When a state that initially refused to implement the ACA Medicaid expansion embraces it, that's great news for state residents who were in the so-called "coverage gap" -- earning too little to qualify for subsidized private plans in the ACA marketplace, but denied the Medicaid coverage which the ACA had originally mandated for them, before the Supreme Court rendered the expansion optional for the states.
For another income group, those with household incomes between 100% and 138% of the Federal Poverty Level (FPL), the expansion may be a blessing for some but not all. People in this income range are eligible for subsidized private plans in states that have refused the Medicaid expansion -- but for Medicaid only in states that implement it.
As of the end of the ACA's last "open season" enrollment period in February 2015, 22 states had not yet adopted the law's Medicaid expansion, and one state, Indiana, had just adopted it, effective February 1. In those states, about one third of enrollees in private health plans purchased in the ACA marketplace had incomes in the 100-138% FPL range and so would have been eligible for Medicaid if their states had embraced the expansion. They constitute perhaps 15-20% of all enrollees in the ACA private plan plan marketplace.
For another income group, those with household incomes between 100% and 138% of the Federal Poverty Level (FPL), the expansion may be a blessing for some but not all. People in this income range are eligible for subsidized private plans in states that have refused the Medicaid expansion -- but for Medicaid only in states that implement it.
As of the end of the ACA's last "open season" enrollment period in February 2015, 22 states had not yet adopted the law's Medicaid expansion, and one state, Indiana, had just adopted it, effective February 1. In those states, about one third of enrollees in private health plans purchased in the ACA marketplace had incomes in the 100-138% FPL range and so would have been eligible for Medicaid if their states had embraced the expansion. They constitute perhaps 15-20% of all enrollees in the ACA private plan plan marketplace.
