Medicaid Expansion: What Might It Mean for You?
Entrusted Legacy Law
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Mar 03, 2023
Pennsylvania - Greater Pittsburgh Area
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As of late 2022, more than 84 million were enrolled in
Medicaid — a number that has steadily increased in recent years. Amid the
pandemic, total enrollees climbed by 20 million people from 2020 to 2022
alone.
Meanwhile, the debate among lawmakers on further expanding
Medicaid in some 11 states continues to evolve. Depending on where you reside,
passage of such an expansion could mean you become newly eligible for
Medicaid.
What Is Medicaid?
Medicaid is a nationwide program designed to provide public
health insurance for low-income individuals, including seniors and people with
disabilities. Established in 1965, it serves today as the single-largest source
of health coverage in the U.S.
Because Medicaid is jointly run by the federal government
and state governments, its benefits — and your ability to qualify for them —
can vary greatly depending on your state.
As a result, certain populations, even if they’re living in
poverty, may not be eligible for Medicaid. For example, in some states, a
healthy, childless adult couple under age 65 with limited means may not qualify
for health coverage through Medicaid if their state hasn’t adopted Medicaid
expansion.
What Is Medicaid Expansion?
Medicaid coverage across the country has evolved since the
program was first created. Different states may employ different eligibility
criteria, income limits, or application requirements.
In 2010, the Affordable Care Act (ACA) attempted to expand
Medicaid coverage to adults between 18 and 65 with incomes below a certain
level, regardless of their age, family status, or health. The ACA also sought
to supply those whose incomes fell within specific limits with premium tax
credits that would help them afford the purchase of a private insurance
plan.
Yet, the Supreme Court ruled that the federal government couldn’t
force states to expand coverage. States can decide whether to expand Medicaid
to cover more people. This has created a coverage gap: Those who have incomes
below 100 percent of the federal poverty level and who live in states that have
opted against expanding Medicaid may not qualify for Medicaid, or for the
premium tax credits.
Medicaid Expansion States
As of early 2023, most states have adopted the ACA’s
broadening of Medicaid. Per the Kaiser Family Foundation, the following states
– in addition to the District of Columbia – have expanded Medicaid coverage per
the ACA:
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Missouri
- Montana
- Nebraska
- Nevada
- New
Hampshire
- New
Jersey
- New
Mexico
- New
York
- North
Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode
Island
- Utah
- Vermont
- Virginia
- Washington
- West
Virginia
States Without Medicaid Expansion
States that haven’t adopted Medicaid expansion per the ACA
include:
- Alabama
- Florida
- Georgia
- Kansas
- Mississippi
- North
Carolina
- South
Carolina
- Tennessee
- Texas
- Wisconsin
- Wyoming
Medicaid Expansion Developments
The map of Medicaid expansion states continues to evolve,
however:
- South
Dakota voters approved a ballot measure adding Medicaid expansion to the
state constitution in November 2022. The expansion will go into effect
beginning July 1, 2023.
- In
February 2023, the North Carolina House of Representatives passed a bill
to expand Medicaid. It now awaits review in the Senate.
- Meanwhile,
also in February 2023, the Wyoming House of Representatives declined to
address a proposed Medicaid expansion bill.
Arguments Against Medicaid Expansion
In states without Medicaid expansion, those opposed to
expanding coverage have voiced such concerns as increased costs and a higher
risk of fraud.
For example, some argue that Medicaid expansion would burden
their state’s budget. Although the federal government funds the majority of
expanded Medicaid, it doesn’t completely cover the costs; states pay 10
percent. In the case of Wyoming, House Majority Floor Leader Rep. Chip Neiman
has raised concerns that the federal government wouldn’t uphold the federal
match, leaving the state to bear more financial responsibility.
Others contend that Medicaid’s most vulnerable beneficiaries
may face greater competition for resources, that other health care options are
available to those in need, or that expansion may not ultimately translate into
better long-term health outcomes.
How Older Adults Can Find Out if They’re Eligible for
Medicaid Coverage
In states that have adopted expanded Medicaid, you may
qualify if your household income lies below 133 percent of the federal poverty
level, according to HealthCare.gov.
For older adults, most states provide Medicaid to those who
receive Supplemental Security Income (SSI). To be eligible for SSI, individuals
must have low incomes, limited assets, and be unable to work due to a
qualifying mental or physical impairment. Per the Kaiser Family Foundation,
some states expand Medicaid to older adults and disabled people whose income
surpasses the SSI limit but falls below the federal poverty level.
You may be able to qualify for Medicaid through the
Medically Needy program if your state has established one. The Medically Needy
program allows people to enroll in Medicaid when they have significant medical
expenses. When they subtract their medical spending from their total income,
they can qualify for Medicaid if their income, minus health care expenses,
falls below a specified limit (which also varies by state).
To find out whether you qualify for Medicaid, consider
consulting the following tools:
- The Benefits.gov
Eligibility Checker will ask you questions regarding things like
household income, number of dependents, and citizenship status to help you
determine whether you might be eligible for Medicaid generally.
- The
HealthCare.gov site can offer additional insights, including:
- Guidance
on Health Insurance Marketplace applications
- Income
calculators
- Premium
tax credit information
- Q&A
tool to determine eligibility for cost-sharing reductions
Again, the rules governing Medicaid and its complex eligibility criteria varies widely by state. To find out whether you may be able to receive public health insurance through Medicaid, consult with your attorney.
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Types of Hearing Loss
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Estate Planning 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086Estate Planning for Everyone You Love and Everything You OwnHave you ever considered what would happenlegally and financiallyto you, your family, your assets, and everything you care about if the unexpected were to occur?If your estate plan is outdated or non-existent, your assets could be lost to the State Department of Unclaimed Property, subjected to an expensive and time-consuming probate process, or even end up in the wrong hands. Without a comprehensive estate plan, your loved ones may face unnecessary financial hardship, legal disputes, or court intervention at a time when they need certainty and protection the most.If you dont know exactly what would happen to everything you own and everyone you love, the first step is to gain clarity. 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