Expanded Medicaid Eligibility

Expanding Medicaid under the Affordable Care Act

The Affordable Care Act created a new Medicaid eligibility group for low-income adults earning up to 138 percent of the Federal Poverty Level. This new eligibility category filled prior coverage gaps, helping millions of low-income workers, students, parents, single adults, and people with disabilities and chronic health conditions access affordable health care. Though a 2012 Supreme Court decision allowed states to initially refuse to participate, 32 states (including the District of Columbia) have expanded Medicaid by 2018, covering roughly 12 million newly eligible adults.

Since 2014, Medicaid expansion has improved health outcomes and financial security for low-income adults while boosting state economies. Studies have found increased diagnosis and treatment for chronic conditions like diabetes, improved access to mental health services, and sharp reductions in medical debts.

The federal government covers more than 90 percent of the costs for newly eligible enrollees. That federal funding creates sustainable jobs, keeps rural hospitals and community clinics open, and has sharply cut uncompensated care costs in expansion states. Medicaid coverage is also cheaper and more efficient than private insurance.

National Health Law Program works with state partners to convince holdout states of the benefits of Medicaid expansion and to defend against threats that would reduce access to care in states that already expanded.