One of the key provisions of the Affordable Care Act is its “Medicaid expansion.” The Medicaid program offers federal funding to states in order to assist pregnant women, children, needy families, the blind, the elderly, and the disabled in obtaining medical care. The Act expands the scope of the Medicaid program and increases the number of individuals the states must cover. For example, the Act requires state programs to provide Medicaid coverage by 2014 to adults with incomes up to 138 percent of the federal poverty level, though many states now cover adults with children only if their income is considerably lower, and don’t cover childless adults at all. The Act increases federal funding to cover the states’ costs in expanding Medicaid coverage. If a state doesn’t comply with the Act’s new coverage requirements, it might lose not only the federal funding for those requirements, but all of its federal Medicaid funds.
In 2012, the United States Supreme Court ruled the Affordable Care Act couldn’t require states to implement the Medicaid expansion, which had made it optional. Thus far, 27 states have chosen to implement the Medicaid expansion. Americans who earn less than 138 percent of the poverty level (for 2014, approximately $15,856 for an individual and $32,499 for a family of four) will be eligible to enroll in Medicaid in states that have implemented the “Medicaid expansion.” States will receive 100 percent federal funding for the first three years to support this expanded coverage, phasing to 90 percent federal funding in subsequent years.