They are not aware that expenses, such as for child care, will be taken into account when Medicaid eligibility is determined. Families may apply to the wrong program or choose not to have their application forwarded to Medicaid because they believe their children are not eligible for Medicaid. States have various options for aligning their income rules. Federal law sets out the rules for calculating a child's family income for determining Medicaid eligibility. These are the minimum requirements.
Federal law permits States to adopt less restrictive income-counting rules without a waiver.
This can be a positive development for uninsured children but would result in additional State expenditures. Similar considerations apply to alignment of asset rules. States that use the same asset test for both programs or that use no asset test in either program have one fewer item to be addressed when coordinated enrollment strategies are designed. Most States have eliminated the asset test in both programs.