![]() As noted, the ACA provides coverage for poor and low-income adults by expanding eligibility for Medicaid to 138 percent of the poverty line. Medicaid plays an even more important role in insuring low-income Americans due to the Affordable Care Act. (States have the option to extend eligibility to all lawfully present children and pregnant women without a five-year wait.) How Did the Affordable Care Act Change Medicaid? Also, lawful permanent residents (often referred to as green card holders) cannot enroll in Medicaid for the first five years, even if they meet all eligibility requirements. This group includes people with temporary protected status whom the federal government has allowed to live in the country for humanitarian reasons and people granted temporary permission to come to the United States for educational purposes, travel, or work in a variety of fields, among others. citizens are ineligible for Medicaid despite having a lawful immigration status. In addition, many people who are not U.S. And, in the typical non-expansion state, even parents are ineligible if their income exceeds just 42 percent of the poverty line ($9,122 for a family of three). In the 15 states that have not implemented the ACA Medicaid expansion (as of April 2020), adults over 21 are generally ineligible for Medicaid no matter how low their incomes are unless they are pregnant, caring for children, elderly, or have a disability. Not all people with low-incomes are eligible for Medicaid. The ACA was intended to extend coverage to all such adults, but a 2012 Supreme Court decision gave states the choice of whether to expand their programs. These include: people in the groups listed above whose income exceeds the limits for “mandatory” coverage seniors and people with disabilities not receiving SSI and with income below the poverty line “medically needy” people (those whose income exceeds the state’s regular Medicaid eligibility limit but who have high medical expenses, such as for nursing home care, that reduce their disposable income below the eligibility limit) and other people with higher income who need long-term services and supports and - thanks to the Affordable Care Act (ACA) - non-disabled adults with income below 138 percent of the poverty line, including those without children. ![]() States may also receive federal Medicaid funds to cover “optional” populations.
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