As Health Law Moves Forward, More With Low-Incomes Gaining Medicaid Coverage
days, several prominent Republican governors have indicated that they will
expand their state Medicaid programs to cover people who have incomes up to 138
percent of the federal poverty level, a major victory for low-income people
with disabilities. In addition, the Department of Health and Human Services has
just released regulations governing the essential health benefits that all
individual and small group health insurance plans must offer as part of the new
health care law.
Congress passed the Affordable Care Act, also known as Obamacare or the
universal health care law, in 2010, the law required all states to expand their
Medicaid programs to cover people who have incomes up to 138 percent of the
federal poverty level, which in 2013 would mean an income of $15,856.20 for an
individual. This Medicaid expansion would allow low-income Americans, including
working people with disabilities, to receive affordable, comprehensive health
insurance from Medicaid instead of having to purchase health insurance via the
private marketplace or through a state or federal health insurance exchange.
(The exchanges are still being set up.)
of business groups, private citizens and state attorneys general challenged the
Affordable Care Act in court, alleging that it exceeded the scope of Congress's
powers. Last year, the U.S. Supreme Court upheld the majority of the law, but
it struck down the provision requiring states to expand their Medicaid
programs. As a result, states can either leave their Medicaid programs as they
are or expand the programs as originally required by the Affordable Care Act.
In states that choose to expand, the federal government will pay for the full
cost of Medicaid benefits for newly eligible beneficiaries through 2016, at
which point the federal government's share of the cost will drop incrementally.
states have already indicated that they will expand their Medicaid programs and
14 states have refused to offer expanded coverage. (To see an interactive map
of which states are going to participate in the expansion, click here). Recently, Governor Rick Scott of Florida, a fierce
opponent of the Affordable Care Act, accepted Medicaid expansion, and he was
followed by another Republican governor, Chris Christie, in New Jersey.
to the Medicaid expansion, the U.S. Department of Health and Human Services has
recently released rules governing the essential health benefits that every
health insurance plan in the individual and small group market must offer. The
essential benefits include mental health care and prescription drugs, along
with rehabilitative services and devices. The new regulations, which are
described here and can be read in full here,
ensure that people with disabilities will receive the coverage that they need
from private health insurers without being subject to price discrimination.