NOTE: The federal poverty line (FPL) for a family of three in 2011 is $18,530 per year. Several states also offer coverage with a benefitpackage that is more limited than Medicaid to parents at higher income levels through waiver or state-funded coverage.SOURCE: Based on the results of a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and theGeorgetown University Center for Children and Families, 2012, with state updates.
Medicaid Eligibility for Working Parents by Income,July 2012
WYWIWVWAVAVTUTTXTNSDSCRIPAOROKOHNDNCNYNMNJNHNVNEMTMOMSMNMIMAMDMELAKYKSIAINILIDHIGAFLDCDECTCOCAARAZAKAL50% -99% FPL (16 states)< 50% FPL (17 states)100% FPL or Greater (18 states, including DC)
More Limited than Medicaid (17 states)Medicaid Comparable (9 states, including DC)
NOTE: Map identifies the broadest scope of coverage in the state. HI, MN, & VT also offer waiver coverage that is more limited than Medicaid.
OR and UT also offer “premium assistance” with open enrollment. The coverage in MO is limited to
adults residing in the St. Louis area.SOURCE: Based on the results of a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and the GeorgetownUniversity Center for Children and Families, 2012, with state updates.
Coverage ofLow-Income Adults by Scope of Coverage,July 2012
No Coverage (25 states)
“Closed” denotes enrollment closed to new applicants
Many poor adults remain ineligible for Medicaid.
The federal minimum level at which states must cover parents through Medicaid today isbelow poverty in every state and below half of poverty in nearly all states. A number of states haveexpanded parent eligibility above this minimum through optional Medicaid authority or waiverprograms (Table 3). However, waiver coverage often has more limited benefits and higher cost sharingthan Medicaid and can be subject to enrollment caps. As of July 2012, 33 states limit Medicaid eligibilityfor parents to less than 100% FPL ($18,530 for a family of three in 2011), with 17 states limiting eligibilityto less than half of poverty (Figure 3, Table 3).
Prior to the ACA, states could not cover non-disabled adults without dependent childrenthrough Medicaid unless they obtained a waiver. Effective April 2010, the ACA provided states a newoption to expand Medicaid to adults to get an early start on the 2014 expansion. Since April 2010, eightstates (CA, CT, CO, DC, MN, MO, NJ, and WA) have expanded coverage for adults through the new ACAoption or a waiver. Nearly all of these states previously provided solely state- or county-funded coverageto some low-income adults. By moving these adults to Medicaid and obtaining federal financing, thesestates were able to maintain and, in some cases, expand coverage. However, overall, Medicaid coveragefor low-income adults remains limited. As of July 2012, only nine states provide full Medicaid coverageto low-income adults, and enrollment is closed in two of these states (Figure 4, Table 3). Seventeenstates solely provide more limited coverage to adults, and enrollment is closed in five of these states.
States must maintain eligibility and enrollment policies that were in place in their Medicaid and waiver programs for parents and other adults at the time the ACA was enacted until exchanges arecertified in 2014.
There is an exception that allows states that cover adults above 133% FPL to reduceeligibility if they are facing a documented budget deficit. Hawaii, Illinois, and Wisconsin have imposedrestrictions under this exception. Nine states (CT, DC, ME, MN, NJ, NY, RI, VT, WI) provide Medicaidcoverage to parents with incomes above 133% FPL, and ten states (AR, CA, ID, IN, IA, MA, NM, OK, OR,UT) provide more limited coverage to parents above this income level. Only the District of Columbia andVermont provide Medicaid coverage to other adults with incomes above 133% FPL, and 12 states (AR,CA, IA ,IN, MA, MN, NM, OK, OR, UT, VT, WI) provide more limited coverage to adults above 133% FPL.In sum, Medicaid, along with CHIP, provide a strong base of health coverage for low-income childrenand pregnant women. However, eligibility for low-income parents and other adults remains very limited.As such, the ACA Medicaid expansion will be key for providing coverage to millions of currentlyuninsured adults.