WSR 22-11-004
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed May 5, 2022, 10:03 a.m., effective June 5, 2022]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency is making housekeeping changes only. WAC 182-505-0100(1) contains an out-of-date hyperlink to federal poverty level income standards. The agency is editing the rule to include the correct hyperlink, which is https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines/prior-hhs-poverty-guidelines-federal-register-references.
Citation of Rules Affected by this Order: Amending WAC 182-505-0100.
Adopted under notice filed as WSR 22-06-048 on February 24, 2022.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: May 5, 2022.
Wendy Barcus
Rules Coordinator
OTS-3254.1
AMENDATORY SECTION(Amending WSR 17-12-018, filed 5/30/17, effective 6/30/17)
WAC 182-505-0100Monthly income standards for MAGI-based programs.
(1) Each year, the federal government publishes new federal poverty level (FPL) income standards in the Federal Register found at ((http://aspe.hhs.gov/poverty/index.shtml))https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines/prior-hhs-poverty-guidelines-federal-register-references.
(a) The income standards for the following Washington apple health programs change on the first day of April every year based on the new FPL, except for subsections (2) and (3) of this section.
(b) The agency determines income eligibility by comparing countable income as determined of the person's medical assistance unit (MAU), as determined under WAC 182-506-0010 and 182-506-0012, to the applicable income standard. Rules for determining countable income are in chapter 182-509 WAC.
(2) Parents and caretaker relatives under WAC 182-505-0240 must have countable income equal to or below the following standards:
Medical Assistance Unit Size | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11+ |
Income Standard | $511 | $658 | $820 | $972 | $1,127 | $1,284 | $1,471 | $1,631 | $1,792 | $1,951 | $1,951 |
(3) Parents and caretaker relatives with earned income above the limits in subsection (2) of this section are the only people who may be eligible for the transitional medical program described in WAC 182-523-0100.
(4) Adults described in WAC 182-505-0250 who are not eligible under subsection (2) or (3) of this section must have countable income equal to or below one hundred thirty-three percent of the FPL.
(5) Pregnant people described in WAC 182-505-0115 must have countable income equal to or below one hundred ninety-three percent of the FPL.
(6) Children with countable income:
(a) Equal to or below two hundred ten percent of the FPL as described in WAC 182-505-0210 (3)(a)(i) receive coverage at no cost.
(b) Greater than two hundred ten percent but equal to or less than three hundred twelve percent as described in WAC 182-505-0210 (3)(a)(ii) receive premium-based coverage. Premium amounts are described in WAC 182-505-0225.