Medicaid and CHIP Plans under the Affordable Care Act - dummies

Medicaid and CHIP Plans under the Affordable Care Act

By Lisa Yagoda, Nicole Duritz, Joan Friedman

Copyright © 2014 AARP. All rights reserved.

The Affordable Care Act (ACA) made it easier to qualify for Medicaid and the Children’s Health Insurance Program (CHIP). The income threshold is higher now, and the enrollment process is being streamlined.

  • Medicaid: The Medicaid program provides health insurance coverage for low-income individuals and families, as well as for some older people, pregnant women, and people with disabilities. Each state runs a Medicaid program, but those programs can differ from state to state in eligibility requirements and benefits.

  • CHIP: The Children’s Health Insurance Program is also offered in every state but differs among states. This program covers people who earn too much money to qualify for Medicaid but who have children and need low-cost access to healthcare coverage for them. (In some states, CHIP covers parents and pregnant women, as well.)

The ACA raised the income threshold for enrolling in Medicaid so that millions more people qualified for this program. However, the Supreme Court struck down the law’s provision making Medicaid’s expansion mandatory in all states. As a result, each state is making its own decision whether to participate in the expansion or stick with its previous income limits for enrollment.

For anyone uncertain about Medicaid or CHIP qualification, the Health Insurance Marketplace is streamlining the process of determining eligibility for these programs and getting enrolled. Some states’ Marketplace websites offer direct links to Medicaid enrollment, for example. In all cases, your state’s Marketplace can help you determine whether you qualify for Medicaid or CHIP.

If you’re uninsured and have low income, don’t risk incurring a tax penalty for not having any health insurance — although if your income is too low to pay taxes, you won’t incur a penalty. Visit your state’s healthcare Marketplace, or the AARP Health Law Answers site, as soon as possible to find out whether you qualify for Medicaid, CHIP, or financial assistance with purchasing a private plan.