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Friday, April 30, 2010

The new and improved Medicaid

Many Americans believe that Medicaid is available to all citizens with low incomes. The assumption is that anyone who is "poor" can qualify for the program. Unfortunately, it's just not that simple.

You must have a low income to be eligible for Medicaid, but you also have to meet other requirements (like being a child, a pregnant woman, or a person with a disability). In most states, if you are an adult that does not have dependent children, you cannot qualify for Medicaid, no matter how low your income. Currently, in 42 states, adults without dependent children are not allowed to enroll in Medicaid, even if they are penniless.

Even for parents with dependent children, Medicaid eligibility varies between the states. For example, in Alabama, a parent cannot qualify for Medicaid if they make more than 24% of poverty (or $4,395 for a family of three in 2010), whereas in Wisconsin, parents that make up to 200% of poverty ($36,620 for a family of three in 2010) may be eligible. The national median for parental eligibility is only 64% of poverty (or $11,718 per year for a family of three in 2010). Current Medicaid eligibility standards leave out large groups of very low-income Americans who are unlikely to have another source of health coverage.

Health reform brings relief to millions of these low-income Americans by requiring states to expand Medicaid to include everyone with income up to 133% of poverty ($24,352 for a family of three in 2010) by 2014 (other than those age 65 and up, most of whom are eligible for Medicare). An estimated 16 million people will enroll in Medicaid over the next decade because of this expansion. This represents an enormous accomplishment, but also presents an enormous opportunity to streamline and simplify the Medicaid enrollment process to ensure that all low-income Americans get the assistance they need.