the "asset test" from its Child Health Assurance Program, meaning Medicaid administrators will take into account only a household's income, not property, investments or bank accounts.

"The asset test has largely been viewed as a barrier to families being able to gain health care," said Mike Willden, director of the state Department of Human Resources.

The change "speeds up the eligibility process to get people into care," Willden said. "I believe we're one of the few states that still have an asset test" for such a program, he said.

The Legislature enacted the change last year as part of the budget. The change is a step in Gov. Kenny Guinn's goal of increasing the number of Nevadans who have access to health care, Willden said.

Since the federal government's welfare reform in 1996, at least 15 states have removed asset tests from Medicaid. The children's program from which Nevada is removing the test represents only a small part of the state's Medicaid program, but officials see it as a step in the right direction.

Under the old rules, a single, pregnant woman whose income was less than $12,382 -- a number derived by calculating 133 percent of the federal poverty level -- would also have to prove that she had less than $2,000 in assets to get assistance such as prenatal care. Necessities like her car and residence weren't counted, but a second car or house generally would have been.

Few people flunk the asset test because few people with low income have thousands of dollars worth of stocks or own a boat, said Leslie Danihel, chief of eligibility and payments for the state Welfare Division.

"People who meet the income limits of our programs generally don't have a lot of assets," she said.

Steve Hansen, CEO of the nonprofit Nevada Health Centers, agreed that "not many women are on the margin" of Medicaid eligibility. The center's clinics in Las Vegas average 60 to 70 births per month, and last month the center opened a clinic devoted exclusively to obstetrics and gynecology.

"These women are poor and will qualify with or without their assets being tested," Hansen said, noting that while eligibility requires an income of less than 133 percent of the poverty level, most of the patients his clinics see are below the poverty level itself -- $9,310 for a single person.

While the asset test weeds out very few candidates, it wastes staffers' time as they verify the assets reported on applications, Willden said.

With the new streamlined system, the state has projected that 138 new cases a month will result from the change, meaning 1,656 people would be added within a year statewide, Roger Mowbray, deputy administrator for the Welfare Division, said.

Separate numbers for Southern Nevada were not calculated, Mowbray said. But based on Clark County's proportion of the total Medicaid rolls, 72.7 percent, about 1,200 people in the county would probably benefit.

As of April, the children's program had 27,062 enrollees.

The change is expected to have a net cost of about $4.1 million, with about $1.85 million coming from the state and the rest from federal matching funds, Mowbray said.

Another Medicare change, the Health Insurance for Work Advancement program, will also begin July 1. That program allows disabled people to buy into Medicaid when they return to work, giving them an incentive to earn an income, Willden said.

About 500 Nevadans are expected to sign up for that program.