Annual Statistical Supplement, 2007
History of SSI, Medicare, and Medicaid Provisions
Supplemental Security Income
- Table 2.B1 Federal benefit rates, by living arrangement, 1974–2007
Medicare
- Table 2.C1 Medicare cost sharing and premium amounts, 1966–2008
Medicaid
- Table 2.C2 Federal medical assistance percentage and enhanced federal medical assistance percentage, by state or other area, 2006–2008
Act | Effective date | Amount a (dollars) | |
---|---|---|---|
Individual | Couple | ||
Own household b | |||
1972 | January 1, 1974 c | 130.00 | 195.00 |
1973 | January 1, 1974 | 140.00 | 210.00 |
1973 | July 1, 1974 | 146.00 | 219.00 |
1974 d | July 1, 1975 | 157.70 | 236.60 |
July 1, 1976 | 167.80 | 251.80 | |
July 1, 1977 | 177.70 | 266.70 | |
July 1, 1978 | 189.40 | 284.10 | |
July 1, 1979 | 208.20 | 312.30 | |
July 1, 1980 | 238.00 | 357.00 | |
July 1, 1981 | 264.70 | 397.00 | |
July 1, 1982 | 284.30 | 426.40 | |
1983 | July 1, 1983 e | 304.30 | 456.40 |
January 1, 1984 | 314.00 | 472.00 | |
January 1, 1985 | 325.00 | 488.00 | |
January 1, 1986 | 336.00 | 504.00 | |
January 1, 1987 | 340.00 | 510.00 | |
January 1, 1988 | 354.00 | 532.00 | |
January 1, 1989 | 368.00 | 553.00 | |
January 1, 1990 | 386.00 | 579.00 | |
January 1, 1991 | 407.00 | 610.00 | |
January 1, 1992 | 422.00 | 633.00 | |
January 1, 1993 | 434.00 | 652.00 | |
January 1, 1994 | 446.00 | 669.00 | |
January 1, 1995 | 458.00 | 687.00 | |
January 1, 1996 | 470.00 | 705.00 | |
January 1, 1997 | 484.00 | 726.00 | |
January 1, 1998 | 494.00 | 741.00 | |
January 1, 1999 | 500.00 | 751.00 | |
January 1, 2000 | 513.00 f | 769.00 | |
January 1, 2001 | 531.00 f | 796.00 | |
January 1, 2002 | 545.00 | 817.00 | |
January 1, 2003 | 552.00 | 829.00 | |
January 1, 2004 | 564.00 | 846.00 | |
January 1, 2005 | 579.00 | 869.00 | |
January 1, 2006 | 603.00 | 904.00 | |
January 1, 2007 | 623.00 | 934.00 | |
Receiving institutional care covered by Medicaid g | |||
1972 | January 1, 1974 | 25.00 | 50.00 |
1987 | July 1, 1988 | 30.00 | 60.00 |
SOURCES: Social Security Act of 1935 (the Act), as amended through December 31, 2006; regulations issued under the Act; and precedential case decisions (rulings). Specific laws, regulations, rulings, legislation, and a link to the Federal Register can be found at the Social Security Program Rules page (http://www.socialsecurity.gov/regulations/index.htm). Social Security Administration, Office of the Chief Actuary, "SSI Federal Payment Amounts," http://www.socialsecurity.gov/OACT/COLA/SSIamts.html. | |||
NOTE: For those in another person's household receiving support and maintenance there, the federal benefit rate is reduced by one-third. | |||
a. For those without countable income. These payments are reduced by the amount of countable income of the individual or couple. | |||
b. Includes persons in private institutions whose care is not provided by Medicaid. | |||
c. Superseded by the provision of 1973. | |||
d. Mechanism established for providing cost-of-living adjustments. | |||
e. General benefit increase. | |||
