A key feature of the Affordable Care Act (ACA) is the expansion of Medicaid to millions of low-income Americans, many of whom are uninsured. Medicaid Expansion has been one of the most controversial parts of the new health care law, and some states are still deciding whether to take part in the expansion, including Virginia. Below are some FAQs about Medicaid expansion that explain the situation in Virginia and in the rest of the country.
Effective January 1, 2014, the Patient Protection and Affordable Care Act (ACA) expands Medicaid to nearly all disabled individuals between the ages of 19-65 (children, pregnant women, parents, and adults without dependent children). However, the reach of the program will depend on both federal and state actions to implement the new law.The ACA will also expand options for community-based care. There will be more opportunities for people of all ages who have a disability to get help with daily activities while remaining in their homes. The Medicaid program continues to move toward providing more community-based care options as an alternative to nursing homes.
Eligibility requirements for the elderly and persons with disabilities do not change under reform although some individuals with disabilities may become newly eligible under the adult expansion. Lawfully residing immigrants will be eligible for the Medicaid expansion, although many will continue to be subject to a five-year waiting period before they may enroll in coverage.
Between 2014 and 2016, the costs of the expansion will be picked up by the federal government in full. After that, the fed’s contribution gradually decreases until it reaches 90% in 2022; it will remain at 90% thereafter and states will pick up the other 10%.
Though a countrywide expansion would provide coverage for some 17 million Americans who otherwise do not qualify for Medicaid, some states, including Virginia, say that paying for even 10 percent of the expansion may be too much for their tight budgets (Virginia is still undecided – see map below).
If Virginia expands Medicaid, an additional 327,000 adults who will be newly eligible for the program will enroll. Even if Virginia does not expand, enrollment is expected to increase by 80,000 as parents and children who are already eligible for Medicaid enroll in health coverage because other aspects of the ACA including the requirement for people to have coverage or pay a penalty, outreach to enroll people into exchange subsidies, and improved coordination.
Virginia will spend $1.3 billion more on Medicaid to cover additional enrollment of currently eligible children and parents through 2022 with or without the expansion. The expansion would increase state spending by $1.3 billion. Altogether, this additional spending is just 5.2 percent more than what Virginia would have spent on Medicaid in the absence of the ACA.
Originally, the ACA called for States that refuse to participate in this expansion to lose federal funding for their current Medicaid programs. However, the Supreme Court ruled the federal government could not withdraw existing Medicaid funding to punish states for not expanding their programs, thus giving states the choice to opt out of the expansion. More than a few states have expressed intentions of doing so.
At The Fairfax and Fredericksburg Elder Law Firms of Evan H. Farr, P.C., with proper planning, families can obtain Medicaid assistance without having to deplete their life savings. Find out more about Medicaid Asset Protection. Call 703-691-1888 to make an appointment for a consultation.
About Evan H Farr, CELA, CAP
