July 2014 — One-year after the Supreme Court’s landmark decision in United States v. Windsor, the Centers for Medicare and Medicaid Services (CMS) continues to release guidance on same-sex marriages and Medicare and Medicaid. CMS recently issued a letter to state Medicaid Directors with guidance on the implication of the decision for non-MAGI Medicaid populations. The guidance gives states the discretion to apply either the IRS’ marriage recognition policy, which recognizes any marriage that is valid in the jurisdiction of celebration, or the state’s own marriage recognition law when determining whether a couple is lawfully married for purposes of Medicaid eligibility.
The guidance is consistent with CMS policy that the agency had previously announced for MAGI Medicaid financial determinations. States will be revising their Medicaid policies in light of the CMS guidance. The guidance also assists same-sex couples and their advocates in understanding how marriage can either positively or negatively affect their ability to access Medicaid benefits. In a more detailed explanation and an upcoming webinar, NSCLC provides more detail on the guidance.