Medicaid is a federal and state program in the United States that helps people with limited income and resources to cover medical costs. Medicaid is the largest source of funding for medical and health-related services for people with low income in the US, with 74 million people enrolled.
Research suggests that Medicaid improves health insurance coverage, access to health care, recipients’ financial security and economic benefits to states and health providers. Medicaid offers additional benefits not covered by Medicare, such as nursing home care.
The Patient Protection and Affordable Care Act (PPACA), also known as the Affordable Care Act or Obamacare, was signed into law by President Obama in 2010. The act expanded Medicaid eligibility and cut the uninsured population in half by 2016.
Who is eligible for Medicaid? There are some mandatory eligibility groups such as low-income families, individuals receiving Supplemental Security Income (SSI), and qualified pregnant women and children. Modified Adjusted Gross Income (MAGI) is used to determine financial eligibility for Medicaid and considers taxable income and tax filing relationships. Additionally, individuals must also be residents of the state they are receiving Medicaid from and are either citizens of the United States or are a certain qualified non-citizen, such as a permanent resident. Some eligibility groups are limited by age, pregnancy, or parenting status. Lastly, states can establish a “medically needy program” for individuals whose income is too high to qualify for Medicaid but can still become eligible by “spending down” or incurring expenses for medical care for which they do not have health insurance.
Individuals who are interested in enrolling in Medicaid should look into their own state’s program to see if they qualify and how to apply.
Of these states, seven have state-expanded Medicaid: California, New York, Pennsylvania, Illinois, Ohio, Michigan, and Washington.
California has the highest number of Medicaid-enrolled individuals with 10,390,661. California has a total of 11,625,691 individuals in Medicaid and Children’s Health Insurance Programs (CHIP), an almost 50% increase since the first Marketplace Open Enrollment Period in October of 2013.