Last week we looked at how the Affordable Care Act and the Republican replacement plan changed health insurance for those of us who buy insurance either through our employers or on the individual market. This week we’ll look at how the ACA and the new plan change access to health insurance for people with low income.
The ACA expanded Medicaid in two ways. First, it added adults in poverty to the program, not just poor children and their parents. Before the ACA, low-income adults without dependent children were ineligible for Medicaid in 26 states—the cost of doctor visits, hospital stays, prescription drugs—all had to be paid in cash. The ACA also pushed Medicaid eligibility up to 138% of the federal poverty line (FPL) for everyone (although some states, like New York and California, were already there). For context, the FPL for a single adult is $12,060 and, for a family of 3, $20,420.
At least until a group of states took the matter to the Supreme Court, which ruled that Congress could not require the Medicaid expansion, even though most of the cost was shared among all federal taxpayers. Currently, 19 states have chosen not to expand Medicaid eligibility. Read more »