Medicaid

What is 'Medicaid'

Medicaid is a health care program that assists low-income families or individuals in paying for long-term medical and custodial care costs. Medicaid is a joint program, funded primarily by the federal government and run at the state level, where coverage may vary.

Medicaid is available only to individuals and families that meet specified criteria. Recipients must be legal permanent residents or citizens of the United States and may include adults with low income, their dependents and people with specified disabilities.

BREAKING DOWN 'Medicaid'

The Health Insurance Association of America (HIAA) indicates that Medicaid is a government-sponsored insurance program for individuals of any age whose resources and income are insufficient to cover health care. In the United States, Medicaid is the largest source of funding for health-related services for low-income persons. Funded jointly by state and federal governments, but mainly by the latter, Medicaid is managed at the state level.

Every state has significant leeway in determining who is eligible for the program. Each state also has the right to not participate in the Medicaid program. It is possible to determine eligibility for Medicaid in one of two ways. One way is to fill out an online application through the Health Insurance Marketplace website. An alternative way to apply is directly through the state’s Medicaid agency, with contact information available through from Healthcare.gov.

Once a person is deemed eligible for Medicaid, he may receive health care and related services for free from any medical provider that accepts the program.

The Patient Protection and Affordable Care Act (PPACA)

Most often referred to as the Affordable Care Act (ACA) and colloquially deemed “Obamacare,” this statute was signed into law by President Barack Obama in 2010. The law states that all legal residents and citizens of the United States with incomes up to 133% of the poverty line qualify for coverage in Medicaid-participating states. While the law has worked to expand both federal funding and eligibility for Medicaid, the U.S. Supreme Court ruled that states are not required to participate in the expansion in order to continue receiving already established levels of Medicaid funding.

As of January 2016, the District of Columbia and 31 states have expanded Medicaid. They are: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia.

Alabama and South Dakota are considering expansion. The remaining 17 states, as of 2016, have chosen not to participate in the Medicaid expansion.

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