f. Benefits originally paid in 2000 and through July 2001 were based on federal benefit rates of $512 and $530, respectively. Pursuant to Public Law 106-554, monthly payments beginning in August 2001 were effectively based on the higher $531 amount. Lump-sum compensation payments were made on the basis of an adjusted benefit rate for months prior to August 2001. | |||
g. Must be receiving more than 50 percent of the cost of the care from Medicaid (Title XIX of the Social Security Act). | |||
CONTACT: Alfreda Brooks (410) 965-9849. |
Effective date a | Hospital Insurance (Medicare Part A) | Supplementary Medical Insurance (Medicare Parts B and D) | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Part B | Part D | |||||||||||||
All expenses in "benefit period" covered except— | Monthly premium b (dollars) |
Annual deductible c (dollars) |
Coinsurance c (percent) |
Monthly premium (dollars) | Annual deductible d,e (dollars) |
Initial coverage limit d,e (dollars) |
Out-of- pocket thresh-old d,e (dollars) |
Base beneficiary premium d,f (dollars) |
||||||
Inpatient hospital deductible (IHD) covers first 60 days (dollars) |
Inpatient hospital daily coinsurance |
Skilled nursing facility daily coinsurance after 20 days (1/8 × IHD) (dollars) |
For enrollee g,h (aged and disabled) |
Government amounts for— |
||||||||||
Days 61 through 90 (1/4 × IHD) (dollars) |
Lifetime reserve days after 90 days (1/2 × IHD) |
Aged | Disabled h | |||||||||||
1966 | 40 | 10 | i | i | . . . | 50 | 20 | 3.00 | 3.00 | . . . | . . . | . . . | . . . | . . . |
1967 | 40 | 10 | i | 5.00 | . . . | 50 | 20 | 3.00 | 3.00 | . . . | . . . | . . . | . . . | . . . |
1968 | 40 | 10 | 20 | 5.00 | . . . | 50 j | 20 j | 4.00 k | 4.00 k | . . . | . . . | . . . | . . . | . . . |
1969 | 44 | 11 | 22 | 5.50 | . . . | 50 | 20 | 4.00 | 4.00 | . . . | . . . | . . . | . . . | . . . |
1970 | 52 | 13 | 26 | 6.50 | . . . | 50 | 20 | 5.30 | 5.30 | . . . | . . . | . . . | . . . | . . . |
1971 | 60 | 15 | 30 | 7.50 | . . . | 50 | 20 | 5.60 | 5.60 | . . . | . . . | . . . | . . . | . . . |
1972 | 68 | 17 | 34 | 8.50 | . . . | 50 | 20 l | 5.80 | 5.80 | . . . | . . . | . . . | . . . | . . . |
1973 | 72 | 18 | 36 | 9.00 | 33 | 60 | 20 | 6.30 m | 6.30 | 22.70 | . . . | . . . | . . . | . . . |
1974 | 84 | 21 | 42 | 10.50 | 36 | 60 | 20 | 6.70 | 6.70 | 29.30 | . . . | . . . | . . . | . . . |
1975 | 92 | 23 | 46 | 11.50 | 40 | 60 | 20 | 6.70 | 8.30 | 30.30 | . . . | . . . | . . . | . . . |
1976 | 104 | 26 | 52 | 13.00 | 45 | 60 | 20 | 7.20 | 14.20 | 30.80 | . . . | . . . | . . . | . . . |
1977 | 124 | 31 | 62 | 15.50 | 54 | 60 | 20 | 7.70 | 16.90 | 42.30 | . . . | . . . | . . . | . . . |
1978 | 144 | 36 | 72 | 18.00 | 63 | 60 | 20 | 8.20 | 18.60 | 41.80 | . . . | . . . | . . . | . . . |
1979 | 160 | 40 | 80 | 20.00 | 69 | 60 | 20 | 8.70 | 18.10 | 41.30 | . . . | . . . | . . . | . . . |
1980 | 180 | 45 | 90 | 22.50 | 78 | 60 | 20 | 9.60 | 23.00 | 41.40 | . . . | . . . | . . . | . . . |
1981 | 204 | 51 | 102 | 25.50 | 89 | n,o 60 | 20 o | 11.00 | 34.20 | 62.20 | . . . | . . . | . . . | . . . |
1982 | 260 | 65 | 130 | 32.50 | 113 | 75 p | 20 p | 12.20 | 37.00 | 72.00 | . . . | . . . | . . . | . . . |
1983 | 304 | 76 | 152 | 38.00 | 113 | 75 | 20 | 12.20 | 41.80 | 80.00 | . . . | . . . | . . . | . . . |
