Description:

Our themes for this session are access and cost. OK. I'm going to talk about coverage options for health insurance for non-pregnant adults. Non-pregnant because pregnant women have different options and more options. Adults because children have different options. Under the ACA, the group most impacted, non-pregnant adults, so we're sticking to them.

Original ACA plan was that people would get Medicaid if they were between 0 and 133% of the federal poverty level. To give that some context, for an individual, if you're income was between 0 and about $14,000, you could get Medicaid. Then, if your income was from $14,000 to about $45,000, which is 400% of FPL, in that case, you would go on the exchange and you could get assistance.

Assistance could mean a few things. And assistance could be a tax subsidy. An assistance could be a tax credit. And it really depended on your income and how much the insurance would cost in that geographic area.

If you were above 400% of the FPL-- so that would be about above $45,000 for an individual-- you could go on the exchanges, but you would not be getting any help. But it still be a place you could shop and compare. Everything changed in summer 2012 because the Supreme Court ruled that requiring every state to expand Medicaid was coercive. Because of that, states can pick. I am expanding Medicaid. I am not expanding Medicaid.

If they chose not to, people who were poor did not have the same options in both types of states. So in expanding states, you can see that from 0 to 400% of the poverty line, there are coverage options which involve assistance. This is not what we are going to see in the non-expanding states for the very poor.

Here is a link to the media file cryan_medicaid_w02_p01.mp4