Medicaid Expansion: 7 States Still Hold Out, Leaving Millions Uncovered
Medicaid, a U.S. health program for low-income individuals, has seen significant changes with the Affordable Care Act's Medicaid Expansion. This expansion aims to provide healthcare coverage to more Americans with low incomes, generally those under 65 with household incomes at 138% of the Federal Poverty Level (FPL) or less. However, not all states have adopted this expansion.
Currently, seven states - Alabama, Florida, Kansas, Mississippi, North Carolina, Texas, and Wyoming - have not adopted Expanded Medicaid. These states typically maintain restrictive eligibility criteria, limiting Medicaid to low-income children, pregnant women, elderly, and disabled individuals, excluding many low-income adults without dependent children. In contrast, 38 states and Washington, D.C., have adopted the expansion, with some states having special eligibility rules to increase coverage.
The Medicaid Expansion offers an enhanced federal matching assistance percentage (FMAP) of 90% for the populations served by the expansion. This financial incentive encourages states to adopt the expansion. For those with incomes between 100%-400% of the FPL, health insurance can be obtained through health exchanges with discounted cost-sharing and premiums. Georgia, South Carolina, South Dakota, Tennessee, and Wisconsin have peculiar circumstances regarding Medicaid expansion, with some having partial expansions or unique eligibility rules.
Medicaid Expansion has significantly increased healthcare coverage for low-income Americans, with about 40 states adopting the provision. However, seven states remain without the expansion, leaving many low-income adults without dependent children without access to Medicaid. The financial incentive of an enhanced FMAP encourages states to adopt the expansion, potentially leading to further increases in coverage.
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