Houghtaling & Downey Bill to Improve Medicaid Eligibility Process Passes Senate

OCEAN TOWNSHIP - A bill (AJR-158) introduced by Assembly Members Eric Houghtaling and Joann Downey that aims to help individuals qualify for Medicaid without racking up significant medical bills was approved on Thursday by the State Senate, and will now proceed to the Governor for approval.

“Right now, the Medicaid application process is a mountain of bureaucracy that can tax the resources of even the most well-prepared households,” said Houghtaling (D-Neptune). “Applicants are routinely faced with surprise expenses stretching into the thousands of dollars, and the entire procedure is a maze of red tape and overlapping regulations. Moreover, as the application period lengthens, families are stuck with mounting medical bills that Medicaid won’t cover.

Under current law, a person who cannot afford their medical bills may also find that they have too many financial assets or too high of an income to qualify for Medicaid. These individuals can become eligible for Medicaid coverage by “spending down” their resources in specific ways, but the process is complex and can take several weeks or months, causing families to incur significant costs that Medicaid will not cover while waiting for their application to be approved.

To combat this, this joint resolution would establish a task force to study State and federal laws and regulations concerning these Medicaid financial resource limits. This task force would then make recommendations for new laws and strategies to make this process more effective and efficient for applicants.

“If you’re a senior in need of long-term care, you can’t afford to apply in January and wait until June for your application to go through,” Houghtaling added. “I should know - my own family has gone through this process, and we came out the other side shaking our heads. It cost us thousands of dollars and the uncertainty of a loved one’s care was a great weight on our family’s mental health. It’s time we stopped playing by a tangled and archaic set of rules and changed Medicaid to provide a simpler, fairer pathway to coverage.”

“Many of the nearly 1.75 million NJ residents who rely on Medicaid have found themselves in this limbo between dwindling personal funds to pay for day-to-day care and a determination of Medicaid eligibility,” said Downey (D-Freehold). “It can take 90 days or longer for approval if the application requires a disability determination, causing great emotional and financial pain for Medicaid applicants and their families. This legislation is a big step forward in protecting our most vulnerable residents.”

get updates