Social Security Lowest and Highest Income to Qualify for Medicaid

Social Security Lowest and Highest Income to Qualify for Medicaid.The Affordable Care Act has raised the income thresholds for Medicaid eligibility, allowing more individuals to qualify for Medicaid support. To be eligible for Medicaid, recipients must have an income below this threshold. By increasing the threshold, a larger number of people became eligible for healthcare coverage.for more information about social security benefits check out .

Social Security Lowest and Highest Income to Qualify for Medicaid

However, there are currently 10 states that have chosen not to expand their Medicaid program, resulting in millions of individuals falling into the “coverage gap.”

These individuals earn too little to qualify for subsidized health plans through the Affordable Care Act insurance exchanges, but their income does not meet their state’s Medicaid requirements.According to a report by the Center on Budget and Policy Priorities, if these 10 states were to expand their eligibility criteria, nearly 2 million more people would be able to receive Medicaid coverage.

The states that have not expanded Medicaid include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. Additionally, North Carolina has yet to implement the Medicaid expansion, which is contingent upon the enactment of the state budget for 2023-2024.

Medicaid Eligibility and Income Thresholds in the United States

In 2020, Census Bureau data revealed that approximately 28 million people, accounting for around 8.6% of the US population, lacked health insurance at some point during the year. This issue has become particularly critical amid the COVID-19 pandemic.

Medicaid, a jointly-funded health insurance program by the federal and state governments, aims to provide healthcare access to individuals with limited income, including children, parents, pregnant women, the elderly, and the disabled.

Medicaid income thresholds vary across states, as each state can choose to offer healthcare services beyond the federally mandated requirements. The Affordable Care Act provided funding for states to expand coverage to all adults with income up to 133% of the Federal Poverty Level (FPL). Accounting for a 5% income disregard, the effective threshold is 138% of the FPL

Every state, including the District of Columbia and US territories, offers Medicaid coverage, but the extent of participation varies. States have the flexibility to set their own income thresholds, either higher or lower than the federal level, resulting in a lack of uniformity in Medicaid eligibility criteria.

The Federal Poverty Level

The Federal Poverty Level is determined based on family size for the lower 48 states and the District of Columbia. In 2023, the limits are $14,580 for a single adult, $30,000 for a family of four, and $50,560 for a family of eight. Under Medicaid expansion, these limits increase to $20,120, $41,400, and $69,772, respectively.

For larger households, an additional amount of $5,140 ($7,093 in Alaska and Hawaii) is added per person in families with nine or more members. The Federal Poverty Level is adjusted annually to account for inflation and takes effect on January 1st.

The District of Columbia has the highest income limits for eligibility, set at 221% for a family of three and 215% for other adults. On the other hand, Texas has the lowest threshold, requiring only 16% of the FPL for a family of three. Pregnant women and children often have higher income thresholds to qualify for Medicaid.

The income threshold percentage may vary based on the claimant’s employment status, but certain categories, such as the elderly, disabled individuals, pregnant women, and children, are typically exempted from such requirements.