LIFE Accounts

The three-year study examined relevant policy, program design, and cultural implications that may have an impact on enabling self-directed Medicaid beneficiaries to save money without losing benefits. Using extensive stakeholder engagement, six elements were studied: savings models; costs and benefits of self-direction; Federal tax policy; state policy context; participant needs; and an implementation plan.

This report describes grant activities (accomplishments and progress) in three major LTC systems areas: Access to LTC Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure. The report also provides illustrative examples of the challenges Grantees have faced as they implement grant activities, and consumers’ roles in the implementation and evaluation of these activities.

The Deficit Reduction Act of 2005 adds a new section 1937 to the Social Security Act (the Act). Under section 1937 a state may amend its State plan to provide alternative benefit packages to some of its recipients without regard to comparability, statewideness, freedom of choice, or certain other traditional Medicaid requirements. This paper looks briefly at how Section 1937 might be used by a state to develop a LIFE Account model.

The Compendium contains basic information about each of the Real Choice Systems Change Grant awards in FY03–FY04 plus the Family to Family and Systems Transformation Grantees awarded in FY05 and FY06. The Compendium will help Grantees identify others with similar goals and activities. Learn more about how the grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. The sixth edition replaces all previous editions.

Review two papers that center on the topic of public disability and health benefits and the fundamentals of the Disability Insurance and Supplemental Security Income programs and their relationships with Medicare and Medicaid. Part I looks at definitions, distinctions and overlaps; it reviews the effects on the Ticket to Work and Work Incentives Improvement Act. Part II discusses major initiative and issues in these programs in light of growing administrative, fiscal, and other problems.

As part of the 2004 Real Choice grants, New Hampshire and Wisconsin proposed to complete a feasibility study and then develop LIFE Account programs. With no federal legislation creating a savings program, grantees are restricted to modified program that works under existing law. This paper considers six options: Section 1115 Demonstrations, Waivers under Section 1915(c) & 1915(b), Section 1915(i) & 1915(j) State Plan programs, and Section 1937 Benchmark programs and suggests some next steps.

This letter is one of a series that provides guidance on the implementation of the Deficit Reduction Act. Section 6044, State Flexibility in Benefit Packages, adds a new section 1937 to the Social Security Act. Review the options that states have to amend plans to provide alternative benefit packages to beneficiaries, without regard to comparability, statewideness, freedom of choice, or certain other traditional Medicaid requirements.