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Expansion of Medicaid in 2014

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 do expand its Medicaid eligibility standards will receive increased federal funding for Medicaid. From 2014-2016 the federal government will cover 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 27 states (including D.C.) are expanding Medicaid, affecting over 10 million low-income citizens across the country. 20 states have chosen to not expand Medicaid and 4 states (IN, PA, UT & VA) have yet to finalize their decisions. Without expanding Medicaid, residents that would otherwise be newly eligible are likely to remain uninsured. Find your state below to see if your state plans to expand Medicaid eligibility and to see approximately how many residents in your state may gain access to health care coverage due to Medicaid expansion:

Alabama

Alabama has elected to not expand its Medicaid program. If Alabama were to expand Medicaid, an estimated 435,000 residents could qualify for Medicaid.

Alaska

Alaska has elected to not expand its Medicaid program. If Alaska were to expand Medicaid, an estimated 53,000 residents could qualify for Medicaid.

Arizona

Starting in 2014, Arizona households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Approximately 463,000 residents of Arizona may now qualify for Medicaid.

Arkansas

Arkansas will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). An estimated 275,000 residents of Arkansas may qualify for Medicaid.

California

Starting in 2014, California households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Approximately 2,875,000 residents of California may now qualify for Medicaid, the highest number of residents for any state.

Colorado

Colorado will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). About 351,000 residents of Colorado may qualify for Medicaid.

Connecticut

Starting in 2014, Connecticut households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). An estimated 122,000 residents of Connecticut qualify for the program due to expanding Medicaid eligibility standards.

Delaware

Delaware will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). Approximately 42,000 residents of Delaware may qualify for Medicaid.

District of Columbia

Starting in 2014, D.C. households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). About 21,000 residents of D.C. may now qualify for Medicaid.

Florida

Florida has elected to not expand its Medicaid program. If Florida were to expand Medicaid, an estimated 1,795,000 residents could qualify for Medicaid, the third highest number of residents for any state after California and Texas.

Georgia

Georgia has elected to not expand its Medicaid program. If Georgia were to expand Medicaid, an estimated 974,000 residents could qualify for Medicaid.

Hawaii

Hawaii will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). Approximately 51,000 residents of Hawaii may qualify for Medicaid.

Idaho

Idaho has elected to not expand its Medicaid program. If Idaho were to expand its Medicaid eligibility standards, an estimated 150,000 residents could qualify for Medicaid.

Illinois

Starting in 2014, Illinois households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Expanding Medicaid in Illinois increases the number of residents that may qualify for Medicaid by approximately 782,000.

Indiana

Indiana has elected to not expand its Medicaid program but is exploring alternative options. If Indiana were to expand Medicaid, an estimated 517,000 residents could qualify for Medicaid. The governor of Indiana, Mike Pence, recently unveiled a version of the state’s Healthy Indiana Plan which proposes expanding HIP to cover up to 350,000 Hoosiers. HIP currently covers 45,000 residents who earn less than 200% FPL who have been uninsured for at least 6 months and cannot get employer-sponsored insurance coverage. The program requires enrollees to contribute to a Personal Wellness & Responsibility (POWER) account which is also funded by the state. The POWER account is used to pay for health care costs before catastrophic coverage kicks in and the amount of contribution depends on income, with those who earn more paying for a greater share of the account.

Iowa

Iowa will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). Approximately 148,000 Iowans may qualify for Medicaid.

Kansas

Kansas has elected to not expand its Medicaid program. An estimated 200,000 residents could qualify for Medicaid if Kansas were to expand its Medicaid eligibility standards.

Kentucky

Starting in 2014, Kentucky households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). About 399,000 residents of Kentucky may now qualify for Medicaid.

Louisiana

Louisiana has elected to not expand its Medicaid program. If Lousiana were to expand Medicaid approximately 422,000 residents may be able to gain access to Medicaid.

Maine

Maine has elected to not expand its Medicaid program. If Maine were to expand its Medicaid eligibility standards an estimated 64,000 residents could qualify for Medicaid.

Maryland

Maryland will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). Approximately 251,000 Maryland residents may now qualify for Medicaid.

Massachusetts

Starting in 2014, Massachusetts households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Expanding Medicaid eligibility standards in the state increases the number of Massachusetts residents that can qualify for the program by about 117,000.

Michigan

Michigan will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). An additional 730,000 residents of Michigan may qualify for Medicaid.

Minnesota

Starting in 2014, Minnesota households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). Expanding Medicaid eligibility standards in Minnesota increases the number of residents that could potentially qualify for Medicaid by about 202,000.

Mississippi

Mississippi has elected to not expand its Medicaid program. If the state were to expand Medicaid, an estimated 333,000 residents could qualify for the program.

Missouri

Missouri has elected to not expand its Medicaid program. If Missouri were to expand its Medicaid eligibility standards approximately 452,000 residents could qualify for Medicaid.

Montana

Montana has elected to not expand its Medicaid program. About 88,000 additional residents of Montana could qualify for Medicaid if the state were to expand the program.

Nebraska

Nebraska has elected to not expand its Medicaid program. If the state were to expand its Medicaid eligibility standards an estimated 110,000 residents may be able to qualify for Medicaid.

Nevada

Nevada will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). 266,000 residents of Nevada may now be able to qualify for Medicaid.

