Can Medicaid Expansion Cause Issues with ACA Health Insurance?

The Affordable Care Act (ACA) has expanded access to health insurance for millions of Americans, including those with low incomes. Normally, in some states and situations, Medicaid is available to people with incomes below a certain level. In some states that have expanded Medicaid, the income limit is higher than in states that have not expanded Medicaid.

What if my income is over the Medicaid limit but I have ACA insurance?

If your income is over the Medicaid limit, you may still be eligible for ACA insurance. ACA insurance is available to people with incomes up to 400% of the federal poverty level (FPL). The FPL is a measure of income that is used to determine eligibility for certain government programs. In 2023, the FPL is $13,590 for an individual and $27,750 for a family of four.

If your income is over 400% of the FPL, you will not be eligible for ACA insurance. However, you may be able to purchase health insurance through your employer or the individual market.

What if my income changes and I become eligible for Medicaid?

If your income changes and you become eligible for Medicaid, you should contact your state Medicaid agency. You may be able to switch from ACA insurance to Medicaid. However, you may have to pay back any subsidies that you received for ACA insurance.

What if I have ACA insurance and I am approved for Medicaid?

If you have ACA insurance and you are approved for Medicaid, you will need to choose which program you want to use. You cannot have both ACA insurance and Medicaid at the same time.

If you choose to use Medicaid, you will need to cancel your ACA insurance plan. You can do this by contacting your insurance company.

If you need help understanding your options and making a decision, you can contact a licensed insurance agent. An insurance agent can help you compare plans and find the best option for you.

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