Why would states not expand Medicaid?

Asked by: Maryam Grady DDS  |  Last update: February 11, 2022
Score: 4.7/5 (64 votes)

Today, twelve states have still not expanded Medicaid. ... They're in what's known as the "coverage gap" — they don't qualify for Medicaid in their state, and make too little money to be eligible for subsidized health plans on the Affordable Care Act insurance exchanges.

Why some states did not expand Medicaid?

Marketplace expansion makes fewer people eligible than a Medicaid expansion, because marketplace coverage has an additional requirement: no member of the family can have an affordable offer of worker coverage.

Which states choose not to expand Medicaid?

However, as of now, 12 states are refusing to expand Medicaid. Those states are Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, Texas, and Wisconsin.

Why would a state choose not to participate in Medicaid expansion despite the federal promise of paying for the additional beneficiaries?

Medicaid expansion would end up displacing higher-quality, employer-sponsored health coverage for millions of Americans. While these individuals will still have “coverage,” and therefore will not increase the ranks of the uninsured, the quality of their coverage will meaningfully decrease.

Why has Wyoming not expanded Medicaid?

Critics have cited concerns that expansion has led to significant cost overruns and decreased profit margins for hospitals in other states. They also worry that the federal government could change its match rates, leaving Wyoming “on the hook” for a greater percentage of costs.

Medicaid, explained: why it's worse to be sick in some states than others

32 related questions found

Does Florida have Medicaid expansion?

Florida is one of 12 states that has not expanded Medicaid eligibility as allowed under Affordable Care Act (ACA). The ACA doesn't provide subsidies for people with income below the poverty level, because the law called for them to have Medicaid instead.

Did North Carolina expand Medicaid?

North Carolina has thus far failed to expand Medicaid, and is one of 11 states where a “coverage gap” still exists. New state budget calls for a legislative committee to study Medicaid expansion in 2022. North Carolina's Medicaid program transitioned to a managed care model in July 2021 after several delays.

Are all states required to expand Medicaid?

The U.S. Supreme Court later ruled that the Medicaid expansion is voluntary with states. As a result, some states haven't expanded their Medicaid programs.

Who decides Medicaid expansion?

The federal government is financing most of the cost of expanding Medicaid, and a small portion is being paid by participating states. The costs for enrollees who are newly eligible under the expanded guidelines were covered 100% by the federal government until the end of 2016.

Which states did not expand Medicaid in 2014?

Coverage under the Medicaid expansion became effective January 1, 2014 in all states that have adopted the Medicaid expansion except for the following: Michigan (4/1/2014), New Hampshire (8/15/2014), Pennsylvania (1/1/2015), Indiana (2/1/2015), Alaska (9/1/2015), Montana (1/1/2016), Louisiana (7/1/2016), Virginia (1/1/ ...

How many states have accepted Medicaid expansion?

To date, 39 states (including DC) have adopted the Medicaid expansion and 12 states have not adopted the expansion.

What state has the highest percentage of Medicaid recipients?

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.

Is Obamacare the same as Medicaid?

The most important difference between Medicaid and Obamacare is that Obamacare health plans are offered by private health insurance companies while Medicaid is a government program (albeit often administered by private insurance companies that offer Medicaid managed care services).

How do you close a coverage gap?

The current House version of the BBB bill would close the coverage gap by allowing individuals with incomes below 138 percent of the FPL to enroll in subsidized plans through the ACA exchanges. Persons eligible for Medicaid in the expansion states would be ineligible for this premium assistance.

What did Medicaid expansion do?

Medicaid expansion drives gains in health coverage among people who were previously eligible for Medicaid, including children and parents. Most children in families with low incomes were eligible for Medicaid before the ACA, but Medicaid eligibility for parents was limited and varied considerably across states.

What is the highest income to qualify for Medicaid?

In 2021, the federal poverty levels (in all states except Alaska and Hawaii, which have higher guidelines) range from $12,880 (for one person) to $44,660 (for eight people). In 2021, the federal poverty level in Alaska ranges from $ $16,090 (for one person) to $55,850 (for eight people).

Who qualifies for MaineCare expansion?

Who is eligible for Expansion? People age 21 to 64, who are not eligible for Medicare, whose income is less than the limit shown for their family size in this chart. home, have savings, and still get MaineCare. eligible even if your income is higher than the limits shown.

How does Medicare expansion work?

Medicare expansion refers to broadening the benefits of the program, as the parts in which beneficiaries enroll through the government provide limited coverage. ... These plans cover the coinsurance costs that come with Original Medicare.

Can I use my Medicaid in a different state?

Can I use my Medicaid coverage in any state? A: No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your coverage when you're temporarily visiting another state, unless you need emergency health care.

How many states expanded Medicaid in sync with the ACA?

Medicaid expansion states: Key takeaways. 38 states and DC have accepted federal funding to expand Medicaid under the ACA.

Did the Affordable Care Act expand Medicare?

Summary: The Affordable Care Act helps lower prescription drug costs for Medicare beneficiaries & helps expand Medicare preventive benefits.

What is the current status of the ACA?

The short answer is: The ACA remained in full force for 2019, especially as it relates to US employers, and for now, remains in effect for 2020 and beyond. Even the individual mandate (requiring individuals to have ACA-compliant health coverage or else pay a penalty) remained in force for 2019 – a surprise to many.

Did South Carolina expand Medicaid?

Because South Carolina hasn't expanded Medicaid, the state's Medicaid population consists of low-income people who are children, elderly, disabled, pregnant, or parents of minor children. Adults who don't fit into one of these categories are not eligible for coverage, no matter how low their income is.

How much would it cost to expand Medicaid in NC?

Data from the North Carolina Office of State Budget and Management show that the total cost of expanding Medicaid in North Carolina is $2.1 billion in FY 2020, rising to $4.2 billion in FY 2021 due to the full calendar year of expansion.