2019 Affordable Care Act Medicaid Expansion by State

Expansion of Medicaid in 2019

What is Medicaid and How do I qualify?

Medicaid is currently the largest provider of health insurance to low income individuals (including senior citizens, people with disabilities and some children) in the United States. Though Medicaid is a partnership between federal and state governments, each state has their own Medicaid eligibility standards based on a percentage of federal poverty levels.

General requirements for Medicaid eligibility include the following:

  • Citizenship Status: You must be a US citizen or an eligible qualified alien.
  • Residency: In order to apply for Medicaid in your state you must be a resident of the state. If you are planning to move you may be able to apply for Medicaid prior to your move. For example, to qualify for Medicaid in Wyoming you must live in the state or plan to live in the state within 45 days of applying for Medicaid. States cannot place length of stay residency requirements.
  • Age: You must meet any age requirements of the specific Medicaid program in which you are enrolled.
  • Social Security:Most Medicaid programs require you to provide a social security number or verification that you have applied for a social security number.

Medicaid Expansion by State

Under The Affordable Care Act, many states are expanding Medicaid in order to allow more people to qualify for Medicaid (starting in 2014). However, not all states have chosen to expand their eligibility standards. States that expanded Medicaid eligibility standards received increased federal funding for Medicaid. From 2014-2016 the federal government covered 100% of Medicaid expansion costs, phasing down to 90% by 2020. It is important to note that there is a 5% disregard for Medicaid eligibility. Thus if a state expands its Medicaid eligibility to 133% of the federal poverty level, then individuals and families that earn up to 138% can still qualify for Medicaid.

Currently 37 states (including D.C.) have adopted Medicaid expansion (some of these are still implementing), affecting about 74 million low-income citizens across the country. 14 states have not yet adopted Medicaid expansion. Find your state below to see if your state has adopted Medicaid expansion and to see approximately what percentage of residents in your state have coverage from Medicaid:

Alabama

Alabama has elected to not expand its Medicaid program. 21% of Alabama’s residents have Medicaid coverage.

Alaska

The state’s Medicaid expansion went into effect on Sep. 1, 2015. Alaska households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 21% of Alaskans have Medicaid coverage.

Arizona

Arizona’s Medicaid program was signed on June 17, 2013. Arizona households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Approximately 22% of the residents of Arizona are covered by Medicaid.

Arkansas

Arkansas’s Medicaid Expansion plan was signed into law on April 23, 2013. Arkansas households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). An estimated 27% of residents have Medicaid coverage.

California

California’s Medicaid Expansion plan was signed into law on June 27, 2013. California households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Approximately 26% of California residents have Medicaid coverage.

Colorado

Colorado’s Medicaid Expansion plan was signed into law on May 13, 2013. Colorado households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). About 20% of the residents of Colorado have Medicaid.

Connecticut

Connecticut was one of the first five states that opted to sign up for the Medicaid expansion after the ACA was enacted. Connecticut households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). An estimated 20% of the residents of Connecticut have Medicaid.

Delaware

Starting in 2014, Delaware households with incomes up to 133% of the federal poverty level were eligible for Medicaid (138% including the 5% disregard). Approximately 18% of the residents of Delaware have Medicaid coverage.

District of Columbia

Starting in 2014, D.C. households with incomes up to 133% of the federal poverty level were eligible for Medicaid (138% including the 5% disregard). About 28% of D.C. residents have Medicaid.

Florida

Florida elected to not expand its Medicaid program. About 19% of Floridians get their health insurance from Medicaid.

Georgia

Georgia elected to not expand its Medicaid program. Approximately 17% of Georgia’s residents have Medicaid coverage.

Hawaii

Starting in 2014, Hawaii households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 18% of the residents of Hawaii have Medicaid.

Idaho

Idaho voters approved a ballot measure in November of 2018 requiring the state to implement the Medicaid expansion. In February 2019, Idaho applied for the Medicaid expansion with the state passing legislation in April of that year seeking various waivers such as a work requirement. The legislation specified that if the waivers are not approved by end of year 2019, then all individuals up to 138% FPL will be enrolled in Medicaid. About 17% of Idahoans obtain their health insurance from Medicaid.

Illinois

Starting in 2014, Illinois households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 20% of residents have Medicaid coverage.

Indiana

On January 27, 2015, the federal government approved Indiana’s alternate Medicaid expansion plan, known as Healthy Indiana Plan (HIP)2.0. Indiana households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 18% of Indiana residents have Medicaid.

Iowa

Starting in 2014, Iowa households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 18% of Iowans receive Medicaid coverage.

Kansas

Kansas has elected to not expand its Medicaid program. An estimated 14% of residents have Medicaid coverage.

Kentucky

Starting in 2014, Kentucky households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). About 27% of the residents of Kentucky have Medicaid.

Louisiana

Louisiana was the 31st state to expand Medicaid. Starting in June, 2016, Kentucky households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). In February 2017, the Louisiana Department of Health announced that more than 400,000 individuals had enrolled in coverage under the state’s Medicaid expansion, and the uninsured rate in Louisiana had decreased by nearly half to 12.5 percent in 2016, down from 21.7 percent in 2013.

