In the context of American public healthcare policy, Medicaid coverage gap refers to uninsured people who reside in states which have opted out of

Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...

expansion under the

Affordable Care Act The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presid ...

(ACA), who are both ineligible for Medicaid under its previous rules that still apply in these states and too poor to qualify for the ACA's subsidies and credits designed to allow middle-class Americans to purchase health insurance. The number of Americans in this gap has been estimated to be almost 3 million as of January 2016, according to the

Kaiser Family Foundation KFF (Kaiser Family Foundation), also known as The Henry J. Kaiser Family Foundation, is an American non-profit organization, headquartered in San Francisco, California. It prefers KFF since its legal name can cause confusion as it is no longer a ...

. The Foundation has also said that 90% of the people in this gap live in the South. In states that have not expanded Medicaid, eligibility requirements for Medicaid are limited to parents making 44% or less of the poverty line, and in almost all such states, all adults without children are ineligible. The coverage gap results from this and a number of factors, such as the fact that the ACA was designed so that the poor would receive coverage through Medicaid and so did not include an alternative program for them. For example, as of April 2014, someone living in

Texas Texas (, ; Spanish language, Spanish: ''Texas'', ''Tejas'') is a state in the South Central United States, South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2 ...

, a non-expansion state, had to be making less than $3,737 per year to be eligible for Medicaid, and had to make at least $11,490 (if a single person) or $23,550 (for a family of four) to be eligible for ACA subsidies. States such as

Idaho Idaho ( ) is a state in the Pacific Northwest region of the Western United States. To the north, it shares a small portion of the Canada–United States border with the province of British Columbia. It borders the states of Montana and Wyom ...

, Utah,

Maine Maine () is a state in the New England and Northeastern regions of the United States. It borders New Hampshire to the west, the Gulf of Maine to the southeast, and the Canadian provinces of New Brunswick and Quebec to the northeast and north ...

Oklahoma Oklahoma (; Choctaw language, Choctaw: ; chr, ᎣᎧᎳᎰᎹ, ''Okalahoma'' ) is a U.S. state, state in the South Central United States, South Central region of the United States, bordered by Texas on the south and west, Kansas on the nor ...

, and

Missouri Missouri is a U.S. state, state in the Midwestern United States, Midwestern region of the United States. Ranking List of U.S. states and territories by area, 21st in land area, it is bordered by eight states (tied for the most with Tennessee ...

addressed the Medicaid gap through

ballot measures A referendum (plural: referendums or less commonly referenda) is a Direct democracy, direct vote by the Constituency, electorate on a proposal, law, or political issue. This is in contrast to an issue being voted on by a Representative democr ...

, a form of

direct democracy Direct democracy or pure democracy is a form of democracy in which the Election#Electorate, electorate decides on policy initiatives without legislator, elected representatives as proxies. This differs from the majority of currently establishe ...

References

Affordable Care Act Medicare and Medicaid (United States) {{US-fed-statute-stub

See also

References