Medicaid and the Affordable Care Act

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.

Learn more

Featured publications

Expanding Medicaid to the New Adult Group through Section 1115 Waivers

July 2018 |

The Patient Protection and Affordable Care Act expanded Medicaid coverage to non-elderly adults with incomes at or below 138 percent of the federal poverty level who were not previously eligible for the program. After the U.S. Supreme Court ruling in June 2012 effectively made Medicaid expansion optional, a number of states have pursued alternative approaches […]
Read More >>

Section 1115 Medicaid Expansion Waivers: Implementation Experiences

February 2018 |

Since 2014, eight states have expanded their Medicaid programs to certain non-disabled adults through a Section 1115 of the Social Security Act, rather than the traditional approach envisioned by the Patient Protection and Affordable Care Act (P.L. 111-148). Although completion of a state-led evaluation is mandatory under Section 1115 waivers, questions related to implementation are […]
Read More >>

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 […]
Read More >>