Obamacare Medicaid Expansion Explained

The ObamaCare Medicaid Expansion is considered as one of the most significant developments in health care reform. It extends Medicaid to the poorest of families in the US, aiming to cover nearly half of the number of uninsured in the country. However, while these and other benefits are stated to be brought about by this expansion, some states still opt out of expanding Medicaid. To dig deeper into this matter, read on.

Primary Purpose of the Medicaid Expansion

The Affordable Care Act (ACA) or ObamaCare Medicaid Expansion extends Medicaid eligibility to all families and individuals who are earning below 138 percent of the Federal Poverty Level (FPL), which includes several groups that were not eligible in the past.

Overview

To better understand the ObamaCare Medicaid Expansion program, let us take a quick look at some points and how they can affect American families.

  • A joint federal and state-funded program, Medicaid aims to provide health care to more than 60 million Americans who are having low income.
  • Since 2013, every state has been imposing different requirements for Medicaid eligibility based upon income, gender, age, number of dependents and other specific requirements, with some states having very narrow eligibility requirements that caused a lot of working adults uninsured.
  • In 2014, states participated in the Medicaid Expansion program, increasing levels of eligibility for every individual to 138 percent of the FPL. For some states that did not participate (these states have unique eligibility requirements), residents may still be eligible for the health insurance marketplace subsidies if they make between 100–400 percent FPL.
  • Before the expansion, a lot of states covered individuals with no income, considering that the program often extends coverage to the employed poor and their families. This year, most of the states that did not participate have a 0 percent eligibility for childless adults, but all states are providing Children’s Health Insurance Program (CHIP) to parents who have no income.
  • Due to the issue of affordability, most poor working families do not have insurance. Now, the Medicaid Expansion is helping cover the gap between the existing Medicaid eligibility and people who can afford to buy private health insurance through marketplace subsidies.
  • You can sign up for Medicaid via the health insurance marketplace of your state during open enrollment.
  • About half the number of uninsured individuals in the US would be covered by the expansion, given that all states would participate, and more than 15 million men, women and children will be Medicaid-eligible in participating states. As 24 states have not expanded Medicaid, 5.7 million people are speculated to be without insurance in 2016.
  • Currently, the uninsured cost hospitals billions in unpaid hospitals bills, which are a primary cause of rising premium costs, and some of these costs are passed indirectly to the average taxpayers who have insurance.
  • Only 54 percent of potentially eligible adults in the country know about the Medicaid Expansion program under the ACA.
  • The federal government is paying for 100 percent of expansion costs for the first 3 years, and then 90 percent after 2022.
  • Cost is one of the most cited reasons for not opting to expand Medicaid. While existing Medicaid programs do cost taxpayers a lot of money, such an expense is balanced out by unpaid hospital bills and their effect on the rising insurance premium costs.
  • Mostly, the states that did not participate in the expansion have the highest uninsured rates, which means they can be greatly helped by the expansion.
  • As some people claim, refusing to expand Medicaid is part of an ongoing effort to break the ACA, regardless what it might cost to the people, using tactics like funding expensive disinformation campaigns, opting out to create exchanges, causing or threatening a government shutdown and attempting to repeal the law.

Waivers and Updates

States, such as Iowa, Arkansas, Minnesota and Michigan, have expanded Medicaid in 2014, while others, such as Indiana, New Hampshire, Tennessee, Pennsylvania and Utah have planned to do it in 2015 to 2016. Other states, including Florida, that have hundreds of thousands of uninsured individuals due to narrow Medicaid eligibility levels are still debating and discussing expansion.

If your state has not opted to expand Medicaid yet, let its representatives know that you deserve the same access to health care that others have.

On the Un-Participative States

Previously, the law required states to expand coverage to every person who is making less than 138 percent of the FPL or lose federal funding to Medicaid, but this provision was altered during a Supreme Court ruling on the ACA. Now, states already have the option to opt out of the expansion program, leaving millions in the poor working class to dwell in the Medicaid coverage gap. Moreover, these states are projected to drive up insurance costs and to save themselves relatively small amounts.

Getting Covered by Medicaid or CHIP

Everyone can sign up for Medicaid and CHIP all year round and may qualify for low-cost and free health care services through Medicaid based on family size and income. If your state did not participate in expanding Medicaid and coverage has been denied to you, you become exempt from the requirement to purchase insurance, without owing the fee. If you are applying for a hardship exemption, you will make yourself qualified to take out catastrophic coverage.

The Importance of the ObamaCare Medicaid Expansion

As previously mentioned, the Medicaid Expansion program will offer almost half of the number of uninsured in the country access to health insurance. Opting out to implement it will not only leave millions of individuals and families without coverage, but will also costs taxpayers money, as they would use costly emergency services, rather than getting the preventative care that they need. For states that do not expand Medicaid or set up a health insurance marketplace, they will be using federal tax dollars to subsidize those who would have been eligible for Medicaid under the expansion.

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