The Pennsylvania Affordable Care Act Medicaid expansion (also referred to as the ACA Medicaid expansion and the Obamacare Medicaid expansion) was enacted in 2015, a year after most other states enacted the expansion. “What is the expansion of Medicaid, and how will it affect my eligibility?” is a question asked by many prospective Medicaid applicants. The Obamacare Medicaid expansion details essentially change the income limits for eligibility, as well as which applicants can receive coverage. Many applicants were not affected by the expansion of Medicaid in PA, especially those who were already approved within the program and receiving benefits. Petitioners who benefit from the Medicaid ACA expansion were the ones who were within the expanded income eligibility limits. The Affordable Care Act Medicaid eligibility rules allowed Pennsylvania residents the opportunity to receive affordable, quality health insurance through government funding. Prospective petitioners looking to apply for Medicaid for the first time should know how the Pennsylvania Medicaid expansion changed the rules. For more about the Obamacare Medicaid expansion, including details regarding the Affordable Care Act Medicaid application, continue reading the information provided below.

Learn About the ACA Medicaid Expansion in Pennsylvania

What is the Obamacare Medicaid expansion in Pennsylvania? In 2015, the Affordable Care Act Medicaid expansion in PA was enacted, which led to a surge in applicants and enrollees. Under the Affordable Care Act expansion of Medicaid, Pennsylvania was able to extend Medicaid eligibility to applicants who would not normally be approved under regular circumstances. While not all states within the U.S. accepted the ACA expansion of Medicaid, Pennsylvania was one of the 31 states that did, and this lead to an increase in applicants. For the states that decided not to participate in the expansion, their Medicaid eligibility requirements remained the same.

The ACA Medicaid eligibility rules shifted to allow the bracket of income requirements to widen, ultimately allowing more applicants the chance to enroll in the program. The states that opted in for the Obamacare Medicaid expansion were provided federal funding as a way to cover the new applicants. However, states would ultimately need to contribute some funding to cover the program. The ACA Medicaid expansion cost to states appeared too high in some cases, which is why not all states opted to expand. To learn more about the ACA Medicaid expansion, you can download our comprehensive guide today.

What does opting into the Affordable Care Act Medicaid expansion mean for Pennsylvania?

The ACA Medicaid expansion allowed for adults with income up to 138 percent of the federal poverty line to be eligible for enrollment, as long as they met the program’s other basic requirements. Before the expansion of Medicaid in Pennsylvania, applicants could only qualify if they met income requirements along with additional requirements, such as being elderly, having dependents or having a disability, for instance. This left a coverage gaps for low-income adults between the 19 and 64 years of age who did not have dependents.

In addition, the PA Affordable Care Act expansion for Medicaid also allowed children in households with incomes up to 319 percent of the federal poverty line to be eligible for either Medicaid or the Children’s Health Insurance Program (CHIP). Due to this accepted expansion for Medicaid benefits, Pennsylvania has increased the number of beneficiaries that it covers by over half a million. Also, there has been a 33 percent reduction in the uninsured residents of Pennsylvania from 2013 to 2015. If the state of Pennsylvania had not opted in for the expansion for ACA Medicaid benefits, then not only would those petitioners not be covered, but the state itself would have lost federal funding. The majority of the Pennsylvania residents who are most affected by the expansion are adults. The ACA expansion of Medicaid mostly helped adults who did not have children or a qualifying condition such as disability, who still sought out affordable health care options.

What happens if the ACA Medicaid expansion is repealed in Pennsylvania?

The Affordable Care Act Medicaid expansion in Pennsylvania has been recently debated, but it currently remains in place. Repealing the ACA Medicaid expansion still may be possible. If these new Affordable Care Act Medicaid eligibility rules were repealed, over half a million Pennsylvania residents would lose Medicaid coverage. For all established Medicaid applicants, staying up-to-date on the ACA Medicaid expansion repeal would be beneficial.