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I’m a low-income single adult, but I’ve never qualified for Medicaid before. I’ve heard that I might qualify in 2014. Is this true?

  • By
  • healthinsurance.org contributor
  • September 17, 2013

Q. I’m a low-income single adult, but I’ve never qualified for Medicaid before. I’ve heard that I might qualify in 2014. Is this true?

A. It depends on where you live. A provision in the Affordable Care Act called for expanding Medicaid eligibility in order to cover more low-income people. But in June 2012, the Supreme Court ruled that states could not be forced to expand their Medicaid programs, so it was left to each state to determine whether to participate or not.

As of July 2013, 28 states were either expanding their Medicaid programs or leaning towards doing so. The ACA allows for expanding Medicaid eligibility for people with household incomes up to 133 percent of the federal poverty level (138 percent under a new method of calculating income, which is why you’ll see either number depending on the source), although states that participate can set higher thresholds.

Childless adults who meet the income criteria will be eligible, which is often not the case prior to 2014. Check with your state’s Medicaid program to see if you qualify.

The federal government will finance most of the cost of expanding Medicaid, and a small portion will be paid by participating states. The costs for enrollees who are newly eligible under the expanded guidelines will be covered 100 percent by the federal government until 2016. That will decrease to 90 percent by 2020, but will not go below that amount.

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