Medicaid Expansion


 

The Medicaid program is designed to help low-income Americans obtain health insurance coverage that they can afford. Unfortunately, this program is limited to a very slim population in most states where far more poverty-stricken individuals are in need of health care.

The Obama administration sought to change the injustice of being poor and uninsured by offering the program to a new group — low-income adults without children. Under the Patient Protection and Affordable Care Act, Americans age 19 to 64 can enroll in health insurance for free and not continue to let the cost of care and coverage be an obstacle.

Adding this new group would have been mandatory for each state if the original version of the Affordable Care Act was upheld, but the Supreme Court decided Medicaid expansion could be optional. With that freedom, about half of states opted out, leaving millions of needy Americans still without coverage. Other states made it possible for childless adults to get covered through the state’s Medical Assistance program.

Beginning in 2014, states that have decided to include this new eligibility group will enroll childless adults who were previously unable to enroll for Medicaid in more than 40 states no matter how little they earned. Additionally, more low-income parents will be able to get covered under Medicaid expansion.

 

Before health reform, parents in more than 30 states didn’t qualify for coverage even if their children did because the income guidelines were set extremely low for parents, like $1,100 per month, for example.

 

Income Guidelines

In states where Medicaid has expanded, adults who earn up to 133 percent of federal poverty level, or $1,319 per month in 2013 for a single earner will qualify.

 

Income Thresholds Before and After the ACA

 

*State income limit must be greater than or equal to the U.S. minimum threshold.
**In states participating in Medicaid expansion, the income limit will be at or above the new U.S. minimum threshold starting in 2014. If a state’s threshold was already above this limit, it may continue to be higher.
^AFDC was Aid to Families with Dependent Children, cash assistance program replaced by TANF (Temporary Assistance to Needy Families) in 1996. Supplemental Security Income (SSI) is the program that provides supports blind, disabled and elderly Americans with cash benefits.

 

Childless Adults: New Eligibility

Medicaid expansion under health reform has cause dispute among many states who believe the program will drain state funds. However, funding for this new group of applicants is provided by the federal government for the early years of expansion.

Billions of dollars in federal funds have been offered to all 50 states to make room for more Medicaid members, but the money has been turned down by 22 states. As of September 2013, three states were debating the benefits of expanding Medicaid and requested more time to further study the effort.

State legislation to authorize a new Medicaid group has been written to enforce the Affordable Care Act’s provision, in the 26 states who support expansion. It is necessary to enact laws to enforce Medicaid expansion, as it is optional.

In order to implement the expansion, the federal government will pay for 100 percent of the program from 2014 to 2016, and starting in 2017, they will gradually reduce funding, holding states responsible for 10 percent of the program costs by 2020. The states themselves do not receive the funds, as they go to doctors and hospitals.

 

Medicaid Expansion By State

26 states have allowed for Medicaid expansion, some signing it into law, and others who plan to expand and have yet to establish state legislation. Four are still on the fence, and may implement it later, while the others have decided against it at this time. Any state can decide to opt in later if they choose, but not as much funding will be available from the government.

 

 

STATES EXPANDING

MAY EXPAND

NOT EXPANDING

Arizona

Indiana

Alabama

Arkansas

Utah

Alaska

California

Florida

Colorado

Georgia

Connecticut

Idaho

Delaware

Indiana

District of Columbia

Kansas

Hawaii

Louisiana

Illinois

Maine

Iowa

Mississippi

Kentucky

Missouri

Maryland

Montana

Massachusetts

Nebraska

Michigan

North Carolina

Minnesota

Oklahoma

Nevada

South Carolina

New Hampshire

South Dakota

New Jersey

Tennessee

New Mexico

Texas

New York

Utah

North Dakota

Virginia

Oregon

Wisconsin

Pennsylvania

Wyoming

Rhode Island

Vermont

Washington