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    Health Care Reform:

    Health Insurance & Affordable Care Act

    Voter Guide: Medicaid

    The Issue:

    Medicaid, the government health care plan for people with low incomes or disabilities, provides insurance to just over 59 million people.

    The states and the federal government jointly fund Medicaid, with the federal government paying at least half of the cost in all 50 states. States must offer Medicaid to certain people (for example, low income children) but can offer enrollment to additional groups (such as low income adults without children). Similarly, states must offer certain Medicaid benefits, such as maternal and newborn care, but can choose to offer additional benefits, such as physical therapy. Even with federal funding, Medicaid costs make up a large percentage of states’ budgets, second only to primary and secondary education. On average, states spend 16% of their state-generated revenue on Medicaid. As a result, , many states have cut some of the optional Medicaid benefits, such as dental care for adults.

    The Affordable Care Act

    Expanding Medicaid Coverage

    Medicaid is an important part of the health reform law’s primary goal, which is to make health insurance available to millions of Americans who do not have it. The Affordable Care Act required states to expand Medicaid.

    Beginning in 2014, people with incomes as high as 138% of the federal poverty level -- $16,242 for individuals and $33,465 for a family of four in 2015 -- are eligible for coverage. These income requirements now include millions of people who previously made too much money to qualify for Medicaid, but often, too little to afford private insurance. It also includes adults without dependent children to enroll, a group previously not eligible for Medicaid coverage in most states.

    The law does not make insurance available to people who are in this country illegally.

    Paying for Medicaid Expansion

    Under health reform, the federal government pays for 100% of states’ costs to expand coverage between 2014 and 2016. After that, federal support scales back to 95% in 2017 and an additional 1% in the following years until it covers 90% of the cost by the year 2020. States pick up the remaining 10% cost at that point.

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