1984 | 356 | 89 | 178 | 44.50 | 155 | 75 | 20 | 14.60 | 43.80 | 94.00 | . . . | . . . | . . . | . . . |
1985 | 400 | 100 | 200 | 50.00 | 174 | 75 | 20 | 15.50 | 46.50 | 89.90 | . . . | . . . | . . . | . . . |
1986 | 492 | 123 | 246 | 61.50 | 214 | 75 | 20 | 15.50 | 46.50 | 66.10 | . . . | . . . | . . . | . . . |
1987 | 520 | 130 | 260 | 65.00 | 226 | 75 | 20 | 17.90 | 53.70 | 88.10 | . . . | . . . | . . . | . . . |
1988 | 540 | 135 | 270 | 67.50 | 234 | 75 | 20 | 24.80 | 74.40 | 72.40 | . . . | . . . | . . . | . . . |
1989 | 560 q | q | q | r 25.50 | 156 | 75 | 20 | 31.90 s | 83.70 | 40.70 | . . . | . . . | . . . | . . . |
1990 | 592 | 148 | 296 | 74.00 | 175 | 75 | 20 | 28.60 | 85.80 | 59.60 | . . . | . . . | . . . | . . . |
1991 | 628 | 157 | 314 | 78.50 | 177 | 100 | 20 | 29.90 | 95.30 | 82.10 | . . . | . . . | . . . | . . . |
1992 | 652 | 163 | 326 | 81.50 | 192 | 100 | 20 | 31.80 | 89.80 | 129.80 | . . . | . . . | . . . | . . . |
1993 | 676 | 169 | 338 | 84.50 | 221 | 100 | 20 | 36.60 | 104.40 | 129.20 | . . . | . . . | . . . | . . . |
1994 | 696 | 174 | 348 | 87.00 | 245 t | 100 | 20 | 41.10 | 82.50 | 111.10 | . . . | . . . | . . . | . . . |
1995 | 716 | 179 | 358 | 89.50 | 261 t | 100 | 20 | 46.10 | 100.10 | 165.50 | . . . | . . . | . . . | . . . |
1996 | 736 | 184 | 368 | 92.00 | 289 t | 100 | 20 | 42.50 | 127.30 | 167.70 | . . . | . . . | . . . | . . . |
1997 | 760 | 190 | 380 | 95.00 | 311 t | 100 | 20 | 43.80 | 131.40 | 177.00 | . . . | . . . | . . . | . . . |
1998 | 764 | 191 | 382 | 95.50 | 309 t | 100 | 20 | 43.80 | 132.00 | 150.40 | . . . | . . . | . . . | . . . |
1999 | 768 | 192 | 384 | 96.00 | 309 t | 100 | 20 | 45.50 | 139.10 | 160.50 | . . . | . . . | . . . | . . . |
2000 | 776 | 194 | 388 | 97.00 | 301 t | 100 | 20 | 45.50 | 138.30 | 196.70 | . . . | . . . | . . . | . . . |
2001 | 792 | 198 | 396 | 99.00 | 300 t | 100 | 20 | 50.00 | 152.00 | 214.40 | . . . | . . . | . . . | . . . |
2002 | 812 | 203 | 406 | 101.50 | 319 t | 100 | 20 | 54.00 | 164.60 | 192.20 | . . . | . . . | . . . | . . . |
2003 | 840 | 210 | 420 | 105.00 | 316 t | 100 | 20 | 58.70 | 178.70 | 223.30 | . . . | . . . | . . . | . . . |
2004 | 876 | 219 | 438 | 109.50 | 343 t | 100 | 20 | 66.60 | 199.80 | 284.40 | u | u | u | u |
2005 | 912 | 228 | 456 | 114.00 | 375 t | 110 | 20 | 78.20 | 234.60 | 305.40 | u | u | u | u |
2006 | 952 | 238 | 476 | 119.00 | 393 t | 124 | 20 | 88.50 | 265.30 | 318.90 | 250 | 2,250 | 3,600 v | 32.20 w |
2007 | 992 | 248 | 496 | 124.00 | 410 t | 131 | 20 | 93.50 x | 280.50 y | 301.10 y | 265 | 2,400 | 3,850 v | 27.35 w |
2008 | 1,024 | 256 | 512 | 128.00 | 423 t | 135 | 20 | 96.40 x | 289.00 y | 323.00 y | 275 | 2,510 | 4,050 v | 27.93 w |
SOURCE: Centers for Medicare & Medicaid Services. | ||||||||||||||
NOTES: The structure of Medicare has become increasingly complex over the years. This table provides a summary of Medicare cost sharing and premium provisions. It should be used as an overview and general guide. It is not intended to explain fully all of the provisions or exclusions of the applicable Medicare laws, regulations, and rulings. Original sources of authority should be researched and utilized.