Maine

Maine implemented Medicaid expansion in January of 2019. It was adopted through a ballot initiative in November of 2017. About 18% of Maine’s residents receive their health insurance through Medicaid.

Maryland

Starting in 2014, Maryland households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 18% of Maryland’s residents have Medicaid.

Massachusetts

Starting in 2014, Massachusetts households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 24% of Massachusetts residents have Medicaid coverage.

Michigan

Starting in April 2014, Michigan households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). About 22% of Michigan residents have Medicaid coverage.

Minnesota

Starting in 2014, Minnesota households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 17% of Minnesota residents have Medicaid.

Mississippi

Mississippi has elected to not expand its Medicaid program. About 24% of residents have Medicaid coverage.

Missouri

Missouri has elected to not expand its Medicaid program. About 15% of Missouri’s residents have Medicaid coverage.

Montana

Starting in 2016, Montana households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Then in November 2018 Montanans voted down a ballot initiative that would have extended the 2016 Medicaid expansion beyond a sunset date set for the end of June 2019. In April of 2019, the Montana Legislature passed a bill that the governor signed extending the expansion until 2025. This new law also directs the state's leaders to pursue a waiver that includes adding a work requirement. About 19% of Montanans receive their health insurance from Medicaid.

Nebraska

Nebraskans approved a ballot measure in November 2018 to expand Medicaid. The expansion implementation will occur in October 2020. Approximately 12% of Nebraskans have Medicaid for health insurance.

Nevada

Starting in 2014, Nevada households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). About 19% of the residents of Nevada have Medicaid.

New Hampshire

New Hampshire Medicaid Expansion program was available as of July 1, 2014, for coverage effective on August 15, 2014. New Hampshire households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 14% of residents of New Hampshire have Medicaid coverage.

New Jersey

Starting in 2014, New Jersey households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). About 17% of the residents of New Jersey have Medicaid.

New Mexico

Starting in 2014, New Mexico households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 34% of the residents of New Mexico have Medicaid.

New York

Starting in 2014, New York households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 26% of the residents of New York have Medicaid coverage.

North Carolina

North Carolina has elected to not expand its Medicaid program. The state has about 18% of its residents in the Medicaid program.

North Dakota

Starting in 2014, North Dakota households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 11% of the state’s residents have Medicaid coverage.

Ohio

Starting in 2014, Ohio households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 21% of the residents of Ohio have Medicaid.

Oklahoma

Oklahoma has elected to not expand its Medicaid program. Approximately 18% of Oklahomans are in the Medicaid program.

Oregon

Starting 2014, Oregon households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 23% of its residents are in the Medicaid program.

Pennsylvania

Pennsylvania’s Medicaid Expansion program was available as of December 1, 2014, for coverage effective on January 1, 2015. Pennsylvania households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). About 20% of Pennsylvania residents have Medicaid coverage

Rhode Island

Starting in 2014, Rhode Island households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 24% of residents have Medicaid coverage.

South Carolina

South Carolina has elected to not expand its Medicaid program. About 19% of the residents of South Carolina have Medicaid coverage.

South Dakota

South Dakota has elected to not expand its Medicaid program. South Dakota has approximately 14% of its residents in the Medicaid program.

Tennessee

Tennessee has elected to not expand its Medicaid program. Approximately 21% of the residents of Tennessee have Medicaid coverage.

Texas

Texas has elected to not expand its Medicaid program. Approximately 17% of its residents have Medicaid coverage.

Utah

Utah residents passed a ballot initiative to expand its Medicaid program in November 2018. In response to this, the state legislature passed a law in 2019 to limit the expansion to 100% of the federal poverty level. About 11% of Utah’s residents have Medicaid coverage.

Vermont

Starting in 2014, Vermont households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). An estimated 28% of its residents have Medicaid.

Virginia

The Virginia legislature passed and the governor signed expansion into law in 2018. Expansion coverage became effective under state plan amendment in November of the same year. About 12% of Virginians have Medicaid health insurance coverage.

Washington

Starting in 2014, Washington households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). About 21% of residents of the state have Medicaid.

West Virginia

Starting in 2014, West Virginia households with incomes up to 133% of the federal poverty level are eligible for Medicaid (138% including the 5% disregard). Approximately 28% of West Virginians have Medicaid.

Wisconsin

Wisconsin has elected to not expand its Medicaid program. Wisconsin has an estimated 17% of its residents in the Medicaid program.

Wyoming

Wyoming has elected to not expand its Medicaid program. The state has approximately 13% of its residents in the Medicaid program.

Sources:

A 50-State Look at Medicaid Expansion: 2017 (April, 2017)

Kaiser Family Foundation, “Status of State Action on the Medicaid Expansion Decision,” as of September 20, 2019.

Kaiser Family Foundation, “Medicaid State Fact Sheets.”

http://familiesusa.org/product/50-state-look-medicaid-expansion

Medicaid Expansion enrollment increase to 400,635; uninsured rate drops:(February 16, 2017)

http://www.dhh.louisiana.gov/index.cfm/newsroom/detail/4169



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