ObamaCare MedicaidWhat is ObamaCare Medicaid Expansion?

ObamaCare medicaid expansion is going to take effect starting Jan 1, 2014. Affordable Care Act (ACA) or commonly known as Obama Care has specific provision to expand medicaid to those who are under age of 65 with incomes up to 133% of federal poverty level (FPL) based on modified adjusted gross income. This includes children, pregnant women, parents, and adults without dependent children. Note that undocumented immigrants are not eligible for Medicaid.


For the first time, low-income individuals who do not have children will be guaranteed to get coverage through Medicaid in every state without need for a waiver. Medicaid and Children’s Health Insurance Program (CHIP) eligibility requirement and enrollment process will be much simpler as this will be handled by newly formed health insurance exchanges in each state.

The federal poverty levels for 2013 is shown int the link below. So based on this, if a family of 4 living in 48 continuous state has household income less than $31,322, then they will be eligible for medicaid coverage.

Here is 2013 Federal Poverty Level Income Information.

Eligibility for ObamaCare Medicaid

An individual is eligible for medicaid if he meets the non-financial criteria based on MAGI (Modified Adjusted Gross Income)-based income and

  • Is a pregnant women.
  • Is above 19 years and below 65 years of age.
  • Has income below 133% of federal poverty level.
  • Is a parent or caretaker relative of a dependent child, as defined in the Medicaid State plan.
  • Is under age 65 and is not entitled to or enrolled for benefits the Social Security Act.

(MAGI- Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Adjusted Gross Income (AGI) is gross income minus tax deductions that are allowable.)

This 2 page final fact sheet from medicaid.gov on medicaid CHIP expansion and eligiblity gives more information

ObamaCare Medicaid Rules:

The new provision in ObamaCare streamlines income based rules and systems for processing Medicaid and CHIP applications and renewals for most individuals. The new rules provide following benefits:

  • Simplifies financial eligibility by consolidating eligibility categories into four main groups–adults, children,parents and pregnant women and by relying on a single “Modified Adjusted Gross Income” (MAGI) standard for determining eligibility for most Medicaid and CHIP enrollees (children and non disabled adults under age 65).
  • Ensures prompt enrollment of people eligible under the new MAGI-based category.
  • People who are disabled or in need of long-term care and supports may enroll in an existing Medicaid eligibility category to ensure that they are quickly enrolled in coverage that best meets their needs.
  • Eligibility verification procedures will  rely primarily on electronic data sources but also giving flexibility to States in determining the usefulness of available data before requesting additional information from applicants. It also simplifies verification process for States via use of a federal data services “Hub” that will link States with federal data sources (e.g. Social Security and Homeland Security).
  • Medicaid renewal eligibility of will first use the information available through existing data sources and medicaid renewal is limited to once every 12 months for the people enrolled through the simplified income-based rules unless the individual reports a change or the agency has information to prompt a reassessment of eligibility.

You can find more information on medicaid and affordable care act here. Following info graphics (courtesy Kaiser health foundation) shows in detail medicaid expansion changes which will take place in 2014.

Obamacare medicaid expansion

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