. . . = not applicable.
|
||||||||||||||
a. The deductible and coinsurance amounts begin in January unless otherwise noted. The monthly premium amounts were effective in July through 1983 and in January for 1984 and succeeding years. | ||||||||||||||
b. Standard premium rate for voluntary enrollment by certain aged and disabled individuals not otherwise entitled to Hospital Insurance (HI). (Most individuals aged 65 and older and many disabled individuals under age 65 are insured for HI benefits without payment of any premium.) In most (but not all) cases, a surcharge applies for those beneficiaries who enroll after their initial enrollment period. | ||||||||||||||
c. Most (but not all) services under Part B are subject to the annual deductible and coinsurance percentages shown. Some noteworthy exceptions are footnoted. Noteworthy exceptions in recent years, as of this writing, include (1) clinical lab tests, home health agency services, and certain prescribed preventive care services, which are not subject to the deductible or coinsurance and for which the beneficiary pays nothing; (2) outpatient psychiatric services, for which the coinsurance is 50 percent; and (3) most services reimbursed under the outpatient hospital prospective payment system, for which the coinsurance percentage varies by service but currently falls in the range of 20 percent to 50 percent. Original sources of authority, such as the laws, regulations, and rulings for Part B, should be consulted if specific details are required. | ||||||||||||||
d. There are substantial premium and cost-sharing subsidies for Part D beneficiaries who meet certain low-income and limited-resources criteria. Subsidy levels vary on the basis of dual-eligibility status (that is, coverage by both Medicaid and Medicare), income level, asset level, and institutionalized/noninstitutionalized status. Premiums and cost-sharing amounts for beneficiaries meeting the criteria may be reduced or waived. (The subsidies are financed by certain payments from the general fund of the U.S. Treasury and from the states.) Original sources of authority, such as the laws, regulations, and rulings for Part D, should be consulted if specific details are required. | ||||||||||||||
e. Under the standard Part D benefit design, there is an initial deductible. After meeting the deductible, the beneficiary pays 25 percent of the remaining costs until the initial coverage limit is reached. The beneficiary is then responsible for all costs until the out-of-pocket threshold is reached. (Included in the total out-of-pocket expenditures are the deductible, the 25 percent of costs that is paid by the beneficiary after the deductible is met until the initial coverage limit is reached, and the 100 percent the beneficiary pays for costs above the initial coverage limit. In determining out-of-pocket costs, only those amounts actually paid by the enrollee or another individual (and not reimbursed through insurance) are counted; the exception to this "true out-of-pocket" provision is cost-sharing assistance from the low-income subsidies provided under Part D and from State Pharmacy Assistance programs.) For costs thereafter, there is catastrophic coverage that requires enrollees to pay the greater of 5 percent coinsurance or a small defined copayment amount ($2 in 2006, $2.15 in 2007, and $2.25 in 2008 for generic or preferred multisource drugs, and $5.00 in 2006, $5.35 in 2007, and $5.60 in 2008 for other drugs). Many Part D plans offer alternative coverage that differs from the standard coverage described above. In fact, the majority of beneficiaries are not enrolled in the standard benefit design but rather in plans with low or no deductibles, flat payments for covered drugs, and, in some cases, partial coverage in the coverage gap. Covered drugs may vary by plan. Original sources of authority, such as the laws, regulations, and rulings for Part D, should be consulted if more specific details are required. | ||||||||||||||
