The Affordable Care Act and Medicaid

Perhaps the most widely discussed change that the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) made to Medicaid was expanding eligibility to adults with incomes up to 138 percent of the federal poverty level (FPL). Originally a requirement, the Supreme Court ruling in June 2012 effectively made the Medicaid expansion an option, and to date, more than half of states have opted to expand. The ACA also made a number of other significant Medicaid changes, such as preventing states from reducing children’s Medicaid eligibility until FY 2019; setting a uniform standard for children’s eligibility at 138 percent FPL; streamlining eligibility, enrollment, and renewal processes; and updating payments to safety-net hospitals.

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Featured publications

Premium Assistance: Medicaid’s Expanding Role in the Private Insurance Market

March 2015 | ,

Premium assistance—the use of Medicaid funds to purchase private market plans—is one way that states may expand coverage to previously ineligible, low-income adults. Arkansas and Iowa have been using premium assistance to purchase plans on the exchange through Section 1115 research and demonstration waivers since January 2014, and other states have expressed interest in this approach. […]
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Medicaid and CHIP in the Context of the ACA

March 2014 |

The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) is changing the insurance landscape by creating new health coverage opportunities for millions of people. Chapter 1 of MACPAC’s March 2014 report raises key questions about whether new benefit packages in the health insurance exchanges meet the needs of medically frail and disabled […]
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