Understanding the Need for Medcaid expansion

When it was approved, the Affordable Care Act only covered individuals and families with an income equal to or above the Federal poverty line. The idea was that people below this level might have trouble paying the monthly premiums under the ACA. 

For those individuals the program proposed the expansion of Medicaid coverage by the states with the Federal government offering to pay up to 90% of the cost. 

In Kansas, Medicaid (known as KanCare) provides health coverage for approximately 377,000 poor, disabled and elderly residents. Non-disabled, childless adults are not eligible.  To qualify for Medicaid,  non-disabled parents must earn less than 33% of the federal poverty level, or about $6,700 for a single mother with two children.

So, individuals who earned more than 33% of the federal poverty level and less than 100% of the federal poverty level fell into what was call the Medicaid gap.  There were too rich to qualify for Medicaid and to poor to qualify for ACA. 

Originally, the drafters of ACA planned for the individuals in the coverage gap to be covered by the state’s expansion of Medicaid.  However, the Kansas Legislature voted not to expand Medicare, despite the Federal Governments agreement to cover 90% of the cost.

ACA proposed the expansion of Medicaid to include those whose income was up to 138% of poverty as a way to lessen the burden of insurance premiums on those with lower income.  During previous discussions on the expansion of Medicaid in Kansas, proposals included expanding Medicaid only to those whose income was 100% of poverty versus 138% and a work requirement for non-disabled Kansas to be covered under the expansion plan. 

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