New Hampshire

The governor of New Hampshire, Maggie Hassan, recently announced the state has decided to expand its Medicaid program to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). An estimated 64,000 residents of New Hampshire may now qualify for Medicaid.

New Jersey

Starting in 2014, New Jersey households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). About 395,000 additional residents of New Jersey may now qualify for Medicaid.

New Mexico

New Mexico will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). Expanding Medicaid eligibility in New Mexico increases the number of eligible residents by approximately 187,000.

New York

Starting in 2014, New York households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). An estimated 903,000 residents of New York may now be eligible for Medicaid.

North Carolina

North Carolina has elected to not expand its Medicaid program. If the state were to expand Medicaid eligibility standards, approximately 804,000 residents could qualify for the program.

North Dakota

North Dakota will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). About 35,000 residents of North Dakota may now be eligible for Medicaid.

Ohio

Starting in 2014, Ohio households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). An estimated 789,000 residents of Ohio may now be eligible for the program due to the state expanding its Medicaid eligibility standards.

Oklahoma

Oklahoma has elected to not expand its Medicaid program. If the state were to expand its Medicaid eligibility standards, approximately 348,000 residents could qualify for the program.

Oregon

Oregon will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). 325,000 residents of Oregon may now qualify for Medicaid.

Pennsylvania

Pennsylvania has elected to not expand its Medicaid program but its governor, Tom Corbett, has developed an alternative proposal called Healthy PA to overhaul Pennsylvania’s Medicaid program. Healthy PA originally included a work-search requirement but due to controversy surrounding the requirement, the state has decided to modify the requirement, proposing a one-year pilot job training program instead. Participants of the voluntary program would receive a reduction in their Medicaid premiums and/or copays. Pennsylvania has submitted a Medicaid expansion waiver to CMS for the center’s approval.

Rhode Island

Starting in 2014, Rhode Island households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). An estimated 57,000 additional residents of the state may now qualify for Medicaid.

South Carolina

South Carolina has elected to not expand its Medicaid program. If the state were to expand its Medicaid eligibility standards, approximately 447,000 residents of South Carolina could qualify for Medicaid.

South Dakota

South Dakota has elected to not expand its Medicaid program. If South Dakota were to expand Medicaid, an estimated 59,000 residents could be eligible for the program.

Tennessee

Tennessee has elected to not expand its Medicaid program. Approximately 501,000 residents of Tennessee could qualify for Medicaid if the state were to expand its Medicaid eligibility standards.

Texas

Texas has elected to not expand its Medicaid program. However, if the state were to expand its Medicaid eligibility standards, approximately 2,502,000 residents could gain access to Medicaid. This figure is second highest out of any state.

Utah

Utah has elected to not expand its Medicaid program. If Utah were to expand its Medicaid eligibility standards about 190,000 residents could gain access to Medicaid.

Vermont

Vermont will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level for Medicaid eligibility (138% including the 5% disregard). Approximately 18,000 residents of Vermont may be newly eligible for Medicaid.

Virginia

Virginia will not expand its Medicaid program this year despite Gov. Terry McAuliffe’s efforts. The state was stuck in a month long budget and Medicaid expansion stalemate, but with the recent unexpected resignation of a senator, the GOP gained control of Virginia’s state Senate and successfully pushed to pass a budget that excludes Medicaid expansion on June 12, 2014. If Virginia had expanded its Medicaid eligibility standards this year, an estimated 462,000 residents could gain access to Medicaid.

Washington

Starting in 2014, Washington households with incomes up to 133% of the federal poverty level will be eligible for Medicaid (138% including the 5% disregard). About 419,000 residents of the state may now be able to qualify for Medicaid.

West Virginia

West Virginia will expand its Medicaid eligibility standards to include households with incomes up to 133% of the federal poverty level (138% including the 5% disregard). Approximately 166,000 West Virginians may now qualify for Medicaid.

Wisconsin

Wisconsin has elected to not expand its Medicaid program. If Wisconsin were to expand its Medicaid eligibility standards, an estimated 274,000 residents may be able to get access to Medicaid.

Wyoming

Wyoming has elected to not expand its Medicaid program. If the state were to expand its Medicaid eligibility standards, approximately 34,000 residents could qualify for the program.

Sources:

A 50-State Look at Medicaid Expansion: 2014 (May 30, 2014)

http://familiesusa.org/product/50-state-look-medicaid-expansion-2014

Indiana's Innovative Medicaid Expansion Idea Could Chart A Path For Major Reform Going Forward (May 19, 2014)

http://www.forbes.com/sites/gracemarieturner/2014/05/19/indianas-innovation-medicaid-expansion-idea-could-chart-a-path-for-major-reform-going-forward/

What’s Next for Pennsylvania’s Medicaid Expansion? (March 10, 2014)

http://capsules.kaiserhealthnews.org/index.php/2014/03/whats-next-for-pennsylvanias-medicaid-expansion

After hours of strife, lawmakers pass budget without Medicaid expansion (June 13, 2014)

http://www.washingtonpost.com/local/virginia-politics/in-virginia-senate-panel-approves-budget-without-medicaid-in-effort-to-avert-shutdown/2014/06/12/326d071a-f1b3-11e3-914c-1fbd0614e2d4_story.html

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