f. Part D base beneficiary premium. The actual Part D premiums paid by individual beneficiaries equal the base beneficiary premiums adjusted by a number of factors. Premiums vary significantly from one Part D plan to another and seldom equal the base beneficiary premium. A surcharge for enrollment after an individual's initial enrollment period may apply. (Late enrollment penalties do not apply to enrollees who have maintained creditable prescription drug coverage.) Enrollment in Part D is voluntary. | ||||||||||||||
g. Standard premium rate for voluntary enrollment in Part B. While this will be the amount paid by most Part B beneficiaries, there are three provisions that can alter the premium rate for certain enrollees. First, in most (but not all) cases, a surcharge applies for those beneficiaries who enroll after their initial enrollment period. Second, beginning in 2007, beneficiaries whose income is above certain thresholds are required to pay an income-related monthly adjustment amount, in addition to their standard monthly premium; see footnote x. Finally, a "hold-harmless" provision, which prohibits increases in the standard Part B premium from exceeding the dollar amount of an individual's Social Security cost-of-living adjustment, lowers the premium rate for certain individuals who have their premiums deducted from their Social Security checks. | ||||||||||||||
h. Beginning in July 1973 for the disabled. | ||||||||||||||
i. Benefit not provided. | ||||||||||||||
j. Professional inpatient services of pathologists and radiologists not subject to deductible or coinsurance, beginning in April 1968. | ||||||||||||||
k. Beginning in April 1968. | ||||||||||||||
l. Home health services not subject to coinsurance, beginning in January 1973. | ||||||||||||||
m. Standard monthly premiums for July and August 1973 were reduced to $5.80 and $6.10, respectively, by the Cost of Living Council. | ||||||||||||||
n. Home health services not subject to deductible, beginning July 1, 1981. | ||||||||||||||
o. Professional inpatient services of pathologists and radiologists not subject to deductible or coinsurance, beginning in April 1968, but only when physician accepts assignment. | ||||||||||||||
p. Effective October 1, 1982, professional inpatient services of pathologists and radiologists are subject to deductible and coinsurance. | ||||||||||||||
q. Unlike all other years, the 1989 deductible was applied on an annual, rather than a benefit period, basis. Once the deductible was paid by the beneficiary, Medicare paid the balance of expenses for covered hospital services, regardless of the number of days of hospitalization (except for psychiatric hospital care, which was still limited by the 190-day lifetime maximum). | ||||||||||||||
r. The coinsurance amount in 1989 was equal to 20 percent of the estimated national average daily cost of covered skilled nursing facility care, rather than 1/8 of the inpatient hospital deductible. The beneficiary paid the coinsurance amount for the first 8 days of care in 1989, rather than for days of care 21 to 100 in a benefit period as in all other years. Skilled nursing facility benefits were available for up to 150 days of care per year in 1989, rather than for up to 100 days of care per benefit period as in all other years. | ||||||||||||||
s. Includes the standard monthly Part B premium and a supplemental monthly flat premium under the Medicare Catastrophic Coverage Act of 1988. Amount shown is for most Part B enrollees. Residents of Puerto Rico and other territories and commonwealths, as well as persons enrolled in Part B only, paid different supplemental flat premiums, resulting in a smaller premium than that shown. | ||||||||||||||
t. A reduced premium is available to individuals aged 65 and older who are not otherwise entitled to HI but who have (or who were married to, widowed, or divorced from a spouse for certain periods of time who has or had) at least 30 quarters of Medicare-covered employment. The reduced premium is $184, $183, $188, $187, $170, $170, $166, $165, $175, $174, $189, $206, $216, $226, and $233, for 1994 to 2008, respectively. | ||||||||||||||
