Current through Register Vol. 24-18, September 15, 2024
(1) A person who meets any of the following
conditions is permanently exempt from deeming and the agency does not count the
sponsor's income or resources when determining eligibility for Washington apple
health (WAH) SSI-related coverage:
(a) The
Immigration and Nationality Act (INA) does not require the person to have a
sponsor. Immigrants who are not required to have a sponsor include those with
the following status with U.S. Citizenship and Immigration Services (USCIS):
(i) Refugee;
(ii) Parolee admitted under Section 212(d)(5)
of the Immigration and Nationality Act (INA);
(iii) Asylee;
(iv) Cuban/Haitian entrant under Section 202
of the Immigration Reform and Control Act of 1986 (IRCA);
(v) Amerasians admitted with an I-551
admission code of AM1, AM2, AM3, AM6, AM7, or AM8; and
(vi) Special immigrant from Iraq or
Afghanistan.
(b) The
person meets the blindness or disability requirements described in WAC
182-512-0050(1);
(c) The person was sponsored by an
organization or group as opposed to another person;
(d) The person is a nonqualified or
undocumented alien as defined in WAC
182-503-0530(3) and
(4);
(e) The person has worked or can get credit
for forty qualifying quarters of work under Title II of the Social Security
Act. The agency does not count a quarter of work toward this requirement if the
person working received TANF, Basic Food, SSI, CHIP, or nonemergency medicaid
coverage. A quarter of work earned by the following people is counted toward
the forty qualifying quarters:
(i) The
person;
(ii) The person's parents
for the time they worked before the person turned eighteen years old (including
the time they worked before the person's birth); and
(iii) The person's spouse if still married or
if the spouse is deceased.
(f) The person has become a United States
(U.S.) citizen;
(g) The sponsor is
dead; or
(h) If USCIS or a court
decides that the person, their child, or their parent was a victim of domestic
violence from the person's sponsor and:
(i)
The person no longer lives with the sponsor; and
(ii) Leaving the sponsor caused the need for
coverage.
(2)
A person is exempt from the deeming process while in the same assistance unit
(AU) as the sponsor.
(3) If the
person, their child, or their parent was a victim of domestic violence, the
person is exempt from the deeming process for twelve months if:
(a) They no longer live with the person who
committed the violence; and
(b)
Leaving this person caused the need for health coverage.
(4) If the person's medical assistance unit
(MAU) has income at or below one hundred thirty percent of the federal poverty
level (FPL), the person is exempt from the deeming process for twelve months.
This is called the "indigence exemption." A person may choose to use this
exemption or not to use this exemption in full knowledge of the possible risks
involved. See risks in subsection (5) of this section. For this rule, the
agency counts the following as income:
(a)
Earned and unearned income received by any member of the MAU from any source;
and
(b) The value of any noncash
items of value such as free rent, commodities, goods, or services received from
another person or organization.
(5) A person who chooses not to use the
indigence exemption must provide verification of the sponsor's income and
resources and will be subject to the deeming rules described in WAC
182-512-0795.
(6) For federally funded programs, if the
person uses the indigence exemption, the agency is required by law to give the
U.S. Attorney General the following information:
(a) The names of the sponsored people in the
person's AU;
(b) That the person is
exempt from deeming due to income;
(c) The sponsor's name; and
(d) The effective date that the twelve-month
exemption began.
