Stimulus Bill Authorizes Small Payments to Social Security, SSI Beneficiaries

On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act of 2009. This new legislation provides a one-time payment of $250 to each of the more than 60 million Social Security and Supplemental Security Income (SSI) beneficiaries; other provisions affect Medicaid and Medicare.

On February 17, 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act of 2009, Pub. L. No. 110-329 (the “Recovery Act”). The Recovery Act authorizes $789 billion in new federal spending to, among other things, save or create 3.5 million jobs, reduce taxes for low- or moderate-income households, protect Medicaid beneficiaries from state cuts, and dramatically invest in the nation’s infrastructure. (See the White House press release and fact sheets on the Recovery Act, available at www.whitehouse.gov/the_press_office/White-House-Releases-State-by-State-Numbers-American-Recovery-and-Reinvestment-Act-to-Save-or-Create-35-Million-Jobs/).

The law contains provisions relating to Medicare, Medicaid, the Administration on Aging (AoA), and Social Security, including a one-time payment of $250 to each of the more than 60 million Social Security and Supplemental Security Income (SSI) beneficiaries. Below are some of the details of the Recovery Act’s provisions relating to these programs.

Social Security

The $250 one-time payment for Social Security and SSI beneficiaries will be delivered in the same manner as the individual’s monthly benefit payments and should arrive by late May 2009. Anyone who has not received the payment by June 4 should contact the Social Security Administration.

It is important to note that these payments will not count as income for purpose of determining eligibility for or amount of benefits under any Federal or federally funded program, such as SSI, Medicaid, Food Stamps or Housing Assistance. Also, it does not count toward the resource limit for SSI or any other Federal or federally funded program for 9 months following the date of receipt.

Receipt of the stimulus payment will not be affected by the existence of an outstanding Social Security or SSI overpayment since these payments are not Social Security or SSI overpayments. However, they will be subject to offset for other federal debts under the Treasury Offset Program.

Medicaid-enrolled residents of nursing facilities and other long-term care facilities will be allowed to keep the $250. If the resident’s check is held in an account with a nursing facility or other LTC facility, the most important thing to remember is that the money belongs to the resident, not to the facility. The resident should ask the facility for the payment. If the facility serves as the resident’s representative payee, they do not necessarily have to give the resident the cash, but if they decide not to turn over the cash, they nonetheless have to use the payment for the resident’s personal needs and should in most cases spend the money on the basis of the resident’s preferences. They cannot apply this payment to the cost of care since the amount the individual is required to pay has not been changed by receipt of this one-time payment. 

Medicaid Provisions

The Recovery Act will also provide substantial help for state Medicaid programs, including a 6.2 percentage increase in every state’s federal medical assistance percentage (“FMAP,” the federal reimbursement rate for state Medicaid spending).  States with higher unemployment rates will be eligible for greater increases. Crucially, states are only eligible for an FMAP increase if their eligibility standards are no more restrictive than the standards they had in place on July 1, 2008. States that have reduced their eligibility standards since then will be eligible for the increased FMAP if they return to their former standards. For example, a state that has reduced its income limit for a Medicaid population since July 1, 2008 will not be eligible for an FMAP increase unless the state restores the income limit that was in effect on July 1, 2008. It is important to note, however, that state Medicaid cuts in services will not impact a state’s eligibility for the assistance.

The White House initially reported that Mississippi, North Carolina, South Carolina and Virginia were not in compliance with the requirements for the increased FMAP, although it later announced that North Carolina had been able to work with federal officials to resolve its problems and will be eligible for the increase.

Other Medicaid provisions include the extension of the Qualified Individual Program through December 31, 2010 (this program assists certain low-income individuals with their Medicare Part B premiums), and a temporary increase in Disproportionate Share Hospital Payments. The Recovery Act will also extend moratoria on Medicaid regulations for targeted case management services, provider taxes, and school-based administration and transportation services through June 30, 2009.  These same regulations were halted through April 1, 2009 by the Supplemental Appropriations Act, 2008, Pub. L. No. 110-252 (see NSCLC Washington Weekly, July 11, 2008).

Administration on Aging Provisions

The Recovery Act also includes $100 million for congregate meals programs and home-delivered meals programs run by the U.S. Administration on Aging.

Medicare Provisions

In addition to the extension of the QI program mentioned above, the Recovery Act included significant funding for Medicare.  The Act blocked scheduled cuts to teaching hospitals and hospice providers and adjusted payments to long-term care hospitals.  It also included substantial funding for in health information technology infrastructure and programs designed to incentive the use of health IT by both Medicaid and Medicare providers.