u. A temporary Medicare-endorsed prescription drug discount card program was offered. For eligible beneficiaries voluntarily enrolling and paying up to $30 annually, discounts on certain prescription drugs were available, as specified by card sponsors. Under a Transitional Assistance (TA) provision, drug-card eligible beneficiaries whose incomes did not exceed 135 percent of the federal poverty level and who did not have third-party prescription drug coverage were eligible for (1) financial assistance of up to $600 per year for purchasing prescription drugs and (2) a subsidized enrollment fee for the discount card. Enrollment began May 2004, discount availability began June 2004, and the program phases out during 2006, as full Part D became available in January 2006. | ||||||||||||||
v. The 2006 out-of-pocket threshold of $3,600 is equivalent to total covered drug costs of $5,100. The 2007 out-of-pocket threshold of $3,850 is equivalent to total covered drug costs of $5,451.25. The 2008 out-of-pocket threshold of $4,050 is equivalent to total covered drug costs of $5,726.25. | ||||||||||||||
w. See footnote f. As of this writing, it is estimated that the average enrollee premium for basic Part D coverage, which reflects the specific plan-by-plan premiums and the actual number of beneficiaries in each plan, was about $23 in 2006, about $22 in 2007, and will be about $25 in 2008. | ||||||||||||||
x. See footnote g. The 2008 Part B income-related monthly adjustment amounts and total monthly premium amounts to be paid by beneficiaries, according to income level and filing status, are shown in the Medicare section of "Program Descriptions and Legislative History" in this Supplement. The analogous amounts for 2007 are shown on page 41 of the 2006 Supplement. | ||||||||||||||
y. Beginning January 2007 for Part B beneficiaries meeting certain income thresholds and thus paying income-related adjustment amounts in addition to their standard Part B premiums (see footnotes g and x), the government amounts are supposed to be reduced accordingly. | ||||||||||||||
CONTACT: Sol Mussey (410) 786-6386. |
State or area | Federal medical assistance percentage a | Enhanced federal medical assistance percentage b | ||||
---|---|---|---|---|---|---|
2006 c | 2007 d | 2008 e | 2006 c | 2007 d | 2008 e | |
Alabama | 69.51 | 68.85 | 67.62 | 78.66 | 78.20 | 77.33 |
Alaska f | 57.58 | 57.58 | 52.48 | 70.31 | 70.31 | 66.74 |
Arizona | 66.98 | 66.47 | 66.20 | 76.89 | 76.53 | 76.34 |
Arkansas | 73.77 | 73.37 | 72.94 | 81.64 | 81.36 | 81.06 |
California | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Colorado | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Connecticut | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Delaware | 50.09 | 50.00 | 50.00 | 65.06 | 65.00 | 65.00 |
District of Columbia g | 70.00 | 70.00 | 70.00 | 79.00 | 79.00 | 79.00 |
Florida | 58.89 | 58.76 | 56.83 | 71.22 | 71.13 | 69.78 |
Georgia | 60.60 | 61.97 | 63.10 | 72.42 | 73.38 | 74.17 |
Hawaii | 58.81 | 57.55 | 56.50 | 71.17 | 70.29 | 69.55 |
Idaho | 69.91 | 70.36 | 69.87 | 78.94 | 79.25 | 78.91 |
Illinois | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Indiana | 62.98 | 62.61 | 62.69 | 74.09 | 73.83 | 73.88 |
Iowa | 63.61 | 61.98 | 61.73 | 74.53 | 73.39 | 73.21 |
Kansas | 60.41 | 60.25 | 59.43 | 72.29 | 72.18 | 71.60 |
Kentucky | 69.26 | 69.58 | 69.78 | 78.48 | 78.71 | 78.85 |
Louisiana | 69.79 | 69.69 | 72.47 | 78.85 | 78.78 | 80.73 |
Maine | 62.90 | 63.27 | 63.31 | 74.03 | 74.29 | 74.32 |
Maryland | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Massachusetts | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Michigan | 56.59 | 56.38 | 58.10 | 69.61 | 69.47 | 70.67 |
Minnesota | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Mississippi | 76.00 | 75.89 | 76.29 | 83.20 | 83.12 | 83.40 |
