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 Article of Interest - Medicaid

COURT: Medicaid Rules Wrong on parent/Non-Parent Benefits
from Gongwer News Service, January 27, 2003
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Michigan was wrong to require non-parental custodians of children to pay more to be eligible for Medicaid benefits than parents, the 6th Circuit U.S. Court of Appeals ruled Monday.

The unanimous decision, in Markva v. Haveman (USCOA docket No. 01-2509), upheld a ruling from the U.S. District Court in Detroit that the rules violated federal statutes and regulations.

The decision enjoins the state from using a different methodology to calculate the eligibility of non-parental custodians of children for Medicaid health benefits than of parents.

"There is simply no basis in the relevant statute or regulations to distinguish among individuals in the 'medically needy' 'caretaker relative' group based on financial responsibility or any other such criteria," said Judge Martha Craig Daughtrey in the decision joined by Judges Karen Nelson Moore and Peter Economus.

A spokesperson for the Department of Community Health said department staff were just reviewing the ruling and had no comment on whether the state would appeal the decision.

The plaintiffs in the case are a group of grandparents raising their grandchildren because the parents are either dead or absent, and sued the state because rules instituted since the 1996 changes in welfare meant they would have to pay proportionally more to be eligible for Medicaid benefits for their grandchildren than would parents.

The courts said although there might be valid policy reasons for the state to differentiate between parents and non-parent custodians, which based its decision on the fact that parents are legally responsible for a child's financial needs, the policy does not meet federal requirements that caretakers for dependant children be treated substantially the same.

"Both parents and non-parents who care for dependent children are members of the 'caretaker relative' Medicaid eligibility group defined" by the law, the court ruled.

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