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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 now. Is this true?

Q. I’m a low-income single adult, but I’ve always assumed I wouldn’t qualify for Medicaid because I don’t have kids. Is it true that I might qualify now?

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 2017, 31 states and DC had accepted federal funding to expand Medicaid. The ACA allows for expanding Medicaid eligibility for people with household incomes up to 133 percent of the federal poverty level (138 percent under the 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 and immigration requirements are eligible for coverage, and nationwide Medicaid enrollment has increased by 29 percent in the first four years of Medicaid expansion. Check with your state’s Medicaid program to see if you qualify.

The federal government is financing most of the cost of expanding Medicaid, and a small portion is paid by participating states. States that have expanded Medicaid pay 5 percent of the cost in 2017. That will increase to 10 percent by 2020, and will remain at that level going forward, with the federal government paying 90 percent of the cost.

Related terms

Federal Poverty Level

  • As of 2017, 31 states and DC had expanded their Medicaid programs.
  • A provision in the ACA called for expanding Medicaid eligibility in order to cover more low-income people, and the federal government pays nearly all of the cost for states that accept this option.