Q:

Who is eligible for Medicaid?

A:

Pregnant women, children, disabled persons and the elderly who meet low-income standards are eligible for Medicaid in every state. In 2014, eligibility expanded in some states to include everyone who earns up to 138 percent of the federal poverty level.

Medicaid health care programs are operated at the state level according to certain minimum standards set by the federal government. State programs must match the federal minimum eligibility standards, but may choose to expand coverage beyond the minimums in order to cover additional people. Thus, the effective minimum eligibility standards vary greatly by state.

For example, federal standards ensure that pregnant women in families earning 133 percent of the federal poverty level or less are eligible for Medicaid in every U.S. state. However, some states offer Medicaid coverage to pregnant women in families earning as much as 185 percent of the federal poverty level, a difference in eligibility requirements that amounts to household income of nearly $8,200 for a husband and wife expecting their first child.

The Patient Protection and Affordable Care Act, popularly known as "Obamacare," includes a program to expand Medicaid eligibility requirements to include all low-income individuals and families that earn 138 percent of the federal poverty level or less. However, the U.S. Supreme Court ruled this part of the law to be voluntary on the part of the states. As of April 2014, 26 states are participating in the expansion of Medicaid eligibility. The remaining 24 states are not moving forward. In those states, the former federal minimum eligibility standards still apply.


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