Opinion ID: 2554470
Heading Depth: 1
Heading Rank: 4

Heading: State Administered General Assistance Medical Program (SAGA-medical)

Text: In addition to federal Medicaid, state law provides for a separate, state medical assistance program, commonly referred to as SAGA-medical, which provides coverage for certain categories of indigent individuals who do not meet the categorical eligibility requirements for federal Medicaid. See General Statutes § 17b-192 (a). Before the legislature enacted Spec. Sess. P.A. 09-5, the SAGA-medical statute provided that coverage under that program would be available to persons ineligible for [federal] Medicaid. General Statutes (Rev. to 2009) § 17b-192 (a). Through the enactment of Spec. Sess. P.A. 09-5, § 55, the legislature altered the statutory eligibility requirements for SAGA-medical such that it currently provides coverage to only those indigent individuals who do not meet the categorical eligibility requirements for federal Medicaid. General Statutes § 17b-192 (a). Unlike federal Medicaid, SAGA-medical has no citizenship or United States residency requirements. See generally General Statutes § 17b-192. Thus, SAGA-medical provides coverage to citizens and indigent qualified aliens who do not meet the categorical eligibility requirements of federal Medicaid. [17] Because the class members are categorically eligible for federal Medicaid, they are ineligible for coverage under SAGA-medical. The class members currently are ineligible for any of these publicly funded medical assistance programs. The class members are barred from receiving federal Medicaid because of the five year rule in the Welfare Reform Act. They are ineligible for assistance under SMANC because Spec. Sess. P.A. 09-5, § 64, substantially repealed SMANC, thereby eliminating its coverage for the class members. Furthermore, the class members are ineligible for SAGA-medical because they are categorically eligible for federal Medicaid notwithstanding the federal five year rule, which bars them from participating in federal Medicaid. In the present case, the plaintiff challenges only the latter two eligibility limitations and not the federal five year rule in the Welfare Reform Act.