With implementation of the Affordable Care Act (ACA), 47 million uninsured Americans will have new options for obtaining health insurance. As of January 1st, 26 states have expanded Medicaid eligibility to include nearly all nonelderly adults with incomes at or below 138% of the Federal Poverty Level (FPL), while two states plan to implement Medicaid Expansion after 2014. The ACA also creates tax credits for people with income between 100% and 400% of the FPL, further increasing opportunities for access to affordable health insurance. Since access to coverage for many low-income and homeless people is dependent on whether or not a state is expanding Medicaid, it is important for providers of housing and services for low-income and homeless people to understand the effects of the ACA in their state.
The Kaiser Family Foundation recently released State Profiles: How Will the Uninsured Fare Under the Affordable Care Act?, a tool to assist people in understanding how the ACA will affect coverage options for the uninsured by state. The tool offers state profiles and graphics which describe the state’s Medicaid expansion status, the number of uninsured residents eligible for assistance, the main pathways for obtaining health insurance for uninsured residents, state income and eligibility levels for Medicaid and Marketplace Tax Credits, and the percent of residents that may be able to gain coverage. This tool can be used by providers of housing and services for low-income and homeless people to identify the primary ways of obtaining health insurance for clients.
HUD has also released a tool detailing how each state and territory is implementing health reform; these profiles are available on HUD's ACA Resource Library Page.
For more information, please visit HUD's OneCPD Affordable Care Act website.
*Because of possible new insurance options, and the increase in access to enrollment for many clients, it is essential that housing and services providers use the information available on websites such as http://www.enrollamerica.org to familiarize themselves with the Health Marketplace options in their state, and develop a plan to assist their constituents to obtain Medicaid or affordable health insurance coverage.
- Every state has a Health Insurance Marketplace that functions as a portal to health coverage.
- Some states have elected to operate their own Marketplace, others to be served by a Marketplace operated by the federal government, and still others to share some responsibilities in partnership with the federal Marketplace.
- The Marketplaces are intended to facilitate access to affordable healthcare coverage for people with incomes below 400% of the federal poverty level (FPL) in every state (even in those that have elected not to expand Medicaid coverage to people with incomes below 138% of the FPL).
- In addition, in all states people who are currently eligible for the legacy Medicaid program can be identified and referred for Medicaid enrollment by the Marketplace, without regard to the states’ decisions about Medicaid coverage expansion.
- The federal government is funding specialized outreach and enrollment assistance in every state.