Medicaid Expansions

This checklist prepared by the National Academy for State Health Policy (NASHP) highlights the ACA Medicaid requirements that will take effect in the next two years, nearly all of which will apply to states regardless of whether the state chooses to expand Medicaid eligibility.  The checklist also highlights a few important optional provisions that states may want to consider as they plan for modernizing their Medicaid programs and complying with federal requirements.

The ACA expands Medicaid to 138% FPL in 2014, which would make millions of adults newly eligible for the program. However, if a state does not expand Medicaid, poor uninsured adults in that state will not gain a new coverage option and will likely remain uninsured. This brief provides an overview of current Medicaid and CHIP eligibility levels for nondisabled children and adults to provide better insight into the impact of the Medicaid expansion.

This brief prepared by Manatt Health Solutions examines some of the legal, policy and operational issues states should contemplate while considering the possibility of using “premium assistance” to purchase coverage for Medicaid-eligible adults in the Exchange. It provides an overview of the benefits of premium assistance along with the logistical challenges of its implementation.  

The ACA will expand access to affordable health insurance for millions of Americans. In states that choose to implement the Medicaid expansion for low-income adults, Medicaid will provide an important new pathway to coverage. Yet, even in states that choose to expand Medicaid a significant proportion of the low-income nonelderly adult population will be excluded from the Medicaid expansion due to their immigration status. This brief provides the first state-specific estimates of the number of uninsured low-income adults that will potentially be excluded from the Medicaid expansion because of their immigration status.

The ACA expands Medicaid significantly beginning in 2014 and the expanded program is to serve as the foundation of the broader framework created by the ACA to cover millions of previously uninsured low-income adults and children. This primer examines how the Medicaid program is structured, who it covers, what services it provides, how it is financed, how much it costs, and how it will change under the ACA.