Are all states required to participate in the ACA Medicaid expansion?
Asked by: Ayden Pfeffer | Last update: May 15, 2025Score: 4.7/5 (51 votes)
Does the Affordable Care Act require states to expand Medicaid?
The law also provides premium tax credits for people with incomes between 100% and 400% of the federal poverty level to buy private insurance plans in the Health Insurance Marketplace ®. The U.S. Supreme Court later ruled that the Medicaid expansion is voluntary with states.
What states do not participate in the Affordable Care Act?
The Affordable Care Act, also known as Obamacare, was enacted in 2010, but 10 states have not expanded Medicaid, the federal-state program that provides health care for low-income people. They are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.
Does the ACA apply to all states?
Under the Affordable Care Act (ACA), Medicaid coverage is extended to nearly all nonelderly adults with incomes at or below 138% of the federal poverty level (FPL) (about $23,556 for a family of three in 2022) in the 42 states (including DC) that opted to expand as of March 2023.
Are all states required to participate in Medicaid?
At the federal level, the Centers for Medicare and Medicaid Services (CMS) within the Department of Health and Human Services (HHS) administers Medicaid and oversees states' programs. States may choose to participate in Medicaid, but if they do, they must comply with core federal requirements.
What to know about Georgia’s controversial approach to expanding Medicaid
Do states accept Medicaid from other states?
One cannot transfer their Medicaid benefits from one state to another state, nor can they receive Medicaid benefits simultaneously in two states. Instead, one must close their Medicaid case, and hence their benefits, in their original state, and then reapply for Medicaid in the state to which they are relocating.
Why has Florida not expanded Medicaid?
Concerns about the financial sustainability of such an expansion and the potential strain it could place on the state's budget were key factors in this decision. This choice set Florida apart from many other states that opted to expand their Medicaid programs to provide healthcare coverage to a broader population.
Is the Affordable Care Act nationwide?
These steps expanded access to affordable, comprehensive Marketplace coverage for millions of middle- and lower-income families nationwide.
Who is exempt from ACA?
Hardship exemptions are available for those who cannot afford to pay for health insurance or for whom health insurance would exceed 8.16 percent of their gross household income.
How many states have refused Medicaid expansion?
To date, 41 states (including DC) have adopted the Medicaid expansion and 10 states have not adopted the expansion. Current status for each state is based on KFF tracking and analysis of state expansion activity.
What are the hardest states to get Medicaid?
The 10 most deficient state programs have overall scores ranging from between 317.8 and 379.1 of the total 1000 points. The worst, in order from 50th to 41st, are in Mississippi, Idaho, Texas, Oklahoma, South Dakota, Indiana, South Carolina, Colorado, Alabama, and Missouri.
Which state has the best ACA plans?
What are the disadvantages of Medicaid expansion?
Residents of states that accept the Medicaid expansion will still face challenges in accessing needed services due to important deficiencies in essential health benefits, financial strain resulting from cost-sharing provisions targeted at Medicaid beneficiaries, and decreased access to specialists relative to those ...
Which state has the best Medicaid program?
The top states—ranked from 1 to 10—are Massachusetts, Nebraska, Vermont, Alaska, Wisconsin, Rhode Island, Minnesota, New York, Washington, and New Hampshire.
Which is better, Obamacare or Medicaid?
Cost to Beneficiaries: Obamacare requires individuals to pay premiums, though these can be subsidized based on income. Medicaid typically has little to no cost for beneficiaries, making it the most affordable option for low-income individuals.
Do states have to follow the Affordable Care Act?
The Act's expanded insurance standards are designed to set a federal minimum; it is the expectation under the Affordable Care Act that state insurance departments will implement and enforce these laws as part of their legal insurance oversight powers.
What is the ACA employer mandate for 2024?
Employer mandate overview
Employers must offer health insurance that is affordable and provides minimum value to 95% of their full-time employees and their children up to the end of the month in which they turn age 26, or be subject to penalties.
Can I refuse health insurance from my employer and get Obamacare?
Obamacare is available to everyone, whether or not their employers offer insurance. From a practical standpoint, though, there are financial consequences to doing this. Often, an employer subsidizes part or all of their employees' coverage.
Is ACA still mandatory?
Residents of California, Massachusetts, New Jersey, Rhode Island, and Washington, D.C. are required to buy health insurance or face a penalty, unless they have an exemption. Maryland and Vermont require residents to report their health insurance status but do not have a financial penalty for being uninsured.
Who has to be ACA compliant?
Who must comply with the ACA? The ACA applies to applicable large employers (ALEs), which are businesses that had 50 or more full-time and full-time equivalent (FTE) employees on average during the previous year.
Does Florida participate in ACA?
Florida leads the nation in Obamacare enrollment after a month of open enrollment. Data released by the Centers for Medicare and Medicaid Services show that 1,458,792 Florida residents signed up for insurance coverage through the “Marketplace” for 2025.
What states refused Medicaid expansion?
Ten states—Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming—have not expanded Medicaid eligibility under the Affordable Care Act to individuals with incomes up to 138% of the federal poverty level.
Why is it hard to get Medicaid in Florida?
Adults under 65 who aren't disabled or caring for minor children are not eligible for Medicaid regardless of how low their income is, because Florida hasn't expanded Medicaid under the ACA.
What is the income limit for Medicaid in 2024?
Definitions. Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.