Missouri | 61.93 | 61.60 | 62.42 | 73.35 | 73.12 | 73.69 |
Montana | 70.54 | 69.11 | 68.53 | 79.38 | 78.38 | 77.97 |
Nebraska | 59.68 | 57.93 | 58.02 | 71.78 | 70.55 | 70.61 |
Nevada | 54.76 | 53.93 | 52.64 | 68.33 | 67.75 | 66.85 |
New Hampshire | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
New Jersey | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
New Mexico | 71.15 | 71.93 | 71.04 | 79.81 | 80.35 | 79.73 |
New York | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
North Carolina | 63.49 | 64.52 | 64.05 | 74.44 | 75.16 | 74.84 |
North Dakota | 65.85 | 64.72 | 63.75 | 76.10 | 75.30 | 74.63 |
Ohio | 59.88 | 59.66 | 60.79 | 71.92 | 71.76 | 72.55 |
Oklahoma | 67.91 | 68.14 | 67.10 | 77.54 | 77.70 | 76.97 |
Oregon | 61.57 | 61.07 | 60.86 | 73.10 | 72.75 | 72.60 |
Pennsylvania | 55.05 | 54.39 | 54.08 | 68.54 | 68.07 | 67.86 |
Rhode Island | 54.45 | 52.35 | 52.51 | 68.12 | 66.65 | 66.76 |
South Carolina | 69.32 | 69.54 | 69.79 | 78.52 | 78.68 | 78.85 |
South Dakota | 65.07 | 62.92 | 60.03 | 75.55 | 74.04 | 72.02 |
Tennessee | 63.99 | 63.65 | 63.71 | 74.79 | 74.56 | 74.60 |
Texas | 60.66 | 60.78 | 60.53 | 72.46 | 72.55 | 72.37 |
Utah | 70.76 | 70.14 | 71.63 | 79.53 | 79.10 | 80.14 |
Vermont | 58.49 | 58.93 | 59.03 | 70.94 | 71.25 | 71.32 |
Virginia | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Washington | 50.00 | 50.12 | 51.52 | 65.00 | 65.08 | 66.06 |
West Virginia | 72.99 | 72.82 | 74.25 | 81.09 | 80.97 | 81.98 |
Wisconsin | 57.65 | 57.47 | 57.62 | 70.36 | 70.23 | 70.33 |
Wyoming | 54.23 | 52.91 | 50.00 | 67.96 | 67.04 | 65.00 |
Outlying areas | ||||||
American Samoa h | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Guam h | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Northern Mariana Islands h | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Puerto Rico h | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
Virgin Islands h | 50.00 | 50.00 | 50.00 | 65.00 | 65.00 | 65.00 |
SOURCE: Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. | ||||||
a. Section 1905(b) of the Social Security Act (the Act) specifies the method to be used to compute the federal medical assistance percentage. From this section the following formula is derived: N = 3-year average national per capita personal income; S = 3-year average state per capita personal income. Federal medical assistance percentage: State share = (S2/N2) × 45 or (45/N2) × S2; Federal share = 100 − state share with 50–83 percent limits. | ||||||
b. This is the Title XXI enhanced federal medical assistance percentage rate specified in section 2105(b) of the Act. The enhanced federal medical assistance percentage is limited to no more than 85 percent. | ||||||
c. Effective October 1, 2005, through September 30, 2006. | ||||||
d. Effective October 1, 2006, through September 30, 2007. | ||||||
e. Effective October 1, 2007, through September 30 2008. These percentages may change for some states pending comments received on implementation of Section 6503(b) of the Deficit Reduction Act. | ||||||
f. The revised federal medical assistance percentages and enhanced federal medical assistance percentages for Alaska for fiscal years 2006 and 2007 have been calculated pursuant to section 6053(a) of the Deficit Reduction Act. These revised percentages replace the percentages previously published for fiscal years 2006 and 2007. | ||||||
g. The values for the District of Columbia (DC) in the table were set for the state plan under titles XIX and XXI and for capitation payments and Disproportionate Share Hospital (DSH) allotments under those titles. For other purposes, including programs remaining in Title IV of the Act, the percentage for DC is 50.00. | ||||||
h. For purposes of section 1118 of the Social Security Act, the federal medical assistance percentage used under titles I, X, XIV, and XVI, and part A of title IV will be 75 percent. | ||||||
CONTACT: Thomas Musco (202) 690-6870. |