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The coverage gap: uninsured poor adults in states that do not expand Medicaid : an update
The coverage gap: uninsured poor adults in states that do not expand Medicaid : an update
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Garfield, Rachel, author
Damico, Anthony, author - Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
Kaiser Commission on Medicaid and the Uninsured, issuing body. - Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, January 2016
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Eligibility Determination -- statistics & numerical data
Health Care Reform -- statistics & numerical data
Insurance Coverage -- statistics & numerical data
Insurance, Health -- statistics & numerical data
Medicaid -- statistics & numerical data
Medically Uninsured -- statistics & numerical data
United States
United States. - Genre(s):
- Technical Report
- Abstract:
- One of the major coverage provisions of the Affordable Care Act (ACA) is the expansion of Medicaid eligibility to nearly all low-income individuals with incomes at or below 138 percent of poverty ($27,724 for a family of three in 2015). This expansion fills in historical gaps in Medicaid eligibility for adults and was envisioned as the vehicle for extending insurance coverage to low-income individuals, with premium tax credits for Marketplace coverage serving as the vehicle for covering people with moderate incomes. While the Medicaid expansion was intended to be national, the June 2012 Supreme Court ruling essentially made it optional for states. As of January 2016, 19 states were not expanding their programs. Medicaid eligibility for adults in states not expanding their programs is quite limited: the median income limit for parents in 2016 is just 44% of poverty, or an annual income of $8,840 a year for a family of three, and in nearly all states not expanding, childless adults remain ineligible. Further, because the ACA envisioned low-income people receiving coverage through Medicaid, it does not provide financial assistance to people below poverty for other coverage options. As a result, in states that do not expand Medicaid, many adults fall into a "coverage gap" of having incomes above Medicaid eligibility limits but below the lower limit for Marketplace premium tax credits (Figure 1). This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap, describes who they are, and discusses the implications of them being left out of ACA coverage expansions. An overview of the methodology underlying the analysis can be found in the Methods box at the end of the report, and more detail is available in the Technical Appendices available here.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (9 pages, 1 unnumbered page))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101678011 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101678011