Medicaid Expansion: Understanding Coverage and Eligibility

In 2010, the Affordable Care Act (ACA) expanded Medicaid eligibility in 39 states. This expansion significantly changed the healthcare landscape for low-income individuals, providing them with access to affordable health insurance.

What is Medicaid?

Medicaid is a federally funded health insurance program that provides coverage to low-income individuals and families. It is administered by each state, and eligibility requirements vary slightly from state to state.

Medicaid Expansion under the ACA

Before the ACA, Medicaid eligibility was primarily based on income and family size. The ACA expanded Medicaid eligibility to include low-income adults with incomes up to 138% of the federal poverty level (FPL). This means that a single individual with an income of less than $18,754 in 2023 could qualify for Medicaid.

No Asset Test in Expansion States

One of the key changes under the ACA is that there is no asset test for Medicaid eligibility in expansion states. This means that individuals can have significant assets, such as savings or investments, and still qualify for Medicaid.

Income Requirements

Income is the primary eligibility factor for Medicaid. To qualify for expansion Medicaid, individuals must have an income that is below a certain percentage of the FPL. This percentage varies from state to state, but it is typically around 138%.

Benefits of Medicaid

Medicaid provides comprehensive health coverage, including:

– Doctor visits
– Hospitalizations
– Prescription drugs
– Mental health services
– Dental care
– Vision care

Applying for Medicaid

Individuals who believe they qualify for Medicaid can apply through their state’s Medicaid office. The application process typically involves providing proof of income, identity, and residency.

Conclusion

Medicaid expansion under the ACA has significantly improved healthcare access for millions of low-income Americans. By eliminating the asset test and expanding income eligibility, the ACA has made it easier for individuals to obtain affordable health insurance coverage. If you have a low income, it is worth exploring whether you qualify for Medicaid. Contact your state’s Medicaid office to learn more and apply.