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On April 6, 2022, the Department of Health Care Services (DHCS) submitted to the Centers for Medicare & Medicaid Services (CMS) an application to amend the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration to increase and eventually eliminate asset limits for certain low-income individuals whose eligibility is not determined using the modified adjusted gross income (MAGI)-based financial methods. Assembly Bill 133 (Chapter 143, Section 364, Statutes of 2021) directed DHCS to seek federal approval to implement a two-phased approach to increase and eventually eliminate the asset limits for non-MAGI coverage groups. Under Phase I, effective July 1, 2022, DHCS must apply a disregard of $130,000 in nonexempt property for a single Medi-Cal enrollee and $65,000 for each additional household member, up to a maximum of ten members. Under Phase II, effective January 1, 2024, DHCS must eliminate the asset test for non-MAGI Medi-Cal programs.​​ 

To date, DHCS has submitted and CMS approved State Plan Amendment (SPA) 21-0053 to implement the resource disregard under Phase I to increase the asset limits for most non-MAGI coverage groups; DHCS has not yet submitted to CMS a SPA for Phase II, but intends to do so in the near future. However, because the statutory authority to apply disregards is limited to certain enumerated coverage groups, SPA 21-0053 does not apply to “Deemed  Supplemental Security Income (SSI) groups,” specifically those mandatory Medi-Cal eligibility groups comprised of individuals who would be eligible for Medicaid if they were receiving SSI and/or State Supplementary Payments, but are no longer receiving such payments and are thus “deemed” eligible for Medi-Cal. Therefore, to maintain access to coverage for individuals in the Deemed SSI groups under both phases, DHCS is requesting that CMS approve a Section 1115 demonstration amendment to permit the state to increase and eventually eliminate asset test limits for these groups.​​ 

To view the CalAIM Section 1115 amendment application, please visit the DHCS website.​​