H.R. 9345: Medicaid Equal Standards Act

This bill would change Medicaid rules for the

expansion population

—the group of adults covered under Medicaid expansion. Starting January 1, 2029, states would be required to use a resources test to decide whether someone in this group is eligible.

In simple terms, a resources test looks at a person’s assets or savings, not just their income. Under this bill, an applicant could be denied Medicaid if their countable resources are above a set limit. The limit would be:

• $10,000 in 2029 for an individual
• Double that amount for married individuals

After 2029, that dollar amount would generally stay the same from year to year, except that in 2033 and every fourth year after that, it would be adjusted based on inflation using the Consumer Price Index.

The bill would also give states some flexibility to make the test stricter. A state could choose to:

• set a lower asset limit than the federal baseline, or
• count some resources that federal Medicaid rules would otherwise ignore.

States would have to check this resources test at two points:

• when someone first applies for Medicaid, and
• each time an enrolled person’s eligibility is reviewed.

The bill says that if someone is found ineligible because they fail the resources test, the state would still be treated as meeting certain Medicaid expansion requirements for funding purposes. The bill also allows states to expand the group of people covered by this rule to include some categories of otherwise excluded individuals, if the state chooses.

In practical terms, this bill would make Medicaid eligibility for expansion adults depend not only on income, but also on whether they have assets above the allowed level. People with higher savings or other countable resources could lose or be denied coverage, depending on state rules.

Relevant Companies

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