Medicaid Expansion: What It Means for States and Individuals

Medicaid expansion is a key provision of the Affordable Care Act (ACA) that has expanded health insurance coverage to millions of low-income Americans. Under Medicaid expansion, states have the option to cover adults with incomes up to 138% of the federal poverty level (FPL), which is about $18,754 for an individual in 2023.

States’ Options Under Medicaid Expansion

States have several options when it comes to Medicaid expansion. They can choose to:

Expand Medicaid to cover all adults up to 138% FPL
Expand Medicaid to a more limited group of adults, such as those with incomes up to 100% FPL
Not expand Medicaid at all

As of 2023, 39 states and the District of Columbia have expanded Medicaid, while 11 states have not.

Benefits of Medicaid Expansion

Medicaid expansion has a number of benefits for both states and individuals. For states, Medicaid expansion can:

Reduce the number of uninsured residents
Improve the health of residents
Boost the economy

For individuals, Medicaid expansion can:

Provide access to affordable health insurance
Improve health outcomes
Increase financial security

Challenges of Medicaid Expansion

Medicaid expansion also comes with some challenges. For states, the main challenge is the cost of expansion. However, the federal government provides significant funding to states that expand Medicaid, and the costs of expansion are often offset by the savings that states realize from reduced uncompensated care costs.

For individuals, the main challenge is finding a provider who accepts Medicaid. However, there are a number of resources available to help individuals find providers who accept Medicaid, such as the Medicaid Managed Care Locator.

How to Apply for Medicaid Expansion

Individuals who are interested in applying for Medicaid expansion can do so through their state’s Medicaid agency. The application process varies from state to state, but generally involves providing information about your income, assets, and household size.

If you are approved for Medicaid expansion, you will receive a Medicaid card that you can use to access health care services. Medicaid covers a wide range of services, including doctor visits, hospital stays, prescription drugs, and mental health services.

Conclusion

Medicaid expansion is a valuable program that has expanded health insurance coverage to millions of low-income Americans. Medicaid expansion has a number of benefits for both states and individuals, and it is an important part of the Affordable Care Act.