Medicaid Coverage

Overview of Medicaid

Medicaid is a health insurance program for low-income Americans funded jointly by states, territories, and the federal government, but administered by the states. More than 50 million people are currently enrolled in Medicaid, making it one of the largest health plans in the United States. Although the Federal government establishes certain parameters for all states to follow, each state administers their Medicaid program differently, resulting in variations in Medicaid coverage across the country.

Beginning in 2014, the Patient Protection and Affordable Care Act (ACA) provided states with the authority to expand Medicaid eligibility to include individuals, largely working adults without children with incomes up to 138 percent of the federal poverty level (FPL). States expanding coverage to this population are eligible for an enhanced federal medical assistance percentage (FMAP) in which the federal government pays 93 percent of the cost of Medicaid services in 2019 and 90 percent in 2020 and beyond, significantly higher than the FMAP for services offered to the “traditional,” non-expansion Medicaid population, including children, the disabled, elderly people, and pregnant women.

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